Untrained emergency room providers should not perform SA exams and collect evidence on children. Providers are required to make sure the abuse/assault is reported to the hotline and/or law enforcement and to facilitate transfer/referral to the appropriate facility for the exam
Providers/nurses can contact Arkansas Children's Hospital for advice via calling operation center (can provide real-time consultation if needed): 888-764-KIDS (5437)
Providers should not provide opinions on a child’s hymen/vagina unless trained in child sexual abuse
Best practice would have the child seen in a local CAC, if available, to be forensically interviewed prior to having an exam performed by a trained pediatric sexual abuse professional
Ensure the patient is medically stable prior to transfer or referral
In most cases, adolescents should be treated similarly to pediatric patients for sexual assault exams
It is important to have someone trained in sexual assault exams perform the exam
Can contact ACH for advice via calling the operation center (can do real-time consultation if needed): 888-764-KIDS
Best practice would have the child seen in a local CAC, if available, to be forensically interviewed prior to having an exam performed by a trained pediatric/adolescent sexual abuse professional
16+ years old
If sexual assault included vaginal penetration - patient must have had previous consensual vaginal penetrative sex.
If a patient does not meet these criteria they do not meet the inclusion criteria for TeleSANE and will be best served by having a medical-forensic exam performed by a SANE-P or under the direction of a physician at Arkansas Children’s.
Tanner stage 4+
Females must be postmenarchal
Be 30kg or more
Able to swallow pills
Able to obtain prescription medications - no concerns for the ability to pay for medications and/or the ability to get to the pharmacy to pick medications up.
NOTE: Careful consideration is given when cases where the abuse is a one-time acute sexual assault (or sexual contact) perpetrated by a family/household member, regardless of minor’s age. This type of assault may be better served in a Child Advocacy Center (CAC). Disclosure of sexual violence is a process dependent on many variables in the individual's life. There have been cases where it is initially reported by the adolescent that they were assaulted once, however, during a forensic interview it is found that it was a case where the abuse happened multiple times and/or chronically. Discuss this type of case thoroughly with the CACD investigator to determine the absolute best care for the patient.
Untrained emergency room providers are not required to perform SA exams and collect evidence on minors, they are required to make sure the abuse/assault is reported to the hotline and/or law enforcement and to facilitate transfer/referral to the appropriate facility for the exam