Sexual Abuse Clinical Pathway — Emergency Department | Children's Hospital of Philadelphia

Clinical Pathways Home Emergency ICU Inpatient Outpatient Specialty Care Primary Care

Provider Resources

Related Pathway

Sexually Transmitted Infections (STI) in Adolescents, ED, Primary Care

All Children/Adolescents < 18 yrs Presenting
with Concern for Sexual Assault/Abuse

Transfer Guidance

PHL ED
- Age ≥ 18 yrs
  - PEM completes MSE
  - Transfer to HUP ED
- Interfacility Transfer: CHOP PHL ED to Outside ED
- KOPH ED
  - PEM completes MSE
  - Transfer to Abington,
    Bryn Mawr, or Paoli ED

ED Triage

Expedite to ED Room as able
Epic Chat ED SW

Team Assessment/Huddle

Upon ED room arrival
SW, SART RN, ED HP/Attending
Review Criteria for SART Activation
Team alert via PHL SART or KOPH SART

Non-acute Sexual Assault Cases
ED Team Evaluation

SART activation not required
Complete history and physical
STI testing, treatment as indicated
SW Evaluation, Reporting

History

Multidisciplinary team interview
Event history, acute symptoms
Screen for Sex Trafficking
Mental health assessment

Team Preparation

Obtaining Consent to Collect Forensic Evidence from Patients Who May Be Victims of Sexual Assault Job Aid
PA Forensic Examination Consent Form
Forensic Evidence Videos
SART cart
PSR label preparation
Evidence collection kit
Chain of custody

Child/Adolescent/Family Preparation
Child Life, analgesia, anxiolysis

General Physical, Genital Exam

Trauma Consult

Injuries associated with sexual assault

Laboratory Testing

STIs
- Indications for STI Testing
- Recommended/Additional Tests
- Laboratory Testing
  - HCG, screening labs for HIV-PEP
  - Toxicology Testing, Drugscan
- Additional imaging, labs as indicated

Treatment

STI Prophylaxis
Syphilis, Vaccinations
HIV Risk Assessment, HIV-PEP
Emergency Contraception
SW mental health assessment
Psychiatry Consult as indicated

Documentation

SW Assessment, Reporting

Discharge Planning

Medical Follow-up
- Care Clinic vs. PCP
SW, Psychological Support Follow-up

Posted: May 2008
Last Revised: November 2024

Authors:

Editors: Clinical Pathways Team

Evidence

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

Emergency Department Clinical Pathway for Evaluation/Treatmentof Children with Sexual Abuse Concerns

Evidence

CHOP Program

Educational Media

Related Links

Emergency Department Clinical Pathway for Evaluation/Treatment
of Children with Sexual Abuse Concerns