CONTACT US: Contact info
|
Citation |
Bechtel K, Ryan E, Gallagher D. Pediatr. Emerg. Care 2008; 24(7): 442-447. |
|
Affiliation |
Department of Pediatrics, Yale University School of Medicine, and Section of Pediatric Emergency Medicine, Yale-New Haven Children's Hospital, New Haven, CT. |
|
Copyright |
(Copyright © 2008, Lippincott Williams and Wilkins) |
|
DOI |
|
PMID |
18580706 |
|
Abstract |
BACKGROUND:: Nearly 44% of sexual assault victims in the United States are younger than 18 years. These victims often present to emergency departments for care after the assault. To date, the effectiveness of sexual assault nurse examiners (SANEs) on the evaluation and management of pediatric and adolescent sexual assault victims in a pediatric emergency department (PED) has not been evaluated. OBJECTIVE:: To evaluate whether the use of SANEs in a PED improves the medical care of pediatric and adolescent sexual assault victims. DESIGN/METHODS:: Medical records of patients who presented to an urban PED with a history of sexual assault and required forensic evaluation (rape kit) from December 2004 to December 2006 were reviewed in a retrospective, blinded fashion for the following documentation: (1) the genitourinary (GU) examination and if a GU injury was present; (2) evaluation for sexually transmitted infections (STIs) (Neisseria gonorrhoeae and Chlamydia trachomatis), and serologies for hepatitis B and C, HIV, and VDRL; (3) prescription of prophylaxis for STIs, HIV, and pregnancy; (4) evaluation by a PED social worker; and (5) referral to sexual assault crisis services. Patients were grouped as to whether a SANE had been involved in their care. The assignment of a patient to a SANE was random, as SANEs in the PED of this institution do not take call from home and are present in the PED as part of their routine nursing shift. To examine the differences between groups, chi analysis or Fisher exact test was used. RESULTS:: Of the 114 patients whose medical records were reviewed, 60 had been evaluated by a SANE (SANE), and 54 patients had not (SANE); 98% of patients were girls. There were no differences between the 2 patient groups with respect to time of day when they presented to the PED, time after assault to presentation to the PED, sex, age, or race. All medical records had the history of the sexual assault documented in the medical record. Patients evaluated by a SANE were more likely to have the GU examination documented (71% vs 41%; P < 0.001) and to have GU injury documented (21% vs 0%; P = 0.024). Eligible patients were more likely to have testing for N. gonorrhoeae and C. trachomatis (98% vs 76%; P
Language: en |