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Care of Prepubescent Pediatric Sexual Abuse Patients in the Emergency Care Setting
Sexual abuse of prepubescent children is quite distinct from that of adult patients. The initial report may be of a single encounter of sexual assault, but abused children commonly experience this mistreatment over multiple weeks, months, or years because of offenders’ ready access to them. Dependence on caregivers and the child’s developmental age and cognitive ability create an opportunity for offenders to manipulate and silence children, especially if the offenders are family members or other trusted adults. Sexual abuse is often hidden by offenders, unwitnessed by others, and many times leaves no obvious physical signs of its occurrence. Children that experience sexual abuse often suffer from a wide range of health problems throughout their lifespan, with acute concerns that include sexually transmitted diseases, physical injuries, and psychological trauma. Child sexual abuse patients are at greater risk for a number of adverse psychological and somatic problems that may extend into adulthood. Pediatric sexual abuse patients are not “little adults” and should not be treated under the same policies or guidelines used in the adult emergency care setting. The Joint Commission requires emergency care facilities to have policies and procedures for identifying, assessing, and maintaining legal responsibility for collection, retention, and safekeeping of evidentiary material relating to patient victims of childhood sexual assault, sexual molestation, abuse, and neglect. Healthcare providers within the emergency care setting have become part of a multidisciplinary team that, along with criminal justice and child protective services, recognizes child sexual abuse as a public health issue with long-term physical and psychosocial effects on children, families, and communities at large. In this trauma-informed approach, pediatric sexual abuse patients can benefit from specialized care by trained pediatric sexual assault nurses examiners (SANE). These recommendations are comparable to those for adult and adolescent sexual assault patients being evaluated and treated by specially trained adult/adolescent SANEs.
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Last Updated: 5/24/2017 9:39:07 AM
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