title: Enhancing the emergency department approach to pediatric sexual assault care: implementation of a pediatric sexual assault response team program.
abstract: OBJECTIVE
  The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients.
  
  
  METHODS
  This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression.
  
  
  RESULTS
  One hundred eighty-four patients met criteria for SART evaluation, of whom 87.5% were female; mean age was 10.1 (SD, 4.6) years. The majority of patients underwent forensic evidence collection (89.1%), which varied by menarchal status among girls (P < 0.01), but not by sex. Evidence of acute anogenital injury on physical examination was found in 20.6% of patients. As per the Centers for Disease Control and Prevention guidelines for acute sexual assault evaluations in pediatric patients, menarchal girls were more likely to undergo testing for sexually transmitted infections and pregnancy (P < 0.01) and to be offered pregnancy, sexually transmitted infection, and HIV prophylaxis (P < 0.01).
  
  
  CONCLUSIONS
  In an effort to improve quality and consistency of acute sexual assault examinations in a pediatric ED, development of a SART program supported the majority of eligible patients undergoing forensic evidence collection. Furthermore, a substantial number of patients had evidence of injury on examination. These findings underscore the importance of having properly trained personnel to support ED care for pediatric victims of acute sexual assault.
authors: From the *Children's National Medical Center, Washington, DC; †The George Washington University, ‡The Children's Hospital of Philadelphia, and §University of Pennsylvania School of Medicine, Philadelphia, PA.
authors: Monika K
authors: MK
authors: Goyal
authors: Cynthia J
authors: CJ
authors: Mollen
authors: Katie L
authors: KL
authors: Hayes
authors: Jennifer
authors: J
authors: Molnar
authors: Cindy W
authors: CW
authors: Christian
authors: Philip V
authors: PV
authors: Scribano
authors: Jane
authors: J
authors: Lavelle
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000293:injuries; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000628:therapy; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D005554:Forensic Medicine / Q000379:methods; D005835:Genitalia / Q000293:injuries; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D007223:Infant; D008297:Male; D019221:Mandatory Reporting; D010348:Patient Care Team / Q000458:organization & administration*; D015143:Philadelphia / Q000453:epidemiology; D011247:Pregnancy; D011258:Pregnancy Tests / Q000706:statistics & numerical data; D058996:Quality Improvement; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D013048:Specimen Handling; D014947:Wounds and Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
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