Acute sexual abuse in children and adolescents

a methodological contribution to improve the quality of care

Abstract

Background: The complexity of consultations for child and adolescent sexual abuse (CSA), added to the high service pressure in Emergency Department (ED), makes legal proceedings to be prioritized over medical action, and security incidents may appear. Our objective was to evaluate the impact of a checklist for the management of acute CSA in ED, assessing the number and type of

security incidents.

Methods: A single-centre, descriptive-observational study was conducted between 2018 in ED. Clinical, epidemiological and follow-up data were collected in those patients younger than 18 that were reported as acute CSA suspicions. Incidents about clinical history, procedures and medication were analyzed. The sample were divided in two groups in relation the use of checklist (Group1: January-May and Group 2: June-December).

Results: Thirty-two patients were included: 13 Group 1, 19 Group 2. In 25 (78.1%) incidents were detected from the clinical history, in 20 (56.3%) from procedures and in 5 (15.5%) from medication. One-hundred by one-hundred clinical history incidents and 100% procedural incidents were observed in Group 1 vs 63.2% and 36.8% in Group 2 (p=0.025 y p=0.007) and 30.8% of medication incidents in Group 1 vs 5.3% in Group 2 (p=0.051).

Conclusions: The implementation of the checklist has led to an improvement in the medical care of patients with acute CSA with a decrease in security incident.