Acute Sexual Assault and Evidence Collection in the DNA Era

Approximately 70000 reports of sexual abuse in children and adolescents are substantiated each year. Many of these cases present to the emergency department for assessment. Knowledge of which cases require emergent evaluation is essential. This article will provide a description of the steps in the assessment of acute sexual assault in children and adolescents including components of the patient interview, proper interpretation of physical examination findings, indications for sexually transmitted infection screening, and prophylaxis as well as forensic evidence collection, assessment of a drugfacilitatedsexual assault, andwhena report to child protective services and law enforcement is appropriate. A case of acute sexual assault will be used to illustrate pertinent points.