Code of Maine Rules › 16 - DEPARTMENT OF PUBLIC SAFETY › 222 - BUREAU OF STATE POLICE › Chapter 20 - UNIFORM STANDARDIZED FORENSIC EXAMINATION KIT FOR GROSS SEXUAL ASSAULT EVIDENCE COLLECTION › Appendix 222-20-C - PREPUBERTAL CHILDREN INSTRUCTIONS

Current through 2024-29, July 17, 2024
If questions arise during the collection of evidence from
				  prepubertal children, please contact the Spurwink Child Abuse Program at
				  1-800-260-6160.
When a forensic examination is performed, it is vital that
				  the medical examination and evidence collection procedures be integrated at all
				  times in order to minimize trauma to the child.
If the alleged perpetrator is a pre-pubertal child, DHS
				  should be notified.
If the assault or last sexual contact occurred within the 72
				  hours prior to the hospital visit or if the time frame cannot be determined,
				  physical evidence from adolescents (15 years or older) can be collected
				  utilizing the uniform standardized forensic examination kit, according to the
				  instructions given for adults. However, physical evidence from prepubertal
				  children should be collected using the following instructions:
NOTE: If it is determined that the last sexual contact took
				  place more than 72 hours prior to the hospital visit, it is extremely unlikely
				  that trace evidence will still be present on the child's body. This is most
				  common in situations involving long-term abuse. Therefore, a careful evaluation
				  of each case must be made to decide which, if any, evidence collection
				  procedures should be implemented.
Regardless of when the last sexual contact might have
				  occurred, valuable evidence can still be obtained through a medical examination
				  and interview of the child. However, it is important that a child not be
				  interviewed multiple times. The interview should be deferred to the most
				  experienced interviewer. Emergency room personnel, including SAFE examiners,
				  may not be the most appropriate persons to interview the child. Please consult
				  with a forensic specialist to determine what evaluation is appropriate before
				  examining and / or interviewing any child.
Do not force any steps of the examination and / or evidence
				  collection process.
The collection of specimens for drug testing is not generally
				  necessary for prepubertal children unless they provide a history consistent
				  with drug ingestion, including drowsiness, altered consciousness, memory loss,
				  impaired motor skills, or other symptoms consistent with drug ingestion. If the
				  child is two years of age or younger and presents with these symptoms, head
				  trauma should be considered.
PLEASE NOTE:
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Unless otherwise noted, do not moisten swabs
				  prior to sample collection.
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All swabs should be air dried prior to
				  packaging.
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Unless otherwise noted, place the evidence
				  collection specimens back into the envelope or bag from which they
				  came.
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All envelopes and bags should be sealed. Attach
				  a tracking label to the outside of the envelope or and fill out all information
				  requested.
Step 1. ORAL SWABS
NOTE: Oral swabs should only be collected if the case
				  history indicates oral contact. Oral swabs may be difficult to obtain from very
				  young children.
Carefully swab the buccal area and gum line using two swabs
				  simultaneously, but collecting all four swabs. Be sure to collect the swabs
				  from the upper and lower buccal areas and gum line, rotating the swabs during
				  collection.
Place the swabs in the swab box. Mark the swab box
				  "Oral".
Step 2. NASAL SWAB
NOTE: Do not collect nasal swab from
				  children.
Step 3. FINGERNAIL CLIPPINGS/SWABBINGS LEFT
				  HAND
NOTE: Do not collect fingernail clippings from young
				  children unless the examination is performed under anesthesia.
Remove folded paper from envelope and place, unfolded, on a
				  flat surface.
Hold patient's left hand over the paper and gently clip the
				  entire nail, allowing the clippings to fall on the paper.
For swabbings, dampen a sterile swab from Step 17 and swab
				  under the nails.
Place the dried swab in the folded paper.
Step 4. FINGERNAIL CLIPPINGS/SWABBINGS RIGHT
				  HAND
NOTE: Do not collect fingernail clippings from young
				  children unless the examination is performed under anesthesia.
Remove folded paper from envelope and place, unfolded, on a
				  flat surface.
Hold patient's right hand over the paper and gently clip the
				  entire nail, allowing the clippings to fall on the paper.
For swabbings, dampen a sterile swab from Step 17 and swab
				  under the nails.
Place the dried swab in the folded paper.
Step 5. KNOWN DNA COLLECTION
Have the patient rinse his / her mouth with water prior to
				  this evidence collection step.
Remove components from kit envelope.
Open the swab protector and slide the protector back to
				  expose the swab head.
Using the swab, vigorously swab the inside of both sides of
				  the patient's cheek for 5 to 10 seconds
Pull the swab head back into the protector and re-close the
				  protector around the swab head.
Step 6. KNOWN HEAD HAIR SAMPLE
NOTE: It is recommended that the head hair standards
				  not be taken from prepubertal children at the time of the initial
				  examination.
Step 7. FOREIGN MATERIAL COLLECTION
NOTE: If patient changed clothing after the assault,
				  inform officer in charge so the police may collect the clothing worn at the
				  time of the assault. Do not cut through any existing holes, rips or stains in
				  patient's clothing. Do not shake out patient's clothing. If secure facilities
				  are available, air dry any wet or damp clothing. Otherwise, notify law
				  enforcement personnel that clothing is wet or damp. If additional clothing bags
				  are required, use only new paper (grocery type) bags.
UNFOLD AND PLACE A CLEAN HOSPITAL BED SHEET ON FLOOR.
Remove paper sheet from "Foreign Material Collection" bag,
				  unfold and place over bed sheet.
Instruct patient to stand in the center of paper sheet and
				  carefully remove each item of clothing.
Collect each item as removed and place each in a separate
				  clothing bag, as labeled.
Refold paper sheet on which patient stood in such a manner
				  as to retain any debris present, then return it to the "Foreign Material
				  Collection" bag.
Step 8. DEBRIS COLLECTION
NOTE: Do not package debris from different areas in
				  the same envelope. Use Step 16 for additional packaging material or use
				  facility materials and make a druggist fold.
Remove the folded sheet of paper from the "Debris
				  Collection" envelope.
Unfold the paper and place on a flat surface.
Collect any debris present on the patient (dirt, hair,
				  leaves, fibers, etc.) and place in the center of the paper.
Fold the paper so as to retain the debris.
Identify the location from which the samples were removed on
				  the anatomical drawings on the envelope.
Step 9. DRIED SECRETIONS
Using two moistened swabs, wipe the genital perineal
				  area.
Using two moistened swabs, wipe the sulcus area
Mark on each swab box the location the swabs were taken
				  from.
Place each set of swabs in the appropriate box.
Step 10. PUBIC COMBING
NOTE: Instead of collecting pubic hair combings from
				  perpubertal children, carefully examine the thighs and external genitalia for
				  any loose hairs or fibers. If any are found, collect according to the
				  instructions given in Step 8 of these instructions.
Step 11. KNOWN PUBIC HAIR SAMPLE
NOTE: It is recommended that the pubic hair standards
				  (if present) not be taken from prepubertal children at the time of the initial
				  examination.
Step 12. GENITAL/PENILE SWABBINGS
Moisten swabs provided with a minimal amount of distilled
				  water.
Holding the swabs together, briskly swab the external
				  genitalia making sure to rotate the swabs during the collection
				  procedure.
Place the swabs in the box and mark "Genital /
				  Penile".
Step 13. ANAL SWABS
NOTE: All four swabs should be used for the collection
				  of anal specimens; however, the swabs should be used one at a time. Swabs may
				  be moistened with a minimal amount of distilled water for the comfort of the
				  patient.
Carefully swab the anus using one swab at a time.
Place the swabs in the swab box and check "Anal".
Step 14. VAGINAL SWABS
NOTE: For prepubertal females, young adolescent
				  females, and for the adolescent who is too traumatized or anxious to have a
				  pelvic examination, evidence specimens can be obtained by gently swabbing the
				  thigh and genitalia area (including the sulcus, fossa navicularis, posterior
				  fourchette for girls and the testicles, scrotum, and perineum for boys) using
				  four swabs slightly moistened with distilled or sterile water (refer to Step 12
				  of these instructions). Unless there is evidence of penetrating trauma in the
				  prepubertal female, it is not necessary to collect vaginal swabs. (If there has
				  been penetrating trauma, vaginal swabs can be obtained during the repair of the
				  trauma). Attempts to collect vaginal swabs on the prepubertal female can result
				  in hymenal trauma that may mimic abuse.
If the swabs are collected under anesthesia, all four
				  swabs can be obtained simultaneously. If it is determined that the simultaneous
				  use of four swabs for the collection of the vaginal specimens may cause
				  unnecessary discomfort or additional trauma to the patient, the swabs should be
				  used one at a time.
Collect four vaginal swabs from the vaginal vault. The swabs
				  should be collected one at a time unless the collection is being done under
				  anesthesia.
Place the swabs in the swab box and mark "Vaginal."
Step 15. CERVICAL SWABS
NOTE: Do not collect cervical swabs from prepubertal
				  children.
Step 16. MISCELLANEOUS EVIDENCE
				  COLLECTION
NOTE: This step is provided for the collection of
				  evidence not previously covered.
Collect item of evidence and allow to air-dry if
				  necessary.
Place in paper bag labeled "Miscellaneous."
Step 17. ADDITIONAL SWABS
NOTE: This step is provided for the collection of
				  evidence not previously covered elsewhere.
If necessary, moisten the swabs provided with a minimal
				  amount of distilled water. Holding the swabs provided, thoroughly swab the area
				  making sure to rotate the swabs during the collection procedure. Check "Other"
				  on the outside of the swab box and identify the sample on the line provided.
				  Place the swabs in the swab box and write the area of the patient's body from
				  which the sample was obtained. Place the swab box in the "Additional Swabs"
				  envelope.
Step 18 and 19. URINE SPECIMEN and BLOOD
				  ALCOHOL/TOXICOLOGY SPECIMEN
NOTE: Generally this specimen will not need to be
				  collected, however, if the patient presents with drowsiness, memory loss,
				  impaired motor skills, etc. or there is a suspicion of a drug used to
				  facilitate rape, follow the instructions provided in the adult
				  instructions
.