Code of Maine Rules › 16 - DEPARTMENT OF PUBLIC SAFETY › 219 - OFFICE OF THE COMMISSIONER › Chapter 71 - UNIFORM STANDARDIZED FORENSIC EXAMINATION KIT FOR SEXUAL ASSAULT EVIDENCE COLLECTION › PRE-PUBERTAL 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, the
				  Office of Child and Family Services should be notified at
1
-
800-452-1999 (Voice) 711 (TTY).
The State of
				  Maine's child abuse hotline is staffed 24 hours a day.
If the assault or last sexual contact occurred within 72
				  hours prior to the hospital visit, or if the time frame cannot be determined,
				  physical evidence from adolescents (13 years or older) can be collected
				  utilizing the uniform standardized forensic examination kit, according to the
				  instructions given for adults. However, physical evidence from pre-pubertal
				  children should be collected using the following instructions:
* 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 / forensic
				  examination of the child and history from the caregiver and / or child.
				  However, it is important that a child not be asked questions by multiple
				  providers / people. A Sexual Assault Forensic Examiner is the most appropriate
				  provider to care for the child, in consultation with the ED physician and the
				  Spurwink Child Abuse Program medical staff.
* 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 pre-pubertal 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 presents with these symptoms, head trauma should be
				  considered.
PLEASE NOTE:
[TICK]
Unless otherwise noted,
do not
				  moisten
swabs prior to sample collection. If moistening is
				  required, use only sterile / distilled water.
[TICK]
All swabs should be air dried prior to
				  packaging, with the exception of the Known DNA Collection swab, which may be
				  packaged immediately using the plastic aerated cap provided.
[TICK]
Unless otherwise noted, place the evidence
				  collection specimens back into the envelope or bag from which they
				  came.
[TICK]
All envelopes and bags containing evidence
				  should be sealed. Attach a tracking label to the outside of each envelope or
				  bag and fill out all information requested.
CLOTHING
				  COLLECTION:
[TICK]
Clothing may be removed and collected at any
				  point during the examination process. When the patient is ready to disrobe, use
				  the paper sheet from the Foreign Material Collection bag to collect any foreign
				  material by placing the sheet on the floor over a clean facility bed sheet and
				  instructing the patient to stand on it while removing each item of clothing.
[TICK]
Collect each clothing item as it is removed and
				  place it in the appropriate clothing bag. Do not shake out the clothing or cut
				  through any existing holes, rips, or stains in the clothing. Air dry any wet or
				  damp clothing if secure facilities are available; otherwise, notify law
				  enforcement personnel that the clothing is wet or damp.
[TICK]
Refold the Foreign Material Collection sheet in
				  such a manner as to retain any material present and place it in the Foreign
				  Material Collection bag.
[TICK]
If the patient changed his or her clothing after
				  the assault, notify law enforcement personnel so the clothing worn at the time
				  of the assault may be collected.
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 the two
				  swabs simultaneously. Be sure to collect the swabs from the upper and lower
				  buccal areas and the gum line, rotating the swabs during collection.
Place the swabs in the swab box and check "Oral".
Step 2. KNOWN DNA COLLECTION
NOTE: Have the patient rinse his / her mouth with
				  water prior to completing this step.
Open the swab protector and slide the protector back to
				  expose the swab head.
Using the swab, vigorously swab the inside of both cheeks
				  for 5 to 10 seconds.
Pull the swab head back into the protector and re-close the
				  protector around the swab head.
Step 3. FINGERNAIL CLIPPINGS / SWABS
NOTE: Do not collect fingernail clippings from young
				  children unless the examination is performed under anesthesia. The fingernails
				  may be swabbed instead.
Remove the folded paper from the envelope and place,
				  unfolded, on a flat surface.
Hold the patient's hands over the paper and gently clip the
				  entire nail, allowing the clippings to fall on the paper.
Refold the paper so as to retain the fingernail
				  clippings.
For young children, use one of the swabs to swab under the
				  fingernails of the right hand and the other swab to swab under the fingernails
				  of the left hand. Allow the swabs to air dry, then place the swabs in the swab
				  box and check "Fingernails".
Step 4. KNOWN HEAD HAIR SAMPLE
NOTE: It is recommended that head hair standards not
				  be taken from pre-pubertal children at the time of the initial
				  examination.
Step 5. DEBRIS COLLECTION
NOTE: This step is provided for the collection of
				  debris such as foreign hairs, fibers, etc. from the patient's body. Do not
				  package debris from different areas of the patient's body in the same envelope;
				  if necessary, use a separate clean facility envelope and make a druggist
				  fold.
Remove the folded paper from the envelope and place,
				  unfolded, on a flat surface.
Collect any debris present on the patient (including the
				  thighs and external genitalia) 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 6. DRIED SECRETIONS / MISCELLANEOUS
				  SWABS
NOTE: This step is provided for the collection of
				  suspected blood, semen, or saliva which may be present on the patient's body.
				  Carefully examine areas of kissing, sucking, or biting for saliva, and other
				  body areas for ejaculate or other dried secretions. An alternate light source
				  is helpful for locating secretions. Do not package swabs from different areas
				  of the patient's body in the same swab box; use separate swab boxes or clean
				  envelopes from facility stock. Additional swabs are provided in this step for
				  the collection of evidence not covered elsewhere in this kit (e.g. nasal swabs,
				  strangulation swabs)
.
Lightly moisten two of the provided swabs with sterile /
				  distilled water and thoroughly swab the dried secretion with both swabs.
Allow swabs to air dry, then place the swabs in one of the
				  swab boxes provided.
Mark on the swab box if the swabs are suspected semen,
				  saliva, blood, or other. If other, please describe.
Identify the location from which the samples were removed on
				  the anatomical drawings on the envelope.
If additional swabs are necessary, lightly moisten the other
				  swabs with a minimal amount of sterile / distilled water and thoroughly swab
				  the area making sure to rotate the swabs during the collection procedure. Place
				  the swabs in the other swab box and check "Other". Identify the sample on the
				  line provided and write the area of the patient's body from which the sample
				  was obtained.
Step 7. PUBIC COMBING
NOTE: Instead of collecting pubic hair combings from
				  pre-pubertal 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 5 of these instructions.
Step 8. KNOWN PUBIC HAIR SAMPLE
NOTE: It is recommended that pubic hair standards (if
				  present) not be taken from pre-pubertal children at the time of the initial
				  examination.
Step 9. GENITAL / PENILE SWABS
Lightly moisten the swabs provided with 1-2 drops of sterile
				  / distilled water.
Holding the swabs together, gently swab the external
				  genitalia from the mons to the perineum, including along the folds between the
				  labia majora and the labia minora in the female patient. Be sure to rotate the
				  swabs during the collection procedure. With the male patient, swab the entire
				  penis and scrotum. Retract the foreskin if uncircumcised.
Allow the swabs to air dry, then place the swabs in the swab
				  box and check "Genital / Penile".
Step 10. ANAL SWABS
If necessary, lightly moisten the swabs with a minimal
				  amount of sterile / distilled water for the comfort of the patient.
Carefully swab the anus using the two swabs simultaneously.
Allow the swabs to air dry, then place the swabs in the swab
				  box and check "Anal".
Step 11. VAGINAL SWABS
NOTE: NEVER use a speculum of any size on a
				  pre-pubertal child.
For pre-pubertal females, some young adolescent females, and
				  for the female patient who is too traumatized or anxious to have a vaginal
				  examination, evidence specimens can be obtained by gently swabbing the
				  perineum, inner thighs, and external genitalia (including the sulcus, fossa
				  navicularis, and posterior fourchette) using two swabs slightly moistened with
				  sterile / distilled water.
Unless there is evidence of penetrating trauma in the
				  pre-pubertal 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 while the child is anesthetized. Attempts to collect vaginal swabs on
				  the pre-pubertal female can result in hymenal and / or vaginal trauma that may
				  mimic abuse.
Carefully swab the vaginal vault using the two swabs
				  simultaneously.
Allow the swabs to air dry, then place the swabs in the swab
				  box and check "Vaginal / Cervical."
Step 12. MISCELLANEOUS EVIDENCE
NOTE: This step is provided for the collection of
				  miscellaneous evidence not covered elsewhere in this kit. Do not package
				  multiple miscellaneous items together in the same bag. Use a separate facility
				  paper bag or one of the clothing bags if available.
Collect the item and allow it to air dry if necessary. When
				  dry, place in the paper bag.
Steps 13 and 14. URINE and BLOOD
				  SPECIMENS
NOTE: Generally these specimens 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
.