a. Situation Management. Management of this situation requires a great deal of tact.

The parents are usually upset with everybody, including health care personnel. The child will also be upset and frightened. If the offender is outside the family, the child may have tried to tell the parents of the abuse. If the offender is inside the family, the child may have tried to tell a family member. In either case, the parents (or other family members) will be very anxious, and you need to reassure parents (or other family members) as well as the child.

b. Role of the Medical NCO. Follow these procedures.

(1) Be calm and understanding. Reassure the parents (or other family members) and the child.

(2) Develop a complete report. Follow local standing operating procedure (SOP) and local advocacy policy. Have the child describe the attacker as completely as possible if the person is not a family member or a friend. You may have the child describe the nature of the attack. Use dolls and drawings as methods of gathering this information from the child. Objective evidence must be gathered such as samples from the vagina, pubic hair, etc. The examining physician will collect these samples from the patient. Be sure any other evidence at the scene is protected.

(3) Conduct a primary assessment. Examine the child to determine whether there are injuries which must be treated immediately.

(4) Do a rapid secondary assessment. Perform a more thorough examination of the child to find what other injuries the child has sustained.

(5) Treat only those injuries which require immediate attention before transporting the patient to a medical treatment facility.