Child Sexual Abuse

Any sexual activity under 13yr classifed as assault, according to RCPCH.

Police (family protection unit) refer for forensic medical viz joint police surgeon and paediatrician. Video colposcopy and swabs. Consent incl data protection important. Bloods only if high risk.  Rapid HBV immunisation.

Social work can consent if guardian is perpetrator.

Difficult to exclude internal injuries since speculum/rectal exams not acceptable for pre-pubescents: relies on details of history.

ULIPRISTAL (ellaOne) new post intercourse contraception, window of 5 days. IU device not suitable for poorly oestrogenised.

Support services: advice leaflets, SW follow up, GUM clinic at 1/52, CAMHS.

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