Medical Services FAQs

• What services do Pediatric SANEs provide to children and families?

  Pediatric SANEs provide a variety of health and medical services to children and families and are available to talk or meet with families.
  

  Children and their caregivers often have many questions and concerns about the impact of sexual abuse on their current health and future well-being. Children and families have concerns about possible injuries and the risk of sexually transmitted infections.

   Services are tailored to meet the individual needs of the child/family and may include:

  • Phone or in-person consultation with the child or their caregiver about medical concerns related to abuse;
  • A head-to-toe physical exam focused on documenting injuries or symptoms of infections related to abuse;
  • A non-invasive MedScope exam of the child’s external genitals to assess for injuries related to abuse. NO internal/speculum exam is done (unless child is a physically mature adolescent and history indicated the need for such exam);
  • Forensic evidence collection using the Massachusetts Pediatric Sexual Assault Evidence Collection Kit (MA PEDI Kit) for children under 12 years of age when sexual abuse occurs within a 72-hour period and a child is not currently in an emergency department;
  • Testing for Sexually Transmitted Infections (STIs) such as gonorrhea, Chlamydia, HIV;
  • Follow-up examinations to document healing of injuries or resolution of medical concerns;
  • Medical case management related to abuse/assault.

• Can I be with my child during the medical exam?

  YES. You are able to be with your child during the medical exam. The Pedi-SANE will meet with the caregiver first to go over the child's medical history. Teens may prefer to meet with the Pedi-SANE without a parent present.

• What happens during a Pediatric SANE examination?

  The exam is very much like exams that all children receive from their primary care provider. The Pedi-SANE exam proceeds from head-to-toe, carefully looking for signs of injuries on the child’s body. Extra attention is given to examine the child’s genitalia in a manner that is not painful or invasive.  A MedScope (video-documentation system) is used to externally light and magnify the child’s genitalia, and allows for digital images of the exam to be obtained and stored. If sexual abuse occurred within a 72-hour period, forensic evidence collection using the MA PEDI Kit may also be completed. 
  

• Are children sedated for Pediatric SANE exams?

  No, children are never sedated because these examinations are non-invasive. An exam done by a Pedi-SANE is not painful or traumatic. In the rare occasion that the child is not able to complete an exam, the exam is usually rescheduled for a later time. Most children find the examination a reassuring and positive experience.
  

• If a child is unable to complete an exam, is another examination always rescheduled?

  If a child is unable to complete the exam, the importance of repeating the exam would be based on the child’s clinical presentation and the level of concern for injury based on the allegations. There are times when it is determined that it is probably not in the best interest of the child to attempt another exam. Those decisions are made in conjunction with the child’s caregiver.

• What is the Massachusetts Pediatric Sexual Assault Evidence Collection Kit (MA PEDI Kit)?

  The MA PEDI Kit is a forensic evidence collection kit that was specially designed for emergency department clinicians to use for children under 12 years of age. This child-friendly kit was developed according to the Do No Harm principle. The MA PEDI Kit is indicated for use when the last sexual contact occurred within a 72 hour period and contains a series of envelopes and cotton-tipped swabs that are used to gently swab the external portions of the child’s body for forensic evidence such as saliva, semen, skin cells, and other foreign material. All evidence collection steps are non-invasive and should not cause discomfort.  Documentation forms contained within the MA PEDI Kit guide emergency clinicians through the process of collecting information from the child’s caregiver in order to avoid interviewing the child. It is critical to collect forensic evidence in a timely way because it can disappear quickly in young children.
  

• What is the cost of Pediatric SANE services?

  There is no cost to a child or family for Pediatric SANE services, as funds for these services are provided by the state. In cases in which testing for Sexually Transmitted Infections (STIs) is indicated, the child’s medical insurance is billed for laboratory testing. In cases in which the child has no insurance, the Pediatric SANE will work with the laboratory to make provisions for free care.