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September 1978, Vol 132, No. 9 >
Article | September 1978

Limitations of Emergency Room Evaluations of Sexually Abused Children FREE

Donald P. Orr, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, California College of Medicine, University of California, Irvine, Irvine, CA 92717 (Dr Orr).


Am J Dis Child. 1978;132(9):873-875. doi:10.1001/archpedi.1978.02120340049009.
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• A retrospective review was performed on charts of all children who were treated in 1975 in the Strong Memorial Hospital (Rochester, NY) emergency room for alleged sexual abuse, suspicious conditions, or complaints related to the genitourinary system, and on a randomly selected comparison sample of children treated for acute otitis media during the same period. In 44 cases of otitis media, pediatric house officers' charting uniformly evidenced adequate care. However, in ten cases of alleged sexual abuse and 29 cases considered suspicious, the evaluations and care were significantly (.01 > P <.001) less adequate. The young pediatric house officer deals with these problems, which are complicated by emotional overtones and psychosocial implications, less effectively than those with more clear-cut, routine diagnoses.

(Am J Dis Child 132:873-875, 1978)

REFERENCES

1 +
Sgroi S:  Sexual molestation of children . Child Today 4:18-21, 1975;.
2 +
DeFrancis V: Protecting the Child Victim of Sex Crimes Committed by Adults . Denver, American Humane Association, Children's Division, 1969;.
3 +
Jaffee AC, Dynneson L, ten Bensel RW:  Sexual abuse of children—an epidemiologic study . Am J Dis Child 129:689-692, 1975;.
4 +
Tormes YM: Child Victims of Incest. Denver , American Humane Association, Children's Division, 1969;.
5 +
Gil DG:  California pilot study , in Helfer RE, Kempe CH (eds): The Battered Child . Chicago, University of Chicago Press, 1974;, pp 216-225.
6 +
Brant RS, Tisza V:  The sexually misused child . Am J Orthopsychiatry 47:80-90, 1977;.
7 +
Browning D, Boatman B:  Incest: Children at risk . Am J Psychiatry 134:69-72, 1977;.
8 +
Folland D, Burke R, Hinman A, et al:  Gonorrhea in preadolescent children: An inquiry into source of infection and mode of transmission . Pediatrics 60:153-156, 1977;.
9 +
Lipton GL, Roth EI:  Rape: Management problems in the pediatric emergency room . J Pediatr 75:859-866, 1969;.
10 +
Stoenner H:  Child sexual abuse growing in the United States , in Plain Talk About Child Abuse . Denver, Denver Humane Society, 1972;, pp 11-13.
11 +
Russo RM, Guraraj VJ, Laude TA, et al:  A chart audit peer review system in an ambulatory service . Pediatrics 56:246-254, 1975;.
12 +
Jacobs CM: Procedure for Retrospective Patient Care Audit in Hospital . Chicago, TAP Institute, Joint Commission on Accreditation of Hospitals, 1973;, pp 7-26.
13 +
Robinson HA:  Review of child molestation and rape . Am J Obstet Gynecol 110:405-406, 1977;.
14 +
Zuckerman AE, Starfield B, Hochreiter C, et al:  Validating the content of pediatric outpatient medical records by means of tape-recording doctor-patient encounters . Pediatrics 56:407-411, 1975;.
15 +
Chamberlin R:  Social data in evaluation of the pediatric patient: Deficits in outpatient records . J Pediatr 78:111-116, 1971;.
16 +
Fessel W, Van Brunt E:  Assessing quality of care from the medical record . N Engl J Med 286:134-138, 1972;.
17 +
Lyons T, Payne B:  The relationship of physicians' medical recording performance to their care performance . Med Care 12:463-469, 1974;.
18 +
Lustig N, Dresser TW, Spellman SW, et al:  Incest: A family group survival pattern . Arch Gen Psychiatry 14:31-40, 1966;.
19 +
Weiner IB:  Father-daughter incest: A clinical report . Psychiatr Q 36:601-632, 1962;.
20 +
Kaufman I, Peck AC, Tagiusi CK:  The family constellation and overt incestuous relations between father and daughter . Am J Orthopsychiatry 24:266-279, 1954;.
21 +
Weiner ER, Korsch BM:  The vulnerability of the medical student: Posthumous presentation of L. L. Stephens' ideas . Pediatrics 57:321-328, 1976;.
22 +
Duff RS, Rowe DS, Anderson FP:  Patient care and student learning in a pediatric clinic . Pediatrics 50:839-846, 1972;.

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References

1 +
Sgroi S:  Sexual molestation of children . Child Today 4:18-21, 1975;.
2 +
DeFrancis V: Protecting the Child Victim of Sex Crimes Committed by Adults . Denver, American Humane Association, Children's Division, 1969;.
3 +
Jaffee AC, Dynneson L, ten Bensel RW:  Sexual abuse of children—an epidemiologic study . Am J Dis Child 129:689-692, 1975;.
4 +
Tormes YM: Child Victims of Incest. Denver , American Humane Association, Children's Division, 1969;.
5 +
Gil DG:  California pilot study , in Helfer RE, Kempe CH (eds): The Battered Child . Chicago, University of Chicago Press, 1974;, pp 216-225.
6 +
Brant RS, Tisza V:  The sexually misused child . Am J Orthopsychiatry 47:80-90, 1977;.
7 +
Browning D, Boatman B:  Incest: Children at risk . Am J Psychiatry 134:69-72, 1977;.
8 +
Folland D, Burke R, Hinman A, et al:  Gonorrhea in preadolescent children: An inquiry into source of infection and mode of transmission . Pediatrics 60:153-156, 1977;.
9 +
Lipton GL, Roth EI:  Rape: Management problems in the pediatric emergency room . J Pediatr 75:859-866, 1969;.
10 +
Stoenner H:  Child sexual abuse growing in the United States , in Plain Talk About Child Abuse . Denver, Denver Humane Society, 1972;, pp 11-13.
11 +
Russo RM, Guraraj VJ, Laude TA, et al:  A chart audit peer review system in an ambulatory service . Pediatrics 56:246-254, 1975;.
12 +
Jacobs CM: Procedure for Retrospective Patient Care Audit in Hospital . Chicago, TAP Institute, Joint Commission on Accreditation of Hospitals, 1973;, pp 7-26.
13 +
Robinson HA:  Review of child molestation and rape . Am J Obstet Gynecol 110:405-406, 1977;.
14 +
Zuckerman AE, Starfield B, Hochreiter C, et al:  Validating the content of pediatric outpatient medical records by means of tape-recording doctor-patient encounters . Pediatrics 56:407-411, 1975;.
15 +
Chamberlin R:  Social data in evaluation of the pediatric patient: Deficits in outpatient records . J Pediatr 78:111-116, 1971;.
16 +
Fessel W, Van Brunt E:  Assessing quality of care from the medical record . N Engl J Med 286:134-138, 1972;.
17 +
Lyons T, Payne B:  The relationship of physicians' medical recording performance to their care performance . Med Care 12:463-469, 1974;.
18 +
Lustig N, Dresser TW, Spellman SW, et al:  Incest: A family group survival pattern . Arch Gen Psychiatry 14:31-40, 1966;.
19 +
Weiner IB:  Father-daughter incest: A clinical report . Psychiatr Q 36:601-632, 1962;.
20 +
Kaufman I, Peck AC, Tagiusi CK:  The family constellation and overt incestuous relations between father and daughter . Am J Orthopsychiatry 24:266-279, 1954;.
21 +
Weiner ER, Korsch BM:  The vulnerability of the medical student: Posthumous presentation of L. L. Stephens' ideas . Pediatrics 57:321-328, 1976;.
22 +
Duff RS, Rowe DS, Anderson FP:  Patient care and student learning in a pediatric clinic . Pediatrics 50:839-846, 1972;.

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