National guidelines on chain of evidence
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National guidelines on chain of evidence. Dr K E Rogstad Royal Hallamshire Hospital Sheffield. Why are they needed. National guidelines produced on managing suspected STIs in children Recommended chain of evidence for medico-legal specimens but there were no national ones for NHS

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National guidelines on chain of evidence

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National guidelines on chain of evidence

National guidelines on chain of evidence

Dr K E Rogstad

Royal Hallamshire Hospital

Sheffield


Why are they needed

Why are they needed

  • National guidelines produced on managing suspected STIs in children

  • Recommended chain of evidence for medico-legal specimens but there were no national ones for NHS

  • Advice from RCPath/rcp joint committee on Infection

    • Just because chain of evidence difficult to do doesn’t mean it shouldn’t be done


Development

development

  • Rcpath formed small group to put together guidelines

  • Out for consultation Feb

  • Comments now being integrated into final version

  • Final version due soon

  • Will go on rcpath website


National guidelines on chain of evidence

AIM

  • To produce a national document which could be used whenever a chain of evidence was needed in NHS (not police forensic swabs) which would be used by clinicians and laboratory staff to save every unit developing their own


When should they be used

When should they be used?

  • suspected STIs in children where abuse possible/suspected

  • Rape victims STI screen where reported to police and assailant arrested or likely to be


When not to be used

When not to be used

  • Adolescents over 13 ears having consenting SI

  • All children having swabs taken

  • All rape victims if not reported/ no suspect


Problems and solutions

Problems and solutions

  • Piloted in Sheffield

  • Forms needed ammending for local circumstances clinic and lab

    • Too many chain of evidence samples initiatednow senior doc needs to agree should be done


Additional points

Additional points

  • If STI found but chain not done, then repeat tests with a chain prior to treatment

  • Implementation needs close collaboration between labs and clinicians

  • Tamper proof bags may be used if wished

  • Guidelines are not for forensic swabs taken by police surgeons

  • Further info from [email protected]

  • Samples of local Sheffield forms available


References

References

National guidelines for management of suspected sexually transmitted infections in children and young people

Thomas A, Forster G, Robinson A, Rogstad K Sex Transm Infect 2002; 78:324-331 www.bashh.org


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