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 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 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

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? 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 Adolescents over 13 ears having consenting SI All children having swabs taken All rape victims if not reported/ no suspect

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 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 karen.rogstad@tesco.net Samples of local Sheffield forms available

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