Limitations of emergency room evaluations of sexually abused children

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 greater than P less than .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.