C.M.R. 16, 219, ch. 71, ADULT INSTRUCTIONS
PLEASE NOTE:
[TICK] Unless otherwise noted, do not moisten swabs prior to sample collection. If moistening is required, use only sterile / distilled water.
[TICK] All swabs should be air dried prior to packaging, with the exception of the Known DNA Collection swab, which may be packaged immediately using the plastic aerated cap provided.
[TICK] Unless otherwise noted, place the evidence collection specimens back into the envelope or bag from which they came.
[TICK] All envelopes and bags containing evidence should be sealed. Attach a tracking label to the outside of each envelope or bag and fill out all information requested.
CLOTHING COLLECTION:
[TICK] Clothing may be removed and collected at any point during the examination process. When the patient is ready to disrobe, use the paper sheet from the Foreign Material Collection bag to collect any foreign material by placing the sheet on the floor over a clean facility bed sheet and instructing the patient to stand on it while removing each item of clothing.
[TICK] Collect each clothing item as it is removed and place it in the appropriate clothing bag. Do not shake out the clothing or cut through any existing holes, rips, or stains in the clothing. Air dry any wet or damp clothing if secure facilities are available; otherwise, notify law enforcement personnel that the clothing is wet or damp.
[TICK] Refold the Foreign Material Collection sheet in such a manner as to retain any material present and place it in the Foreign Material Collection bag.
[TICK] If the patient changed his or her clothing after the assault, notify law enforcement personnel so the clothing worn at the time of the assault may be collected.
Step 1. ORAL SWABS
Carefully swab the buccal area and gum line using the two swabs simultaneously. Be sure to collect the swabs from the upper and lower buccal areas and the gum line, rotating the swabs during collection.
Allow the swabs to air dry, then place the swabs in the swab box and check "Oral".
Step 2. KNOWN DNA COLLECTION
NOTE: Have the patient rinse his / her mouth with water prior to completing this step.
Remove the components from the envelope. Open the swab protector and slide the protector back to expose the swab head.
Using the swab, vigorously swab the inside of both of the patient's cheeks for 5 to 10 seconds.
Pull the swab head back into the protector and re-close the protector around the swab head.
Step 3. FINGERNAIL CLIPPINGS / SWABS
Remove the folded paper from the envelope and place, unfolded, on a flat surface.
Hold the patient's hands over the paper and gently clip the entire nail, allowing the clippings to fall on the paper.
Refold the paper so as to retain the fingernail clippings.
If the patient declines clippings, use one of the swabs to swab under the fingernails of the right hand and the other swab to swab under the fingernails of the left hand. Allow the swabs to air dry, then place the swabs in the swab box and check "Fingernails".
Step 4. KNOWN HEAD HAIR SAMPLE
Remove the folded paper from the envelope and place, unfolded, on a flat surface.
Run a gloved hand through the patient's hair, gently removing 10-12 hairs (total) from various scalp locations (front, top, sides, and back of head). The patient may be more comfortable performing this step himself or herself. If the required number of hairs is not collected, have the patient pull the additional required hairs. Alternatively, the hairs may be cut close to the scalp.
Place the hairs in the center of the paper and refold so as to retain the hairs.
Step 5. DEBRIS COLLECTION
NOTE: This step is provided for the collection of debris such as foreign hairs, fibers, etc. from the patient's body. Do not package debris from different areas of the patient's body in the same envelope; if necessary, use a separate clean facility envelope and make a druggist fold.
Remove the folded paper from the envelope and place, unfolded, on a flat surface.
Collect any debris present on the patient and place in the center of the paper. Fold the paper so as to retain the debris.
Identify the location from which the samples were removed on the anatomical drawings on the envelope.
Step 6. DRIED SECRETIONS / MISCELLANEOUS SWABS
NOTE: This step is provided for the collection of suspected blood, semen, or saliva which may be present on the patient's body. Carefully examine areas of kissing, sucking, or biting for saliva, and other body areas for ejaculate or other dried secretions. An alternate light source is helpful for locating secretions. Do not package swabs from different areas of the patient's body in the same swab box; if necessary, use separate swab boxes or clean envelopes from facility stock. Additional swabs are provided in this step for the collection of evidence not covered elsewhere in this kit (e.g. nasal swabs, strangulation swabs).
Lightly moisten two of the provided swabs with sterile / distilled water and thoroughly swab the dried secretion with both swabs.
Allow the swabs to air dry, then place the swabs in one of the swab boxes provided.
Mark on the swab box if the swabs are suspected semen, saliva, blood, or other. If other, please describe.
Identify the location from which the samples were removed on the anatomical drawings on the envelope.
If additional swabs are necessary, lightly moisten the other swabs with a minimal amount of sterile / distilled water and thoroughly swab the area making sure to rotate the swabs during the collection procedure. Allow the swabs to air dry, then place the swabs in the other swab box and check "Other". Identify the sample on the line provided and write the area of the patient's body from which the sample was obtained.
Step 7. PUBIC COMBING
Remove the folded paper and comb. Unfold the paper and place it under the patient's buttocks.
Comb the pubic hair in downward strokes to allow any debris or loose hairs to fall onto the paper.
Remove the paper from under the patient, place the comb in the center of the paper, and refold so as to retain the comb and any evidence collected.
If the patient has a shaved pubic area, DO NOT pluck the hair. Observe the area carefully for any pubic hairs. If found, place in the folded paper and document on the envelope that a foreign pubic hair was found on the patient's shaved pubic area.
Step 8. KNOWN PUBIC HAIR SAMPLE
NOTE: Skip this step if the patient shaves his or her pubic area.
Remove the folded paper from the envelope and place, unfolded, on a flat surface.
Remove 3-5 hairs (total) from various regions of the pubic area by cutting the hairs close to the skin. The patient may be more comfortable performing this step himself or herself.
Place the hairs in the center of the paper and refold so as to retain the hairs.
Step 9. GENITAL / PENILE SWABS
Lightly moisten the swabs provided with 1-2 drops of sterile / distilled water.
Holding the swabs together, briskly swab the external genitalia from the mons to the perineum, including along the folds between the labia majora and the labia minora in the female patient. Be sure to rotate the swabs during the collection procedure. With the male patient, swab the entire penis and scrotum. Retract the foreskin if uncircumcised.
Allow the swabs to air dry, then place the swabs in the box and check "Genital / Penile".
Step 10. ANAL SWABS
If necessary, lightly moisten the swabs with a minimal amount of sterile / distilled water for the comfort of the patient.
Carefully swab the anus using the two swabs simultaneously.
Allow the swabs to air dry, then place the swabs in the swab box and check "Anal".
Step 11. VAGINAL / CERVICAL SWABS
Carefully swab the vaginal vault (including the fornix) and cervix using the two swabs simultaneously. Swabbing the cervix is particularly important if more than 12 hours have passed since the assault. Do not swab the os.
Place the swabs in the swab box and check "Vaginal / Cervical."
Step 12. MISCELLANEOUS EVIDENCE
NOTE: This step is provided for the collection of miscellaneous evidence not covered elsewhere in this kit, such as tampons, sanitary pads, condoms, etc. Do not package multiple items together in the same bag. Use a separate facility paper bag or one of the clothing bags if available.
Collect the item and allow it to air dry if necessary. When dry, place in the paper bag.
Step 13. URINE SPECIMEN
NOTE: If the patient presents with drowsiness, memory loss, impaired motor skills, etc. or there is a suspicion of a drug used to facilitate rape, and the ingestion is suspected to have occurred within 96 hours of the hospital examination, the patient should be asked for consent to have a urine sample collected for identification of "rape drugs." If consent is given, immediately collect urine as specified below. To assist the toxicologist, document the date and time when the drug was probably ingested, the date and time the specimen was collected, and any drugs or alcohol voluntarily ingested in the last five days.
Using normal medical procedure and one 100 ml sterile urine collection container from facility stock, collect a 100 ml urine sample.
Attach a tracking label to the container and close it tightly.
Seal the container with evidence tape, place the container in the ziplock bag, and close the bag.
Place on ice until the packaging of specimens is done at the end of the forensic examination.
When packaging, place the ziplock bag with the urine container in the urine collection box.
Seal the box, attach a tracking label and the biohazard and urine stickers, and fill out all information requested.
DO NOT PLACE THE BOX CONTAINING THE URINE SPECIMEN BACK IN THE KIT. Instead, use the packaging materials provided. Instruct law enforcement to freeze the urine until transport to HETL for analysis.
Step 14. BLOOD SPECIMEN
NOTE: If the patient presents with drowsiness, memory loss, impaired motor skills, etc. or there is a suspicion of a drug used to facilitate rape, and the ingestion is suspected to have occurred within 96 hours of the hospital examination, the patient should be asked for consent to have a blood sample collected for identification of "rape drugs". If consent is given, immediately collect a blood sample as specified below. Use two 10 ml gray-topped blood tubes or four 5 ml gray-topped blood tubes (potassium oxalate and sodium fluoride). To assist the toxicologist, document the date and time when the drug was probably ingested, the date and time the specimens were collected, and any drugs or alcohol voluntarily ingested in the last five days.
Using normal medical procedure and appropriate blood collection tubes, withdraw a sample from the patient allowing the blood tubes to fill to maximum volume. Attach a tracking label to the blood tubes.
Place the tubes in the enclosed bubble pack and seal.
Place on ice until the packaging of specimens is done at the end of the forensic examination.
When packaging, place the bubble pack in the blood collection box.
Seal the box, attach a tracking label and the biohazard and blood stickers, and fill out all information requested.
DO NOT PLACE THE BOX CONTAINING THE BLOOD SPECIMENS BACK IN THE KIT. Instead, use the packaging materials provided. Instruct law enforcement to refrigerate (not freeze) the blood until transport to HETL for analysis.
C.M.R. 16, 219, ch. 71, ADULT INSTRUCTIONS