C.M.R. 16, 222, ch. 20, app 222-20-B
PLEASE NOTE:
[TICK] Unless otherwise noted, do not moisten swabs prior to sample collection.
[TICK] All swabs should be air dried prior to packaging.
[TICK] Unless otherwise noted, place the evidence collection specimens back into the envelope or bag from which they came.
[TICK] All envelopes and bags should be sealed. Attach a tracking label to the outside of each envelope or bag and fill out all information requested.
Step 1. ORAL SWABS
Carefully swab the buccal area and gum line using two swabs simultaneously, but collecting all four swabs. Be sure to collect the swabs from the upper and lower buccal areas and gum line, rotating the swabs during collection.
Place the swabs in the swab box. Mark the swab box "Oral".
Step 2. NASAL SWAB
Dampen each swab with distilled water.
Carefully insert one swab in each nostril and swab ONLY the nasal area.
Place the swabs in the swab box. Mark the swab box "Nasal."
Step 3. FINGERNAIL CLIPPINGS/SWABBINGS LEFT HAND
NOTE: Fingernail clippings are preferred. If patient refuses clippings, collect swabbings.
Remove folded paper from envelope and place, unfolded, on a flat surface.
Hold patient's left hand over the paper and gently clip the entire nail, allowing the clippings to fall on the paper.
For swabbings, dampen a sterile swab from Step 17 and swab under the nails.
Place the dried swab in the folded paper.
Step 4. FINGERNAIL CLIPPINGS/SWABBINGS RIGHT HAND
NOTE: Fingernail clippings are preferred. If patient refuses clippings, collect swabbings.
Remove folded paper from envelope and place, unfolded, on a flat surface.
Hold patient's right hand over the paper and gently clip the entire nail, allowing the clippings to fall on the paper.
For swabbings, dampen a sterile swab from Step 17 and swab under the nails.
Air-dry the swab and place in the paper..
Step 5. KNOWN DNA COLLECTION
Have the patient rinse his / her mouth with water prior to this evidence collection step.
Remove components from kit envelope.
Open the swab protector and slide the protector back to expose the swab head.
Using the swab, vigorously swab the inside of both sides of the patient's cheek for 5 to 10 seconds
Pull the swab head back into the protector and re-close the protector around the swab head.
Step 6. KNOWN HEAD HAIR SAMPLE
NOTE: Collect a minimum of 10 - 12 full-length hairs (total), including root, from various scalp locations.
Remove folded paper from envelope and place, unfolded, on a flat surface.
Run a gloved hand through and along the patient's hair, gently removing 10-12 hairs (total) from various scalp locations. 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.
Place the hairs in the center of the paper and refold paper so as to retain the hairs.
Step 7. FOREIGN MATERIAL COLLECTION
NOTE: If patient changed clothing after the assault, inform officer in charge so the police may collect the clothing worn at the time of the assault. Do not cut through any existing holes, rips or stains in patient's clothing. Do not shake out patient's clothing. If secure facilities are available, air-dry any wet or damp clothing. Otherwise, notify law enforcement personnel that clothing is wet or damp. If additional clothing bags are required, use only new paper (grocery type) bags.
UNFOLD AND PLACE A CLEAN HOSPITAL BED SHEET ON FLOOR.
Remove paper sheet from "Foreign Material Collection" bag, unfold and place over bed sheet.
Instruct patient to stand in center of paper sheet and carefully remove each item of clothing.
Collect each item as removed and place each in a separate clothing bag, as labeled.
Refold paper sheet on which patient stood in such a manner as to retain any debris present, then return it to the "Foreign Material Collection" bag.
Step 8. DEBRIS COLLECTION
NOTE: Do not package debris from different areas in the same envelope. Use Step 16 for additional packaging material or use facility materials and make a druggist fold.
Remove the folded sheet of paper from the "Debris Collection" envelope.
Unfold the paper and place on a flat surface.
Collect any debris present on the patient (dirt, hair, leaves, fibers, etc.) 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 9. DRIED SECRETIONS
NOTE: This step is provided for the collection of dry or damp suspected blood, semen or saliva, which may be present on the patient's body. Carefully examine for areas of kissing, sucking, or biting for saliva; body areas for ejaculate; lubricant not collected elsewhere; or other dried secretions. A Woods (UV) Lamp is helpful for locating secretions on patient's body.
Collect dried secretions by lightly moistening two of the provided swabs with distilled water, and then thoroughly swabbing the area with both swabs.
Re-swab the area with two additional dry swabs at the same time.
Mark on each swab box whether the swabs are the first or second swabs. Also identify on each box whether or not the swabs are suspected semen, saliva, blood, or other. If other, please describe.
Place each set of swabs in the appropriate box.
Identify the location from which the samples were removed on the anatomical drawings on the envelope.
If multiple secretions are present, repeat the procedure using the additional swabs found in Step 17. Do not package swabs from two different areas in the same swab box.
Step 10. PUBIC COMBING
Remove the folded paper and comb provided in the "Pubic Hair Combings" envelope.
Unfold the paper and place under the patient's buttocks, and using the comb provided, 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.
Step 11. KNOWN PUBIC HAIR SAMPLE
NOTE: Collect A MINIMUM OF 3-5 full-length hairs (total), including root, from various regions of the pubic area.
Remove folded paper from envelope and place, unfolded, on a flat surface.
Run a gloved hand through and along the patient's pubic hair, gently removing 3-5 hairs (total) from various regions of the pubic area. 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.
Place hairs in the center of the paper and refold so as to retain the hairs.
Step 12. GENITAL/PENILE SWABBINGS
Moisten swabs provided with a minimal amount of distilled water.
Holding the swabs together, briskly swab the external genitalia, 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.
Place the swabs in the box and mark "Genital / Penile".
Step 13. ANAL SWABS
NOTE: Swabs may be moistened with a minimal amount of distilled water for the comfort of the patient.
Carefully swab the anus using four swabs simultaneously.
Place the swabs in the swab box and check "Anal".
Step 14. VAGINAL SWABS
Carefully swab the vaginal vault using the four swabs simultaneously.
Place the swabs in the swab box and check "Vaginal."
Step 15. CERVICAL SWABS
NOTE: This step is particularly important if more than 12 hours have passed since the assault
Carefully swab the cervix using the four swabs simultaneously.
Place the swabs in the swab box and check "Cervical." .
Step 16. MISCELLANEOUS EVIDENCE COLLECTION
NOTE: This step is provided for the collection of evidence not previously covered elsewhere (e.g., tampons, sanitary napkin, etc.).
Collect item of evidence and allow to air-dry if necessary.
Place in paper bag labeled "Miscellaneous."
Step 17. ADDITIONAL SWABS
NOTE: This step is provided for the collection of evidence not previously covered elsewhere.
If necessary, moisten the swabs provided with a minimal amount of distilled water. Holding the swabs provided, thoroughly swab the area making sure to rotate the swabs during the collection procedure. Check "Other" on the outside of the swab box and identify the sample on the line provided. Place the swabs in the swab box and write the area of the patient's body from which the sample was obtained. Place the swab box in the "Additional Swabs" envelope.
Step 18. 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, the patient should be asked for consent to have a urine sample collected for identification of "rape drugs." If drug facilitated sexual assault is suspected, determine whether ingestion of the drug occurred within the last 96 hours (4 days). If so, immediately collect urine as specified below. If the ingestion of the drug occurred within the last 24 hours, also collect a blood sample. 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. Use a 100 ml sterile urine specimen jar from hospital stock if a urine specimen is needed. Do not place the urine specimens back in the kit instead use the packaging materials provided.
Using normal hospital procedure and one 100 ml sterile urine collection container from hospital stock, collect a 100 ml sample in the jar.
Attach a tracking label to the jar.
Seal the jar tightly.
Seal with evidence tape and place in the ziplock bag and close.
Place the ziplock in the "Urine Collection" box.
Seal the box, attach a tracking label, and fill out all information requested.
DO NOT PLACE BOX BACK IN SEX CRIMES KIT.
If possible, freeze box until transport to HETL for analysis. If unable to freeze, refrigeration is acceptable.
Step 19. BLOOD ALCOHOL/TOXICOLOGY 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 24 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. 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. Use two 10 ml gray-topped blood tubes (potassium oxalate and sodium fluoride) from hospital stock if a blood sample is needed. Do not place blood alcohol tubes into kit, instead use packaging materials provided.
Using normal medical procedure and two 10 ml gray-topped (potassium oxalate and sodium fluoride) blood collection tubes, withdraw a sample from the patient allowing blood tube to fill to maximum volume.
Attach a tracking label to the blood tubes.
Place the tubes in the enclosed bubble pack and seal.
Place the bubble pack in the "Blood Collection" box.
Seal the box, attach a tracking label, and fill out all information requested.
DO NOT PLACE BOX BACK IN KIT.
If possible refrigerate (DO NOT FREEZE) box until transport to HETL for analysis.
C.M.R. 16, 222, ch. 20, app 222-20-B