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OSCC Suspected Child Abuse and Neglect (SCAN) Clerking Note

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OSCC Administrator

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LMP

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Place Of Examination

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Informant / Case Notified By

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Accompanying Person To Hospital

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Ward

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Telephone No

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Parents/Guardian

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Siblings

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Suspected Perpetrator (S)

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Type Of Abuse

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Factors Leading To Child Abuse And Neglect

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SCAN TEAM MEMBERS INCHARGE

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Jkm Social Worker-In-Charge

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Name

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Telephone No

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Investigation Officer

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Name

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Police Report No

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Telephone No

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School Counsellor

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Name

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Name Of School

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Telephone No

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Medical Social Worker In Charge

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Name

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Telephone No

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HISTORY

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Date Of Incident(S)

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Time Of Incident(S)

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Location Of Incident

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Suspected Perpetrator

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Nature Of Incidents(S)

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Other Relevant History

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Social/Family History

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Medical History

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PHYSICAL EXAMINATION

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DIAGNOSIS

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MANAGEMENT

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Specimens (Tick only specimens taken)

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Chemistry Department

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Pathology Lab

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Management of Rape within 72 hours

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Contraception: T. Levonogestrol 1.5mg stat

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HIV Prophylaxis: T. Combivir (Zidovudine 300mg/Lamivudine 150mg) BD for 4/52

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Antibiotic:

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Plan

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Orders

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Referral

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Outgoing Referrals

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Comments

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SIGNATURES

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SCAN TEAM MEMBERS INCHARGE
HISTORY
PHYSICAL EXAMINATION
DIAGNOSIS
MANAGEMENT
SIGNATURES