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    Maryland CHAMP

    The Maryland Child Abuse Medical Providers' Network

    Maryland CHAMP has developed the following practice recommendations and resources to assist in the evaluation of and response to suspected child maltreatment. Please use this information in consultation with a child abuse medical expert.
    Peer review recommendations
    In order to assure the highest quality of care for Maryland children, CHAMP recommends that ALL clinicians who evaluate children for suspected maltreatment participate in peer review. Click here to access CHAMP's Peer Review Recommendations.
    Web-based peer review
    When evaluating children for physical or sexual abuse, it is highly recommended to use TeleCAM to enable peer review and to document the physical findings. TeleCAM is a secure and HIPAA-compliant Web-based application that allows Maryland health care professionals to upload case information (including photographs) and receive rapid feedback from Maryland CHAMP faculty. Anyone with Internet access is able to use TeleCAM.
    Maryland health care professionals, who evaluate children for suspected maltreatment and who would like to participate in this valuable peer review system, please contact CHAMP Program Manager, Sara Lewis, to learn more and/or sign up for a TeleCAM account.
    If you are unable to use TeleCAM, CHAMP recommends at least using the following forms in conducting medical examinations for evaluating possible child abuse:
    For information and guidelines for evaluating different aspects of maltreatment, please access the CHAMP Physician's Handbook (2008). Individual sections of the CHAMP Physician's Handbook can be accessed below.
    Policy Statements
    The American Academy of Pediatrics (AAP) Committee on Child Abuse and Neglect periodically issues policy statements on important areas of practice. Please access all American Academy of Pediatrics Policy Statements pertaining to child abuse and neglect. 
    American Academy of Pediatrics Clinical Report:
    Postexposure Prophylaxis in Children and Adolescents for Nonoccupational Exposure to Human Immunodeficiency Virus
    The AAP Clinical Report, Post Exposure Prophylaxis in Children and Adolescents for Nonoccupational Exposure to Human Immunodeficiency Virus (2003)reviews accidental exposure to HIV in children and adolescents and provides recommendations for PEPs in those circumstances. This report includes an algorithm (found below) to assist in the assessment. Any decision to start PEPs should made with the child, family and “a clinician experienced in HIV exposure and management.”
    The decision to start HIV nPEP should not be delayed while awaiting HIV testing of the alleged perpetrator unless results can be returned within 1 hour. When testing alleged perpetrators, consent must be obtained as per usual.
    When 28 days of PEP have been completed, the medication is normally stopped. Follow up blood tests must be done to assess HIV status.
    Fig 1.
    Possible exposure to HIV in children and adolescents: algorithm for decision-making for use of PEP.

    Pediatrics June 1, 2003 vol. 111 no. 6 1475-1489