1. Obtain child’s medical history by calling parents directly for this information or, if impossible, seek information from CPS workers who have taken medical histories.
2. Perform complete pediatric physical exam to include as much of the Early Pediatric Screening, Detection, and Treatment (EPSDT) exam as possible. Pay particular attention to:
A. Neurological screen
B. Respiratory rate
3. Contact poison control if clinically indicated
-1-800-876-4766.
4. Required clinical evaluations.
A. Temperature
B. Liver function tests: SGPT, SGOT, Total Bilirubin and Alkaline Phosphatase
C. Kidney function tests: BUN and Creatinine
D. Baseline electrolytes: Sodium, Potassium, Chloride and Bicarbonate
E. CBC
F. If not performed earlier, a urine specimen should be collected. This should be done within 12 hours of identification of the child because some chemicals/drugs are eliminated in a short time. Urine screen and confirmatory test results should be reported at any detectable level.
NOTE: If any tests are run for forensic purposes, chain of evidence procedures with confirmatory test results must be used, if available and feasible for the child, the following tests may be added to the above list:
Optional Clinical Evaluations:
G. Complete metabolic panel (Chem. 20 or equivalent)
H. Pulmonary function tests
I. Oxygen saturation
J. Heavy metals screens
NOTE: Heavy metals screen is indicated only if the methamphetamine lab was NOT ephedrine-reduction or cold cook methods, (e.g. if phenyl-2-propanone method was used, or clinically indicated.
5. Conduct Suspected Child Abuse and Neglect (SCAN) team evaluation (if indicated) at CAP.
6. Conduct a developmental screen. This is an initial age appropriate screen, not a full scale assessment; it may require a specialist. To be performed at CAP.
7. Provide a mental health screen and crisis intervention services as clinically indicated. These services require a qualified pediatrician or mental health professional and may require a visit to a separate facility.
8. OBTAIN A MEDICAL RECORDS RELEASE. All medical records associated with each child must accompany the case file for purposes of continuity of care.
9. For any positive findings, follow up with appropriate care as necessary. ALL children must be provided long term follow up care (See Protocol #5) using specified schedule.
10. Long term shelter and placement options should be evaluated and implemented by a CPS worker.
