explain all procedures; reinforce the "wellness" of the child;
allow the child as much control as possible;
keep interruptions to a minimum;
limit the number of people present. Law enforcement or child protective agency representatives or others involved in the investigation should not be in attendance;
decide whether the presence of the caretaker is desirable during the exam. Under no circumstance should the exam be held in the presence of a caretaker who is suspected of perpetrating the abuse;
decide whether the use of sedation or anesthesia is appropriate. Use of medication should be restricted to situations where suspected major injuries require assessment or surgical repair. If used: explain procedures to the child and caretaker; reassure the child that s/he will be protected during the procedure; and obtain consent from parent or caretaker.
