Medical Facilities Procedures for DEC

These are recommended procedures developed by the National Alliance for Drug Endangered Children.  Various localities may need to adjust the strategies depending on their resources.  As local, state and federal protocols are approved and implemented, this information will be updated.
The first task of a medical team in a drug endangered child situation (if case does not call for emergency activation) is to evaluate and begin necessary treatment.  Medical personnel also play a vital role in collecting and preserving evidence.

1) Head to toe exam of the child within two to four hours to ensure medical stability and document any acute findings that might need treatment or change over time.  This may take place in an emergency room, physician's office or by EMTs on the scene.  This initial exam should include (but NOT be limited to) a good pulmonary exam, skin exam, neurological exam and affect (IE: scared, happy, detached, etc.).  This may include observations by EMTs, RN on the scene or other personnel to document the affect of the child.

2) Blood tests need to include a CBC (anemia, cancers, thrombocytopenias), chemistry panel including BUN/Cr and LFTs (kidney and liver damage, electrolyte imbalances).  This can be done acutely or within 72-hours.

3) Collect urine for toxicology.  This should happen as soon as possible but MUST occur within six hours for optimal results.  Submit to a lab that screens and reports for the level of detection of the test not just at NIDA standards.  Chain of Evidence forms may be used or usual medical protocols for urine toxicology screens may be followed.

Beginning May 1, 2006, medical care facilities will use a standard form to record information when treating children removed from a Meth environment. You may download a free copy here.  You will need a copy of Adobe Reader to open the file.