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National guidance for child protection in Scotland - Scottish ...

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9. Drug and alcohol use <strong>in</strong> relation to assault 10. Post assault – ask if relevant<br />

Was alcohol consumed? Eaten Yes No <br />

No Yes Not known Drank Yes No <br />

If Yes please specify Passed ur<strong>in</strong>e<br />

Note time<br />

Yes No <br />

Prior Dur<strong>in</strong>g After offence Bowels open Yes No <br />

Start of dr<strong>in</strong>k<strong>in</strong>g Wiped/washed Yes No <br />

specify site and disposal of e.g. cloth/tissue<br />

End of dr<strong>in</strong>k<strong>in</strong>g<br />

Quantity and type of beverage consumed Changed clothes<br />

Specify<br />

Yes No <br />

Self harm<br />

Sites<br />

Yes No <br />

Compla<strong>in</strong>ts of pa<strong>in</strong>/soreness/bleed<strong>in</strong>g post assault<br />

Details<br />

Yes No <br />

Brushed teeth gums dentures <br />

Have any illicit drugs been used/adm<strong>in</strong>istered to the<br />

subject with<strong>in</strong> 4 days of the exam<strong>in</strong>ation?<br />

If Yes please specify<br />

No Yes Not known <br />

Mouth wash spray used <br />

Washed bathed showered douched <br />

Changed tampon pad sponge diaphragm <br />

Prior Dur<strong>in</strong>g After offence<br />

Forensic samples taken be<strong>for</strong>e exam<strong>in</strong>ation started<br />

Give details<br />

Details<br />

Are any other substances suspected of hav<strong>in</strong>g been<br />

used/adm<strong>in</strong>istered which could be relevant to the offence?<br />

No Yes Not known <br />

By whom taken<br />

If Yes please specify<br />

Give details<br />

Prior Dur<strong>in</strong>g After offence<br />

If applicable – drugs/alcohol history<br />

57

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