1. Taken from: The Manual for Forensic Medicine: A guide for clinicians authored by Ralph J. Riviello

2. * …pertaining to a legal process * Forensic Nursing…applying nursing principles and practice to matters that are legal in nature

3. * Improper actions made inadvertently by undertrained staff include: * Destroying evidence * Throwing away evidence * Losing pertinent evidence * Writing illegible records * Creating partial documentation * Incomplete medical records * Delaying forensic examination * Missing subtle injuries * Making “educated guesses” about projectiles

4. * Medical trauma nursing care is the FIRST priority * Forensic work can be done simultaneously or after the patient has been stabilized

5. * Clothing worn by the victim should be saved and placed into PAPER bags * Plastic bags encourage mold that can influence analysis of DNA * Place each piece of clothing in a separate bag to prevent cross contamination * Label each bag with patient information and give it to the law enforcement officer * If clothing is soaked with blood or body fluids place it in a red biohazard bag * If the clothing must be cut avoid cutting through bullet holes or penetration sites * Document, in detail, this process

6. * If time and safety permit, photograph the injuries * This provide visual documentation and will help with legal recall at later dates * Document, in detail, this process

7. * Clearly and objectively document any injuries found during your examination of the patient * i.e. circular, red area noted to the patient’s right forearm, no bleeding or open wounds found * NOT bite marks seen on patient’s right forearm * This would be an assumption and could discredit other documentation

8. * Sexual assaults * Domestic violence * Substance abuse * Assaults * Automobile or pedestrian accidents * Worker’s compensation cases * Elder abuse or neglect * Institutional abuse or neglect * Death in the Emergency Department * Sudden infant death

9. * Can cause a severe and lasting psychological effect in healthcare personnel * Can lead to alterations in self and professional identity * ED staff observe many different forms of trauma suffered by their patients

10. * ED staff are valuable to forensic evidence collection and preservation * Proper treatment and documentation help avoid unintentional destruction of evidence * Anyone can be a victim that requires forensic interventions * Violence affects all those involved, including the healthcare worker