1st Edition

Forensic Science in Healthcare
Caring for Patients, Preserving the Evidence

ISBN 9781439844908
Published February 4, 2011 by CRC Press
373 Pages 96 B/W Illustrations

USD $115.00

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Book Description

First responders confronted by forensic cases are forced to consider the competing concerns of administering proper medical treatment while at the same time safeguarding vital evidence. Forensic Science in Healthcare: Caring for Patients, Preserving the Evidence presents precise on-scene protocol designed to ensure that the actions of the response team provide the necessary care and yet maintain the integrity of the evidence for legal purposes.

Following an introduction to forensics, the book explains how to recognize and identify patients with forensic issues, offers guidelines on proper documentation, and provides tips on forensic photography and capturing critical images. It reviews basic principles of evidence collection before moving into specific case scenarios, including domestic violence, sexual assault, child and elder abuse, youth violence, and death investigation. The book also examines occupational concerns for forensic personnel as well as legal issues such as testifying in depositions and in court.

Enhanced with photographs, illustrations, templates for documentation, and case-specific recommendations, this one-stop reference provides first responders with practical understanding of the steps that should be followed to ensure not only patient protection but evidence preservation.

Table of Contents

Introduction to Forensics
Red Flags
The Evolution of Crime, Violence, and Crime Detection
Living Forensics
The Scope of Crime and Violence in Modern Society
The Financial Cost of Violence
The Emotional Cost of Violence
The Role of Healthcare
Standards of Care
The Nursing Process
Medical Documentation
General Physical Examination
Wound Documentation
Blunt Force Injuries
Sharp Force Injuries
Mixed Blunt and Sharp Injuries
Fast Force Injuries (Gunshot Wounds)
Thermal, Electrical, and Chemical Injuries
Digital Evidence
Tampering and Spoliation of Records
Healthcare Role in Evidence Collection
Healthcare Providers
Categories of Evidence
Types of Evidence
Basic Principles of Evidence Collection
General Procedures
Chain of Custody
Common Types of Physical Evidence in Medical Settings
Biological Evidence
Body Fluid Collection
Bite Marks
Blood Alcohol and Other Toxicological Specimens
Fetal Drug Exposure
Sexual Assault
Domestic Violence and Abuse
Physical Abuse
Sexual Abuse
Psychological Abuse
Economic Abuse
Joint Commission
Intervention for Domestic Violence
Patient History
Psychological History
Physical Examination
The Care Plan
Mental Health Plan
Safety Plan
Resource List
Community Resources
Sexual Assault
Goals of Care
Role of the First Responder and Healthcare Provider
Sexual Assault Nurse Examiners (SANE)
A National Protocol
Child Abuse and Neglect
Definition of Child Abuse
Forensic Resources
Basic Assumptions
Healthcare’s Role
Child Neglect
Sexual Assault of Children
Pediatric Specimens
Munchausen by Proxy Syndrome
Sudden Infant Death Syndrome (SIDS)
Failure to Thrive
Sexual Assault of Children
Reporting Laws
Child Sexuality
Perpetrators and Victims
Short- and Long-term Psychological and Physical Harm
Signs of Sexual Abuse in Children
Prehospital Care
Physical Injury
Initial Disclosure
Nursing Diagnoses
Youth Behaviors and Violence
Risky Behavior
Drug Use
Dating Violence
Guns and Gangs
Stranger Danger
Child Pornography
Elder Abuse
Categories of Elder Abuse
Joint Commission Standards
Risk Factors for Abuse
Signs and Symptoms of Physical Abuse
Signs and Symptoms of Sexual Abuse
Signs and Symptoms of Emotional or Psychological Abuse
Signs and Symptoms of Neglect
Signs and Symptoms of Self-Neglect
Signs and Symptoms of Abandonment
Signs and Symptoms of Financial or Material Exploitation
Reasons Elder Abuse Isn’t Reported
Reasons for Abuse or Neglect in Institutionalized Settings
Safety Planning
Death Investigation
Some Thoughts to Consider
Cause, Manner, and Mechanism of Death
Role of the Death Investigator
Implications for Healthcare Providers
Assisting Survivors
Traumatic Grief
The Consultation Autopsy
Organ and Tissue Donation
Summary of HCFA CFR
In Conclusion
Occupational Issues for Forensic Personnel
Safety in the Workplace
Workplace Violence
Hostage-Taking Scenarios
Sexual Harassment
Electrical Hazards
Altitude-Related Illness
Bomb Threats
Forensic Response
Regulations and Reporting
Legal Issues
Testifying in Court

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Connie Darnell is an operating room nurse at Los Alamos Medical Center in New Mexico.


". . . an excellent resource for all healthcare providers and right on target for our EMS colleagues."
—Philip J. Froman, MD, FACEP, EMS Medical Director, Albuquerque, New Mexico

"This quick reference guide is a resource of fundamentals for first responders confronted with forensic cases. Law enforcement officers, fire personnel, EMTs, nurses and physicians will find precise instructions for on-scene actions to ensure that valuable forensic evidence is properly safeguarded. The author has distilled the essentials for those who do not have the time to wade through a lot of peripheral nice to know information to find immediate answers for the forensic scenario at hand. Occupational health and safety issues are also addressed. Color illustrations, charts, tables, references and online resources amplify the text and provide useful guidance for field personnel. If you can have only one quick reference manual, it should be this one!"
—Janet Barber Duval, Forensic Nurse

"Well-organized chapters with plenty of key points, photographs, illustrations, references, tools, and information help empower health care professionals to protect patients entrusted to their care. … This book is an excellent resource for all first responders, but it is also a must-read for nurses at all levels in all settings. The author does an excellent job of incorporating forensic information with nursing observation and documentation. Managers will find valuable information for developing policies and procedures and the tools necessary to help staff members protect the forensic patient’s legal rights in the health care setting."
—Phyllis J. Fawcett, Regional Clinical Informaticist, Community Health Systems, Franklin, Tennessee, in Journal of Operating Room Nurses