Forensic LOGO Noriega

Forensic Science:
A basic overview
Carol A. Noriega, MSN, RN, CEN
Forensic Science Defined
“FORENSIC” - “pertaining to the law”.
It is also noted that the word forensic is an
adjective and should be used in conjunction
with a noun; such as Forensic Science.
-Tabers Cyclopedic Medical Dictionary
Clinical Forensic Practice
• Pioneer of forensic nursing
• “Health care providers can no
longer work in isolation from
the legal issues previously
delegated to law enforcement.”
Virginia Lynch MSN, RN
• Maintain a high index of
Clinical Forensic Practice
“Emergency care providers are usually the first
to see the patient, first to talk with the family,
first to handle the patients property and first to
deal with specimens and evidence.”
[The Healthcare Provider] must be able to
recognize that a potential forensic issue exists.
-Linda McCracken, RN, Nurse Clinician and
Forensic Nurse Consultant;
Potential Forensic Cases
individuals involved in MVC
attempted homicide or suicide;
injuries involving firearms, knives, or other weapons;
accidents (including fire, falls or electrocution)
work-related accidents
overdoses or illegal drug use
sexual or non-sexual assaults
anyone in police custody for any reason
sudden unexpected death
Why should Trauma Providers
• Trauma care providers are very good at finding
out what is injured. We excel in the “E” of the
mnemonic of trauma care: “EXPOSE” the
patient to see what is hurt.
• Unfortunately, the act of “expose” can
inadvertently destroy valuable evidence.
– i.e. cutting through the bullet hole, instead of
around it.
• Is there a better way?
The Better Way…
• A Collaborative, consistent approach, between
all disciplines when dealing with victims
and/or victimizers in the health care setting.
• Linda McCracken, RN developed a mnemonic
The Forensic ABCs of Trauma Care
The Forensic ABCs of Trauma Care
Assessment of the victim
Does the injury match the story?
The Forensic ABCs of Trauma Care
B = Bridge the gap
– liaison with outside agencies
• law enforcement, EMS, medical examiner, etc.
The Forensic ABCs of Trauma Care
• C = Chain of custody
– know the methods of
evidence collection
– establish continuity of
evidence possession and
The Forensic ABCs of Trauma Care
D = Documentation of findings
– Stay factual
The Forensic ABCs of Trauma Care
• E = Evidence
– Preserve and
collect when
The Forensic ABCs of Trauma Care
• F = Families
– keep them informed (as appropriate)
The Forensic ABCs of Trauma Care
• Going to court
Be prepared to provide
written or oral testimony
The Forensic ABCs of Trauma Care
• Hospital policies
- Know
where and how to access your
institution’s or agencies forensic protocols
The Forensic ABCs of Trauma Care
• Index of Suspicion
• Be aware of signs of abuse and violence.
• …does the story match the injury?
Assessment of the Victim
Bridge the Gap
Chain of Custody
Documentation of Findings
Going to Court
Hospital Policies
Index of Suspicion
KEY SKILL: Critically Noticing
• The practice of “critically noticing” on the part
of health care practitioners is essential.
• The intuition of an experienced seasoned
clinician, coupled with an accurate
assessment, is a powerful combination.
• Forensic Science is the combining of Science
and law.
• Health care providers play an integral part of
the healthcare team as well the legal team
• Use the mnemonic “The Forensic ABCs of
Trauma Care” as an organized method of a
forensic assessment.
• “Critically Noticing” is an essential practice of
healthcare providers.
• Eldridge, K. Assessment of trauma nurse knowledge
related to forensic practice. Journal of Forensic
Nursing 4 (2008) 157-165
• Lynch, V. A. Forensic Nursing, 2006
• McCracken, L. Living forensic: A natural evolution in
emergency care. Accident and Emerg Nurs J. 7, 4,
211-216, 1999
• McCracken, L. The forensic ABC’s of trauma care.
Canadian Nurse. 97, 3, 30-33, 2001
• Pyrek, K. M. Forensic Nursing, 2006
8:00 AM
2:30 PM
UK Healthcare ‘Trauma-tizers’
2012 Kentucky Tough Mudder Finishers
Carol Noriega, MSN, RN, CEN
[email protected]

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