Csi

Abstract

Emergency department (ED) nurses care for victims of trauma almost daily. Although preservation of evidence is crucial, the ED is chaotic when a trauma patient arrives and staff members must do everything possible to save the patient's life. However, an integral responsibility of the staff nurse is collection and preservation of forensic evidence. This article provides insight into the process undertaken by a multidisciplinary team to develop a set of evidence-based guidelines for forensic evidence collection. The team compiled evidence from more than 20 articles and consultations with law enforcement officials and forensic experts. This information was used to develop a set of guidelines for forensic evidence collection in the ED or operating room. Staff educational needs presented some challenges. Training was designed to specifically address the roles of three major groups of staff: patient representatives and emergency and trauma nurses. Educational topics included evidence recognition, handling of clothing, gross/trace evidence, documentation, packaging of evidence, and use of the "chain-of-evidence" form. Practice modifications included development of a new "chain-of-evidence" form, a forensic cart in the operating room, and use of a collapsible plastic box for collection of clothing in the ED.

Active Shooters

“…The victim's clothing should be removed with no cuts made through any bullet holes that may be present. These bullet holes contain valuable evidence in the form of gunpowder residue that should not be disturbed (Eisert et al, 2010). The clothing should not be placed on the floor or any table but should go into a paper bag as well.…”

“…Although nurses may have to lend their energy toward taking care of an injured victim or the shooter who may also be injured, the scene will no doubt be charged with nervous energy and anxiety. When the scene is safe, there are some steps the ED nurse should utilize to secure the area and preserve any forensic evidence that might be present for law enforcement until they arrive (Eisert et al, 2010).…”

Evidence Collection for the Unconscious and Unconsented Patient

“…The forensic examination includes evidence collection for possible DNA with a thorough assessment and documentation of injury. The forensic sexual assault exam is similar to all forensic exams and is a systematic procedure used in assessing, collecting, documenting, and packaging of samples [7]. In the specific case of sexual assault, a sexual assault forensic kit is often employed to guide the collection of evidence.…”

“…Professional guidelines in medical care include the importance of evidence collection. An example of this is from a New York emergency department [7] guideline that provides, "The medical needs of the patient are paramount. The next concern, however, must be the recognition, collection, and proper handling of forensic evidence from patients that received gunshot or stab wounds or were severely assaulted" [7].…”