Microscopy in Forensic Medicine and Nursing

This article details the various types of microscope use within the fields of Forensic Medicine and Nursing. Here is a brief Q and A Session regarding this:

Q At what times as a Forensic Nurse would you have the opportunity to use a microscope if any?

A Forensic nurses use microscopes to identify sperm during a post-rape examination.

Q What sorts of protocols would you use as a Forensic Nurse or Examiner in order to preserve the integrity of microscopic evidence?

A First is is imperative that consent be obtained. Then the protocols indicated below shoul dbe followed every time.

Protocols for Collection of evidence:

The nurses preserve vital fragments of trace evidence by careful handling of the patient’s clothing and personal property. Gloves – universal precautions, must wear all times.(When handling any specimens, clothing, anything that could potentially be evidence).

Avoid cross-contamination, particularly of clothing and fluids.

Each evidence item must be individually packaged, sealed and labeled.

Blood work should be drawn as soon as possible
“It is better if the genital exam is done prior to the patient using the bathroom. If there has been oral contact the mouth exam should be done before the patient eats, drinks or brushes her teeth. In most cases a forensic exam is not valuable for evidence collection over 72 hours from the time of the assault but the patient may still require medical treatment.”
Sexual Assault Needs Assessment Project: SAFE nurse, (Oct 14 2002) http://www.everything2.com/index.pl?node_id=1372922

According to “Guidelines for the Preservation of Physical Evidence in Living Patients” Linda McCracken RN (2003), http://www.forensic-ed.com/guidelines.htm

Body Fluid: Collect fluids around wounds or wet body contents, seminal fluid, fluid stains by absorbing stain into a clean 4×4 or cotton swab. Allow swab to air-dry and place in a labeled bag, then seal in a PAPER envelope. Large amounts of fluids will not be collected unless specifically requested by law enforcement.

Seminal stains- allow to air dry, wrap in paper, and package evidence in paper bag.
If on clothing, wrap the item in clean paper, place the article in a brown paper bag, seal and label.

Hair & Fibers: Collect, fold in a piece of paper and place in a separate paper envelope, seal, and label. If hair is attached, such as in dry blood or caught in metal, or glass, leave hair intact on the object, mark it, wrap it, and seal it in an envelope

Debris: Collect and place in separate paper envelopes. Collection of large quantities of small glass fragments can be accomplished with use of hand-held vacuum.

Collect clothing or other material showing evidence of gun powder residue or shot holes. The clothing should be carefully wrapped in clean paper and folded as little as possible to prevent dislodging powder particles.

If there is any indication that the victim’s hands may contain trace evidence gunshot residue, hair, fibers, or residue under the fingernails, and sampling is delayed due to patient treatment, place a small paper bag over each hand and secure with tape

Fabrics, clothing: Remove carefully in as few pieces as possible. Avoid cutting through bullet holes, stab wounds, tears, rips or other defects.

Cut along seam lines, away from site of injury. Cutting along seam lines may also preserve blood spatter evidence.

If clothing is wet, inform the law enforcement officer receiving the evidence. If wet clothing is not given to the police within two hours, hang each item separately to air dry with a clean sheet underneath each item.

NEVER MIX ITEMS OF CLOTHING if items are heavily saturated, place them in the appropriate paper bag, seal, and label the bag, and then place the item in a clear plastic bag. This will avoid leakage, cross contamination of evidence and contamination to staff. Dry garments, fabric etc.- place each item on a piece of paper, before placing in a paper bag. Leave flat if possible; insert a clean piece of paper between layers if the item must be folded.

In the trauma setting, placing a clean sheet on the trauma room floor, and depositing each item of clothing in separate piles, allows law enforcement the opportunity to confiscate whatever evidence they deem essential in that specific case.

Once patient is transferred off of the trauma stretcher, bag the sheet the patient was lying on for trace evidence.

Clothing or any other items which may become evidence should NEVER be released to the family or anyone other than law enforcement.

Document the name and badge # of the officer authorizing release of any item. If items of evidence cannot be given to police in a timely manner, lock them in a secure place, or give to hospital security (documenting security officer identification) and document all in nurses’ notes.

Do you enjoy considering these sorts of problems? The Canyon College Online Forensic Nursing Certification Program is now accepting applications.

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