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ER 1 > Forensics > Flashcards

Forensics Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Three types of modes of death

A
  • natural
  • unnatural (accidental, suicidal, homicidal)
  • unknown
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2
Q

What deaths are reportable to the coroner or ME

A
  • unexpected
  • suicide
  • accidental
  • while in custody
  • self-abortion
  • etoh intoxication
  • Not: dies under provider’s care, knew sick, know likely to die
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3
Q

Rigor Mortis and body temps

A
  • occurs at 3 hours
  • 4 hours: extremities still warm
  • 6 hours: trunks still warm
  • Lose about 1.5 degree body temp F per hour dead
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4
Q

Dependent lividity

A
  • Occurs where blood pools after heart stops beating
  • Red where blood pools, white where body was bearing weight
  • Allows understanding of body position after death
  • Also, if see during resuscitation, sign person will not recover…
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5
Q

What animal eats in a linear, buffet fashion?

A

rats

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6
Q

What to think when see abrasion, damage to neck on dead person?

A
  • could be pre-death injury
  • Could also be a post-mortem finding, skin becomes very fragile and tears easily, could be due to rough handling by EMS, funeral home, etc.
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7
Q

How does tension pneumo kill?

A

Pushes mediastinum away from injured side, can squish vena cava, kinks it like a hose = no blood to heart. Tx will quickly resolve!

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8
Q

What to consider if pt has road rash

A

If not removed in 24 hours becomes a perm tattoo

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9
Q

Signs of basilar skull fx

A
  • battle sign (behind ear)
  • raccoon eyes
  • CSF otorrhea and CSF rhinorrhea
  • TM perf
  • Hemotympanum
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10
Q

What is a pattern contusion

A

bruise that shows what was used to cause injury: pool stick injury

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11
Q

How to differentiate injury dt fall vs. fight?

A
  • Fall injuries will occur on the “parts that stick out” on the face
  • Fight can occur in recessed areas like eye socket.
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12
Q

Laceration definition and how to differentiate from cut

A
  • blunt trauma
  • skin stretches until it rips in a jagged fashion
  • will contain bridging tissue (area that survived trauma)
  • will contain abrasion around the wound
  • Cuts will be straight, no surrounding abrasion
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13
Q

Child abuse

A
  • bruising on face, abdomen, thighs, hips
  • Lacerations on lips (scalloped edge if not repaired)
  • Flagellation marks from whipping
  • Cigarette burns: round
  • Cephalohematoma: grab by hair and pull

excuse me while I vomit

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14
Q

MVA

A
  • Extent of accident does not always equal extent of bodily injury
  • Ask: where in car, seat belt worn? Will help determine MOI
  • Chevron marks: tire ran them over
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15
Q

Auto-Pedestrian accidents

A
  • can sometimes tell how person was standing when hit:
  • bilateral injury at same level indicates standing still
  • bilateral injuries at different levels indicates moving
  • Check wounds for paint fragments
  • Look at the car
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16
Q

IV drug use tid-bits

A
  • Smoke, soot, etc. on needle is cause of peri-venous fibrosis (hypo pigmentation)
  • Bent needle = easier access
  • Bulb syringe: use to get all drug by washing out
  • Skin popping: SQ injection vs. IV. Lesion called “rosette”. Can get infected and ulcerate
  • Frothy edema
  • Tattoos: Charlie Chaplin/King Herald = heroin, can be used to hide tracks, roadmap to veins
17
Q

Hangings

A
  • leave a looped mark, not a straight line
  • If hang long enough will get petechia in leg called tardieu sign, turn into purpura
  • Don’t forget about autoerotica… Family might try to cover it up
18
Q

Signs of smothered with a pillow

A

White around lips, nose, chin

19
Q

Knife injuries

A
  • Dull: black collar abrasions (dt friction)
  • Single edged: sharp on one side of the cut, dull on the other
  • Figure 8 and dull: scissors
  • Hands: usually sign of defense
  • Prod marks: poke marks near injury
  • Vital erythema (cut when alive, red and blood) vs. no blood (cut when dead and not bleeding)
20
Q

What should you try to do when cutting off clothing and treating patient

A
  • try to not damage evidence (cut through GSW hole)

- look for evidence like paint, keep if you can

21
Q

GSW

- how to tell if from distance or close

A
  • close will have soot, gunpowder, etc. on skin

- Far will just be damage from bullet

22
Q

GSW

- enter vs. exit

A 
Entrance hole 
- will be smaller than bullet (stretches skin as enters)
- Collar abrasion
- Bone spicules travel same direction as bullet
Exit
- bigger hole bc now bullet tumbling
- no soot, etc. 
- stellate dt tumble

*** NEVER name entrance or exit, just number wounds 1, 2, etc.

23
Q

What finding can be found if a revolver is used?

A

cylinder gap

- if cheap gun, some material will come out gap and cause secondary injury next to bullet hole

24
Q

Higher power guns

A
  • more injury

- exit wound bigger than with handgun

ER 1 (18 decks)

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