Injury Patterns Flashcards
Interpretation of injury patterns can tell
Causal object or weapon Manner of infliction - assault - accident - self-infliction Sequence of infliction - tentative or scattered first - fatal or grouped later
Intentions of self-inflicted injuries
Suicide Personal gain - spite, compensation, wasting time, malingering - seen on cheeks forehead, arms and legs - sparing of eyes, nose, lips, ears and genitals Self-mutilation - feature of psychiatric illness - criss-crossing incisions and stabs - face, eyes and genitals targeted
Patterns of self-infliction
Sharp force or gunshots over blunt force Accessible target site Clothes drawn aside Hesitation wounds Only few potentially fatal Evidence of previous self-harm
Patterns of accidental injury
Any type of injury - often in combination Not aimed or grouped at target sites Clothing involved Defensive injuries possible
Patterns of assualt
Any type of injury - often in combination Aimed at target sites Multiple injuries Clothing involved Several may be potentially fatal wounds Defensive injuries common
Why are stab wounds widely scattered in assault
Victim and assailant movement
Frenzied attacking
Defensive injuries
Why are injuries just down one side in assault
Attacker right handed
Victim left handed
Victim pinned up against wall leaving one side more accessible
Why are injuries present on arms and legs in assault
Victim unconscious or dead so no longer able to defend
Victim backed up into corner
Why are injuries closely clustered in assault
Easy reach of attacker
Repeated stabbing movement
Victim pinned/held down in position
Victim unconscious or dead
Why are shoes good weapons in assault
Easy access Stamping legs produces large force due to body weight Hard sole Hard edges Easily cleans Natural No license or arouses suspicion
Features of a shod foot assualt
Punches targeted to face
- black eyes
- nasal fracture
- bruising and lacerations to lips
- bruises, abrasion and lacerations to cheeks, chin and ears
Kicks/stamps targeted to face and ears
- laceration to eyebrows, cheeks and ears
- fractures of maxilla, orbits and zygoma
Airway obstruction
- blood, tongue, mobile face fracture
Kicks to shoulders and back
- lacerations of spleen -> internal haemorrhage
- pinched duodenum under spine and crushed/lacerated by blunt force -> gastric acid leaks into peritoneal cavity -> inflammation -> peritonitis
Features of assaultive incisions
Targeted sites
Closely groups
Deep and forceful
Survival and capabilities depend on
Site of injury and structures damaged
Degree of blood loss
Rate of blood loss
Capabilities often surprising
Complications of injuries
Early - haemorrhage - loss of function - fat or air embolism Late - infection - pneumonia - unconscious on back unable to clear secretions - ARDS - DVT and PE - renal failure - multi-organ failure - DIC
Internal haemorrhage
Blunt force - intra-cranial Sharp force - intra-thoracic -> haemopericardium and haemothorax - intra-abdominal
