Trauma 1 Flashcards
Terminology of Injury
Non-specific terms used by laypersons and non-forensic healthcare professionals may have specific legal meanings.
Misuse of terms can affect legal proceedings (e.g., “laceration” vs. “incised wound”).
Classification of Injury
Jurisdictions have specific legal classifications of injuries.
Familiarity with classifications is essential for forensic practitioners to assist courts.
Common classifications in England & Wales
Fatal outcomes
Non-fatal outcomes
Sexual offences
Fatal Outcome
Murder (homicide)
Manslaughter (homicide)
Non-Fatal Outcome:
- Assault, assault occasioning actual bodily harm
- Common assault
- Battery, or common battery
- Wounding or wounding with intent
- Poisoning
- Inflicting grievous bodily harm or causing grievous bodily harm with intent
Sexual Offences:
Penetrative
Non-penetrative (with or without extra-genital injury)
List homocide offences according tp England & Wales
Murder
Manslauter
Voluntary manslaughter
Involuntary manslaughter
Def of murder
Unlawfully killing someone with intent to kill or cause grievous bodily harm (GBH).
Three types of manslaughter
- Killing with murder intent but with partial defenses like loss of control or diminished responsibility.
- Gross negligence manslaughter: Conduct with gross negligence leading to death.
- Unlawful and dangerous act manslaughter: Unlawful act causing danger that results in death.
Diffrence between voluntary and invultary manslaughter
MS: Involves partial defenses (first type of manslaughter).
Involuntary Manslaughter: Gross negligence manslaughter and unlawful and dangerous act manslaughter.
Legal Definition of Wounds:
- A wound is an injury breaking the continuity of the skin.
- A bruise or non-broken skin injury is not a wound.
- A broken bone is not legally a wound unless it’s a comminuted fracture.
Offences Against the Person Act 1861:
Section 18: Wounding or causing grievous bodily harm with intent; punishable by life imprisonment.
Section 20: Wounding or inflicting grievous bodily harm without intent; maximum prison sentence of 5 years.
Section 47: Assault occasioning actual bodily harm; substantial injuries requiring medical treatment.
Sources of Information for Non-fatal Violence-Related Injury in England and Wales
- Violence and Society Research Group at Cardiff University: Reports on violence-related injuries via the National Violence Surveillance Network.
- Office for National Statistics: Provides data on all types of violent crime.
Inflammatory Response:
Tissue damage triggers cellular function disturbance and host inflammatory response.
Damaged cells express molecules (DAMPs, Alarmins), recognized by immune cells (neutrophils, monocytes/macrophages).
Immune cells produce cytokines and chemokines, recruiting more immune cells to the injury site.
Blood clotting system activates to stop bleeding, and vascular changes facilitate immune cell delivery.
Trauma Response Outcome:
- Dependent on injury nature, severity, presence of pathogens, and body’s physiological responses.
- Effective local response leads to inflammation resolution, tissue healing, and normal function restoration.
- Severe/systemic responses can cause major organ dysfunction, failure, and death
Modern Trauma Care:
- Focuses on minimizing adverse physiological trauma consequences and sustaining life for surgical repair.
- Aims to prevent metabolic acidosis, hypothermia, and coagulopathy.
Factors Influencing Trauma Fatality:
- Nature and Severity of Injury: Incompatibility with life (e.g., decapitation) and vital organ injuries.
- Mechanism of Injury: Energy transfer nature affects survivability (e.g., knife vs. gunshot).
- Emergency Medical Care Speed and Availability: Rapid care and trauma/intensive care facilities.
- Age and Health Status: Influences survivability (e.g., older age, pre-existing health conditions).
- Physiological Response: Medical/surgical intervention, infection, and sepsis impact.
