摘要:

Physicians are increasingly involved in the medical care of victims of gunshot wounds. Many of the victims survive their injuries, and more are likely to do so as advances in medicine continue. Clinicians are replacing forensic pathologists as witnesses. Emergency physicians are among the first medical personnel to observe the wound characteristics in their unaltered states and thus have a responsibility to document these characteristics as accurately and completely as possible. An understanding of the fundamental differences in weapons and ammunition types, as well as a basic understanding of ballistic principles, will assist the clinician in accomplishing this task.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Because human bite marks may constitute major evidence in criminal and civil cases, the emergency medicine clinician should be skilled in both treating and documenting these injuries. This article describes the typical and atypical appearance of human bite injuries, differential diagnosis, and method for documentation of the injury for forensic use. It also gives examples of major crimes that were solved because of the alert involvement and cooperation of the hospital medical team.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Tattoos are frequently encountered in the emergency department patient population. The number of individuals seen with tattoos has increased dramatically; in many instances, the tattoos are simply decorative or related to a current fad. However, some of these tattoos may be clinically relevant to the emergency physician. Tattoos may indicate gang membership, a history of incarceration or drug abuse, sexual orientation, and more. Tattoos may definitively identify a person (a role well known to coroners and law enforcement) and are frequently a means to nonverbally communicate one's beliefs or lifestyle to others. The emergency physician who is knowledgeable about tattoos gains immediate insight into his or her patients and may gather clinically relevant data.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Suspects forcibly brought into police custody frequently have injuries requiring emergency medical attention. Nonlethal law enforcement techniques create specific injury patterns that emergency physicians must recognize to effectively treat such patients. Failure to adequately treat these patients or failure to diagnose these patients may have disastrous medicolegal ramifications. Therefore, emergency physicians should be familiar with nonlethal law enforcement techniques and their injury patterns.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Patients in police custody are brought to emergency departments primarily for the treatment of drug overdose or withdrawal, smuggling of contraband, and trauma. Excited delirium from methamphetamine, cocaine, or phencyclidine intoxication may be a harbinger of death. Use of physical restraints and less-than-lethal deterrents during the arrest may increase morbidity and may require prompt aggressive treatment. Forensic issues arise when police request blood for alcohol assays, body searches for contraband, and retrieval of bullets for evidence. It is estimated that medical evidence plays a role in one-fourth of all criminal trials. Emergency department personnel must protect the patient's rights and respond to police requests. The medical record should be accurate, impartial, and suitable for testifying in court. A clear medical record may obviate the need for future subpoenas.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Inmates are a unique patient population. When emergencies arise or their medical problems exceed the capabilities of the prison infirmary, inmates are frequently referred to the local hospital emergency department. There are many unique aspects of the prison environment that must be considered when managing these patients. These patients are high risk from a medicolegal standpoint, and their medical care and chart should reflect this reality. Correctional medicine is an emerging subspecialty area focusing on the issues related to the care of this patient population.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Health care providers caring for those in custody should recognize the unique security risks associated with this patient population. Emergency department staff are trained to focus their attention on patient care and may, inadvertently, leave medical supplies about which can be made into weapons at the bedside. Patients in custody may hide these materials and later create weapons for either defensive or attack purposes. Law enforcement officers and medical personnel are usually not the intended targets; instead, these devices are used for self-protection or to injure other inmates.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Mandatory reporting and screening laws are proliferating, and emergency physicians must be aware of the laws or risk criminal charges and malpractice claims. Most laws specifically provide physician immunity with respect to breaches of confidentiality whenever reports are made in good faith. These laws reflect a societal need to identify and intervene on both the medical and legal aspects of certain problems such as infectious diseases, adverse drug reactions, child abuse, elder abuse, and domestic violence. The coroner, the state departments of motor vehicles, departments of health and social services, law enforcement, the medical board, and the Health Care Financing Administration (HCFA) are some of the authorities to which emergency physicians are required to report. Everyday emergency practice requires awareness and compliance with myriad reporting laws.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In 1994, the Department of Emergency Medicine at Loma Linda University Medical Center (LLUMC) set out to implement a comprehensive emergency department (ED) model-A model that headed in the opposite direction of many popularized solutions whose objective is to keep patients out of the ED. This model increased the number of services offered patients in the ED. It triaged them within its walls to an area that would be cost-effective for the parent's acuity and allowed patients to immediately move to a higher level of care if the provider saw the need. Three years of data have determined the comprehensive ED model to be an effective, patient-focused alternative to the "demand management" methods. Low-acuity patients at LLUMC are treated in less costly areas provided by the comprehensive ED model. The high-techñladen MainED space is better used as a result of a 25% increase in complex patients since 1993.

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0164-2340    

出版商:OVID    

年代:1999

数据来源: OVID