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It is often in our profession that we attend to scenes where an alleged crime was committed and evidence is the only thing that can bring the perpetrator to justice. It is also said that numerous cases are thrown out of court due to contaminated evidence or evidence being destroyed at the scene, be it by law enforcement officials, bystanders or paramedics.
It is a misconception that only scenes where a crime was committed should be protected. However, Forensic Medical Management can play a huge role in determining the cause of death and small actions by emergency medical personnel can compromise evidence. Although your first concern is patient treatment the scene and body of the patient should be protected as far as possible.
We as emergency personnel are not always trained in forensics, but we can make a difference and soon others will follow. Even if law enforcement is on scene before your arrival or the scene was disturbed, you should still try and protect the scene from your side, these include accident scenes.
You as an emergency care worker have a duty to administer life saving procedures and your actions should take preference.
A few tips that might just change the outcome of a case:
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The rescuer should always try to use the same entrance and exit path into a crime scene.
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If law enforcement personnel are present on the scene, ask them if there is any evidence that you should look out for. Tell the officer with you of what you have moved and its position before you have moved it, as he/she needs to document it.
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Do not “clean up” the scene by removing or washing blood stains from certain areas.
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If your patient is a suspect for ballistic evidence, a glove or a plastic bag should be placed over his hands to avoid accidently removal of gunshot residue. Provided there are no injuries to the suspect’s hands.
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Keep unnecessary people and staff away from the scene. If there are any witnesses near the patient, ask them to either wait outside or get the police to remove them. Suspects and witnesses should never be together in the same room.
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If your patient was shot, do not cut through the bullet hole in the clothing.
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Sexual assault patients should not wash themselves and not remove their clothes. If this was done, the clothes should be placed in a bag and marked. Ask the patient if the clothes he/she is wearing at this moment is the clothes that he/she wore at the time of the incident.
Whenever you resuscitated a patient you should leave all disposable equipment on the patient. Anything from endotracheal tubes to intravenous lines should be left on the patient. ECG electrodes and bandages should not be removed. You should inform the investigating officer of all medication given to the patient or alternatively supply him/her with a copy of your patient report form.
Hard to believe, but this can actually assist the pathologist during the autopsy.
These are only a few things that we can do to help investigators bring perpetrators to justice.
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