Forensic study about how to deal with Sharp Force Injuries –causes and treatment,Sharp Force Injuries is an injuries produced by pointed objects or objects with sharp edges.
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Can be defined as Injuries produced by pointed objects or objects with sharp edges are referred to as “sharp force injuries.” Sharp force injuries are characterized by a relatively well-defined traumatic separation of tissues, occurring when a sharp-edged or pointed object comes into contact with the skin and underlying tissues. Three specific subtypes of sharp force injuries exist, as follows: stab wounds, incised wounds, and chop wounds.
Common Causes of Sharp Force Injuries
- Common causes of sharp force injuries in forensic settings include injuries from
- Violence
- Accidents
- Suicide
- Homicide
- Disaster
- Common objects that can cause sharp injuries include;
- Straight edged razor
- Knives
- Glasses
- Swords
- Axes
- Hatchets
- Meat cleavers
- Bayonets
The most common symptoms and signs of sharp force injuries
- The most common symptoms and signs of sharp force injuries include pain, swelling, redness, bleeding and tenderness.
- Other clinical features will depend on the type of sharp force injuries like;
- Stab wounds
- Are produced by pointed instruments and the depth of the wound track in the body exceeds its length in the skin.
- The edges of the wound in the skin are typically sharp without abrasion or contusion.
- Most of stab wounds are homicidal
- In describing stab wound one should never use the term laceration.
- Incised Wounds
- Incised wounds or cuts are produced by sharp-edged weapons or instruments.
- The sharp edge of the instrument is pressed into and drawn along the surface of the skin, producing a wound whose length is greater than its depth.
Some of incised wound are self inflicting and they have tail at the end (start as deep and end as a tail.
- Chop Wounds
- Chop wounds are produced by heavy instruments with a cutting edge, e.g., axes, machetes, and meat cleavers.
- The presence of an incised wound of the skin, with an underlying comminuted fracture or deep groove in the bone, indicates that one is dealing with a chopping weapon.
Investigations of Sharp Force Injuries
- Investigation process in forensic medicine involves examination of the body and laboratory, radiological, pathological and others depending on the case.
- Examination will involve general, local examinations and systemic examination; general examination is concerned with looking at the whole body of the client from head to toe.
- Local examinations involve examination wounds in order to determine size, depth, nature of the wound, nature of the margins and the base and describe the wound in terms of its direction.
- Investigations of these injuries need to be carefully done and documented because its findings are going to be used before the court of law.
- All the findings should be documented properly in patient’s file and relevant legal document e.g. PF3, right and assurance form.
Treatment of Fatal and Non-fatal Sharp Force Injuries
- Treatment of non fatal sharp injuries involves:
- Debridement, stitching, wound dressing etc
- Ant pain injectables or tablets like paracetamol etc
- Anti inflammatory if needed
- Oral antibiotics
- Tetanus toxoid vaccine if needed
- Refer if needed
- Treatment of fatal sharp injuries
- Ensure Airway, Breathing and Circulation
- Intravenous fluid like ringers lactate, normal saline
- Debridement, stitching, wound dressing etc
- Ant pain injectables
- Intravenous antibiotics as a stat dose
- Refer
Refer Fatal Sharp Injuries for Post-mortem Examination
- Deaths occurred as a result of confirmed/suspected medical legal sharp force trauma/injuries should be referred to higher level health facility for post-mortem examination.
- In case, the deceased had arrived at health facility while alive, the health provider should be aware of the legal obligation and be able to recognize pattern of injury and document his observation in a manner consistent with legal standards.
- While referring dead body for post-mortem examination, remember to include detailed information of clinical presentation on arrival and what has been done at your facility.
Linkage for Continuum of Care
- A care delivery approach that links medical services, police, legal services and social support services within a confined geographic area.
- Requires a well-functioning referral system.
- Referrals within and between health facilities:
- Referrals within can be between OPD, IP and gender desk if available
- Referral between can be heath facility and police, legal services or social welfare office if not available at the health facility.
Preventive Measures of Sharp Force Injuries
- Eliminating the unnecessary use of sharps
- Incorporating safety-engineered protection mechanisms
- Implementing safe systems of work
- Using personal protective equipment
- Information and training