Oxford Handbook of Forensic Medicine 1st edition by Jonathan Wyatt, Tim Squires, Guy Norfolk, Jason Payne James ISBN 0191653241 9780191653247

1. Scope of Forensic Medicine

• Introduction to forensic medicine
• History of forensic medicine
• Developing clinical forensic medicine
• Forensic medicine around the world
• Professional bodies and discipline
• Forensic organizations
• Consent
• Mental capacity
• Confidentiality
• Preparing a witness statement
• Sample witness statement
• Appearing in court
• Professional and expert medical evidence
• Medical negligence

2. Forensic Aspects of Death

• Definition and diagnosis of death
• Changes after death: lividity
• Rigor mortis
• Changes after death: decomposition
• Time interval since death
• Death scene investigation
• The coroner system in England and Wales
• Coroner’s inquest
• Fatal accident inquiry in Scotland
• Homicide
• Serial killers
• Suicide
• Dyadic death
• Sudden death from natural causes
• Accidents as a cause of death
• Environmental causes of death
• Deaths during sport
• Specific sport-related deaths
• Cardiovascular collapse during exercise
• Trauma scoring

3. Forensic Autopsy

• The autopsy: terminology and definitions
• Historical perspective
• Forensic or clinical autopsy
• Forensic autopsy procedure: summary
• The autopsy report
• External examination
• Forensic autopsy: evisceration
• Dissection: cardiovascular system
• Dissection: respiratory system
• Dissection: endocrine system
• Dissection: digestive system
• Dissection: lymphatic system
• Dissection: musculoskeletal system
• Dissection: cranium and nervous system
• Dissection: genitourinary system
• Autopsy samples: legal aspects
• Autopsy samples: histology and toxicology
• The pediatric forensic autopsy
• Exhumation
• Mass graves and war crimes
• Health and safety issues
• High-risk autopsy
• Infection risks of autopsy
• Death certification

4. Asphyxia

• Definitions and historical perspective
• Clinical features of asphyxia
• Strangulation
• Hanging
• Compression asphyxia
• Smothering
• Choking
• Autoerotic asphyxia
• Drowning

5. Forensic Pathology of Physical Injury

• Injury classification
• Terms used to describe injuries
• Describing injuries
• Body diagrams
• Bruising
• Progression of bruising with time
• Lacerations, abrasions, and scratches
• Incised wounds
• Stab wounds
• Slash wounds
• Skin wound healing
• Defence injuries
• Intimate partner violence and abuse
• Elder abuse and neglect
• Torture
• Scalp injury and skull fracture
• Primary brain injury
• Traumatic intracranial hemorrhage
• Further complications of brain injury
• Facial injury
• Spinal injury
• Chest injury
• Abdominal injury
• Fractures of the pelvis and extremities
• Burns
• Explosive injuries
• Investigations after an explosion
• Firearms
• Rifled gunshot injuries
• Shotgun injuries

6. The Police Custody Unit

• The custody unit
• Purpose of detention
• Police and Criminal Evidence Act 1984
• The custody record
• Conditions of detention
• The forensic physician
• Vulnerable persons in custody
• Appropriate adults
• Solicitors and legal representatives
• Fingerprints and drug testing
• DNA and the national database
• Non-intimate and intimate samples
• Intimate searches
• Approach to custody work
• Personal safety
• The medical room
• Documentation
• Assessing fitness to detain
• Instructions to custody staff
• Levels of observation by custody staff
• Detainees requiring continuing healthcare
• Prescribing medication
• Deaths in custody

7. Life-Threatening Emergencies in Custody

• Approach to life-threatening custody emergencies
• Airway obstruction 1
• Airway obstruction 2
• Choking
• Near hanging
• Tension pneumothorax
• Respiratory arrest
• The recovery position
• Cardiac arrest in custody
• Modified advanced life support
• Shock
• Epileptic fit
• The unconscious patient
• Suspected meningitis

8. Assessing and Managing Illness in Custody

• Assessment of illness
• Management of chronic illness
• Diabetes
• Chest pain
• Palpitations
• Breathlessness
• Asthma
• Alcohol intoxication
• Alcohol withdrawal
• Other problems of alcoholics
• Detainees under the influence of drugs
• Drug withdrawal
• Body packers, pushers, and stuffers
• Other presentations and problems

9. Assessing and Managing Injury in Custody

• Approach to assessment of injury
• Clinical assessment of injury
• Documenting injuries
• Restraint techniques and injuries
• Chemical restraint agents
• Handcuffs
• Injury from police weapons
• Taser
• Head injury from a custody perspective
• Head injury assessment
• Referral of head injury to hospital
• Custody management of head injury
• Facial injury
• Spinal injury
• Dermatomes
• Skin wounds
• Bite wounds
• Closed limb injury
• Upper limb injury
• Lower limb injury
• Blunt chest injury
• Abdominal injury

10. Traffic Law and Medicine

• Road traffic accidents in perspective
• Road traffic safety
• Investigating road traffic collisions
• Patterns of injury in fatal road trauma
• Patterns of fatal pedestrian injury
• Patterns of injury in fatal collisions: vehicle occupants
• Fatal injury patterns: motorcyclists and cyclists
• Medical conditions and fitness to drive
• Alcohol and driving performance
• Drink-driving legislation
• Provision of specimens for analysis
• Taking blood samples in a police station
• Hospital procedures
• Failure to provide samples under the Road Traffic Act
• Failure to provide blood and/or urine
• Failure to provide a breath sample
• Field impairment testing by police
• Medical examination of drug-impaired drivers
• Drugs and driving performance
• Drugs and driving: cannabis
• Drugs and driving: opioids
• Drugs and driving: benzodiazepines
• Drugs and driving: stimulants

11. Adult Sexual Assault

• Definitions and law
• Background to adult sexual assault
• Examination suites
• Principles of assessment
• Assessment procedure
• History of assault: the complainant
• Further medical history: complainant
• Examination for adult sexual assault
• Female genital examination
• Male genital examination
• Anal examination
• Examination of suspects
• Collecting forensic samples
• Persistence of forensic material
• Sexual assault examination kit
• Documentation of findings
• Interpretation of genital findings
• Interpretation of anal findings
• Treatment, counselling, and follow-up
• Appearance in court

12. Child Abuse and Neglect

• Background and historical perspective
• Types of child abuse
• Medical approach to child abuse
• Children Act 1989 and 2004 (England and Wales)
• Physical abuse: medical perspective
• Presentation of physical abuse
• Physical abuse: examination
• Physical abuse: interpreting findings
• Development of sexual characteristics
• Sexual abuse: presentation
• Sexual abuse: approach to examination
• Sexual abuse: examination procedure
• Sexual abuse: interpreting findings
• Recommended terminology
• Female child genital findings
• Anal findings in suspected child abuse
• Sexual abuse and infections
• Neglect and emotional abuse
• Fictitious illness by proxy
• Management of child abuse

13. Psychiatric Aspects

• Introduction
• Definitions of some common terms
• Anxiety disorders
• Mood disorders
• Psychotic illness
• Learning disability
• Psychiatric illness, alcohol, and drugs
• Violent/disturbed behaviour
• Assessment of the mental state
• Assessment of suicide risk
• Fitness for interview
• Fitness to be charged/plead
• Mental capacity and the 2005 Act
• Mental health legislation
• Compulsory hospitalization
• Sections 136 and 135 (Mental Health Act 1983)
• Diversion from the criminal justice system
• Forensic psychiatry
• Forensic psychology

14. Forensic Toxicology

• Introduction to forensic toxicology
• Arsenic poisoning
• Common drugs and poisons
• Toxicology and sudden death
• Signs of poisoning at autopsy
• Postmortem sample collection
• Interpretation of postmortem toxicology
• Controlled drugs legislation
• Alcohol overview
• Alcohol and sudden death
• Toxicological kinetics
• Diamorphine (heroin) and morphine
• Methadone (physeptone)
• Other opioid substitutes
• Stimulants: amphetamines and ecstasy
• Cocaine
• Hallucinogens and related substances
• Benzodiazepines
• Phenothiazines
• ‘Date rape’ drugs
• Poisonous gases
• Volatile substances
• Antidepressants
• Paracetamol poisoning
• Aspirin and non-steroidal poisoning
• Harold Shipman
• Public health
• Drugs in sport
• Drugs and substance dependence
• Glossary of drug terminology

15. Forensic Science

• Introduction to forensic science
• Crime scene management
• Crime scene investigation
• Locard’s principle
• Identification: matching and uniqueness
• The Ruxton case
• Daubert
• Trace evidence: background
• Trace evidence: glass
• Trace evidence: paint
• Trace evidence: hairs and fibres
• Fingerprints
• Forensic analysis of DNA
• Interpretation of DNA analysis
• National DNA database
• Exonerating the innocent
• Forensic biology
• Source of blood
• Blood pattern analysis
• Forensic identification of semen
• Forensic identification of other fluids
• Forensic anthropology
• Forensic archaeology
• Forensic entomology
• Environmental forensics
• Document analysis
• Forensic miscellany
• Fire: background
• Fire prevention and safety
• Behaviour of fire indoors
• Behaviour of fire outdoors
• Fire: investigation
• Explosions and explosives
• Explosion investigation
• The context effect and scientific evidence
• Forensic statistics
• The prosecutor’s fallacy