Evidence

While the average practitioner may not be in a position to collect detailed physical evidence, having a polaroid-type camera in the office or clinic can be very beneficial for the patient.  There may be legal restrictions on using a digital camera (ask local police department). Printing out digital photos right away and sealing them in an evelope may take away the concern of digital manipulation.
If physical evidence is collected, such as bloody clothing, seal in a paper bag, not plastic, as plastic increases mold/bacterial growth.
Photographs
  • Explain photographs will become part of the medical record
  • Have patient sign Form “Consent for Photography”
  • Use a “color bar” on the first picture of the series
  • Take one photo of chart with name/MR#, or ID card/sticker
  • Take one whole body photo with clothes on
  • Take at least one picture of face
  • Use coin or ruler to measure injuries
  • Take photo of torn or bloodied clothing
  • Have patient change to a gown and drape
  • Take a photo of geographical area (i.e. arm) and then a close up of the injury
    • at 90
    • tangential (to best show swelling)
    • from the angle of injury
  • Also take photos of any past, permanent injuries
  • 2 sets of photos should be taken if instant pictures - signed on back by patient, photographer and witness with name, DOB, date, time, MR#.  Place one set in medical record and one in sealed envelope for law enforcement.
  • Ask patient to return in 2 days for follow up evaluation of injuries and repeat photos
  • Establish protocols to insure digital image software is secure from alteration
  • Maintain strict HIPAA privacy protections on photo storage and release

The Polaroid website, which provided the photo above, also provides imaging tips

[Adapted from Guidelines for the Health Care of Intimate Partner Violence, California Medical Training Center, 2004]