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Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.

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Treatment of almost all medical conditions has been affected by the COVID-19 pandemic. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Please visit to see if there is temporary guidance issued by NICE in relation to the management of this condition, which may vary from the information given below.

A forensic medical examination is a top-to-toe examination looking for injuries and taking samples that may be used as evidence in a police investigation and any subsequent prosecution. A forensic examination can be very time-consuming but is vitally important. Histories from caregivers should be obtained separately and as soon as possible; careful documentation is essential. A forensic examination should only be performed by a health professional who has the appropriate training and with appropriate facilities available. Much of the following can be applied to adults and younger patients.[1, 2]

General principles

  • Remember to take your time; look, record and look again; you only get one chance to get it right!
  • Consult with the requesting officer and agree procedures.
  • Obtain full informed consent (and record any failure of co-operation).
  • Check antecedents; record a brief chronology of events.
  • Think ahead; is the person fit to be detained/interviewed?
  • Assess the patient's understanding and state of mind.
  • Secure a chain of evidence; complete all required forms.
  • Where required and appropriate, prescribe any treatment, and issue instructions for care.
  • Consider whether a re-examination is necessary and when.
  • Record abuse verbatim if possible.
  • Record reasons for any refusal.


  • Obtain the medical forensic history in a private, quiet setting.
  • Consider and address the patient's needs prior to information gathering, including identifying the level of his/her communication skill.
  • Ask about past medical history, current health, drugs or medicines.
  • List the complaints.
  • Ask for explanation of injuries seen and accurately record the answers.


  • Carry out a general medical examination.
  • Carry out a specific examination (eg vaginal and pelvic examination following sexual abuse/assault) and collect samples.
  • Examine the body surface fully, or record why any areas were not examined.
  • Use a magnifying glass on lesions; this can reveal information on causation.
  • The record of the position of injuries should be unequivocal; use body diagrams/sketches.
  • Consider whether photography is required (written consent is necessary); photographs of any injuries should ideally be taken by a qualified medical photographer.

Brief definitions

  • Bruises (contusions): caused by blunt force, initially at point of contact, but can enlarge or track down tissue planes under the influence of gravity. May not be visible initially. Pattern may indicate the agent responsible, eg a number of 'finger' bruises on the upper arm, indicating the victim being grabbed.
  • Petechial bruises sometimes reproduce texture of clothing, and may be produced by asphyxia.
  • Abrasions: epidermal injury (not full thickness) always indicates the point of injury. One side may be raised, indicating the direction of the blow/injury.
  • Lacerations: full-thickness skin injury, ragged, caused by blunt force. The shape may indicate the agent responsible.
  • Incisions: sharp cutting implements, clean edges without abrasions.

Consider differential diagnosis of injuries found on examination - for example:

Consider appropriate further investigations - for example:

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