Algorithm on practical skill
Algorithm on practical skill (алгоритм по практическому навыку)
1. External examination of the dead body with preparing of the protocol (наружный осмотр трупа с составлением протокола).
1. Study of situational task.
2. Describe the position of a corpse and location of body parts (head, hands, legs, mutual disposition of the body parts relative to each other) the objects that are placing on/under the body or near it.
3. Describe the state of the hands.
4. Describe the state and position of the clothing and footwear on the corpse.
5. Describe gender, approximate age, body constitution, color of skin, visible mucosa, the state of the pupil, cornea, state of natural orifices, special signs (for example, tattoos, etc.)
6. Describe the nature of the early cadaver changes (location and nature of the cadaveric spots, the degree of cooling of parts of the body, rigor mortis, cadaveric drying, measurement of temperature of body and the temperature of the environment).
7. Describe the nature and degree of late cadaveric changes (putrefaction, mummification, adipocere, peat tanning and others.) The presence of extraneous odors.
8. Description of corpse body damages, their location, the nature, size, shape, features of edge and ends, overlay, marks like blood.
9. Description of corpse bed state.
Algorithm on practical skill (алгоритм по практическому навыку)
2. Determination of the time of death (установление давности наступления смерти).
1. Study of situational task.
2. Determination of the time of death based on the body temperature (in the axilla, rectum, if possible, in the liver tissue) and the environment temperature.
3. Determination of the time of death according to the cadaveric spots (based on their color, intensity, color change in dosed pressure and time of their recovery).
4. Determination of the time of death according to the degree of rigor mortis (taking into consideration its prevalence and expressions in the muscles of the body).
5. Determination the time of death according to rigor mortis, the change of the pupil shape in pressure on the eyeball, and the others.
6. Determining the nature and expressions of late cadaveric changes (putrefaction, mummification, adipocere, peat tanning and others), indicating the degree of their severity and localization.
Algorithm on practical skill (алгоритм по практическому навыку)
3. Description of the injuries (bruises, abrasions, wounds) on the dead body and living person (описание телесных повреждений (кровоподтеки, ссадины, раны) при осмотре трупа и судебно-медицинской экспертизе живого лица).
1. Study of situational task.
2. Specify the type of each of damage (bruise, abrasion or wound) separately.
3. Localization – an anatomical area of the body and a distance from damage to nearby anatomical landmarks on a rectangular coordinate system (if necessary, the distance from the each damage to the plantar surface of the foot is measured).
4. The form of damage indicated in relation to the geometrical figures.
5. The dimensions of damages specified only on the metric system, the direction of the body axis.
6. To indicate the color of damage the basic colors and shades are used.
7. The feature of the edges and ends, the fundus of the wound, the wound channel occurrence, features of abrasions relief, signs of inflammation or wound healing.
8. Describe the overlay and pollution, the state of the surrounding tissues.
Algorithm on practical skill (алгоритм по практическому навыку)
4. Determination of the feature and mechanism of wounds (gunshot wounds, lacerations, incised wounds, stab wounds, chopped wounds) (определение характера и механизма образования ран (огнестрельные, ушибленные, резаные, колото-резаные, колотые, рубленые).
1. Study of situational task.
2. Specify the type of each damage separately.
3. Localization - the exact anatomical area of the body and the distance from damage to nearby anatomical landmarks on a rectangular coordinate system (if necessary, the distance from the each damage to the plantar surface of the foot is measured).
4. The form of damage is indicated in relation to the geometrical figures.
5. The dimensions of damages specified only on the metric system, the direction of the body axis.
6. The basic colors and shades are used to indicate the damage of color.
7. Describe the features of the edges and ends, the fundus of the wound, the wound channel occurrence, signs of inflammation or wound healing.
8. Describe the overlay and pollution, the state of the surrounding tissues.
Algorithm on practical skill (алгоритм по практическому навыку)
5. Description and determination of mechanism of the shaft (diaphyseal) fracture caused by transversal action of the blunt subject (описание и определение механизма образования диафизарного перелома длинной трубчатой кости от действия тупого предмета в поперечном направлении).
1. Perform a visual (stereomicroscopic) study on the fracture fragment of a long bone.
2. Establish the location of fracture zone on bone: the type of a surface of the diaphysis it is, the orientation of the fracture line relative to the longitudinal axis of the bone, the state of bone fragments edges, the degree of joining of bone fragments, fracture surface; presence of additional cracks on the bone.
3. The presence of additional «fan-shaped» cracks on the "lateral" (relative to the fracture zone) surfaces of diaphysis, their direction.
4. Establish the place of traumatic force exposure on bone: determine the surface of the bone its localization, the orientation of the fracture line relative to the longitudinal axis of the bone, the state of the edges and fracture, longitudinal cracks, the bone fragments (their shape, the location of base and top).
Algorithm on practical skill (алгоритм по практическому навыку)
6. Description and determination of mechanism of the flexing and extensing rib fractures (описание и определение механизма образования сгибательных и разгибательных переломов ребер).
1. Perform a visual (stereomicroscopic) study of fracture on the fragment of rib.
2. Establish the location of fracture zone on rib: determine the surface of the rib, the orientation of the fracture line with the longitudinal axis of the rib, the state of rib fragments edges , the degree of joining of rib fragments, fracture surface; presence of additional cracks on the rib.
3. Establish the place of traumatic force exposure on rib: determine the surface of the rib, a fracture line orientation relative to the longitudinal axis of the rib, the state of rib fragments edges, the degree of joining of rib fragments, fracture surface; presence of additional cracks on the rib.
Algorithm on practical skill (алгоритм по практическому навыку)
7. Formulation of the medico-legal diagnosis based on the results of autopsy if death was caused by mechanical injury(es), mechanical asphyxia, hypothermia, electricity (формулировка судебно-медицинского диагноза по результатам вскрытия трупа в случаях смерти от механических повреждений, механической асфиксии, отравлений, переохлаждения, действия технического электричества).
1. Study of situational task.
2. Study of objective data obtained during autopsy, expertise results (forensic chemical examination, forensic histological examination, etc.) available for the solution to this concrete problem, clinical, instrumental and laboratory data obtained from the medical records of healthcare organizations (according to the task).
3. Drawing up a forensic medical diagnosis indicating: underlying disease, a complication of the underlying disease, concomitant diseases (diseases with the code). In identifying ethyl alcohol in cadaver after the diagnosis its concentration in biological fluids is indicated.
4. Thus, the forensic medical diagnosis should be structured and use headings.
Algorithm on practical skill (алгоритм по практическому навыку)
8. Description and determination of the mechanism of elementary blood traces (spots) (описание и установление механизма образования элементарных следов крови).
1. Study of situational task.
2. The description of all traces of blood should include: location, name, form, size. Furthermore, in the description of the pool of blood it is established the following: detailed description of the edges, the presence of imprint in clot; traces of drawing (the direction of the bands, their width, character of edges and ends); impregnation of blood (the establishment the side (front or underside) of blood clothes impregnation; drips (the direction and the form of the ends of the drips); drops (the size of the area with traces of blood drops, the number of them, the presence of secondary spattering of splash on the periphery, detailed description of the edges); splash (the size of the area with traces of blood splash, its form, the number of splash, the direction of oval splash, the direction of the sharp ends and a point elements, (in teardrop shape of splash or in the form of an «exclamation mark»); smears and imprints: detailed description of the edges.
3. Determination of the mechanism of formation of blood traces (spots).