Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Melbourne, VIC, Australia.
Department of Clinical Forensic Medicine, Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Melbourne, VIC, Australia.
Forensic Sci Med Pathol. 2022 Jun;18(2):165-169. doi: 10.1007/s12024-022-00460-x. Epub 2022 Feb 9.
Emerging evidence suggests that an onset or escalation of interpersonal violence has been occurring during the COVID-19 pandemic, particularly among persons in intimate or familial relationships. Strangulation (or neck compression) is a common form of interpersonal violence and can result in serious adverse health outcomes, including death. The identification and attribution of injuries from non-fatal strangulation are complex, as there may be an absence of external signs of injury and their appearance may be delayed by many days. There is a heavy reliance on clinician identification of 'red flag' symptoms and signs, the presence of which necessitates urgent further assessment. Additional challenges arise when acute non-fatal strangulation symptoms and signs are shared with other clinical conditions. In such cases, differentiating between the conditions based on the symptoms and signs alone is problematic. We present the diagnostic challenges faced when conducting forensic assessments of COVID-19-positive and suspected COVID-19 (S/COVID) patients following allegations of non-fatal strangulation in the setting of physical and sexual assaults. The implications of shared symptoms and signs, for forensic clinicians, primary healthcare, and emergency practitioners, as well as other frontline service providers, are discussed.
新出现的证据表明，在 COVID-19 大流行期间，人际暴力的发作或升级一直在发生，特别是在亲密或家庭关系中的人之间。勒杀（或颈部压迫）是一种常见的人际暴力形式，可导致严重的健康不良后果，包括死亡。非致命性勒杀伤的识别和归因很复杂，因为可能没有外部损伤迹象，而且它们的出现可能会延迟数天。临床医生识别“红旗”症状和体征的依赖性很强，这些症状和体征的存在需要紧急进一步评估。当急性非致命性勒杀症状和体征与其他临床情况共享时，会出现额外的挑战。在这种情况下，仅根据症状和体征来区分这些情况是有问题的。我们介绍了在身体和性侵犯后对 COVID-19 阳性和疑似 COVID-19（S/COVID）患者进行法医评估时所面临的诊断挑战。讨论了共享症状和体征对法医临床医生、初级保健医生和急诊医生以及其他一线服务提供者的影响。
