Injuries (Major Trauma, Non-Accidental and Accidental, Occupational)

Depending on the location of the program (acute care hospital versus community clinic versus family justice center), one area of expanded practice is consultation in injury cases. The injuries may be the result of major trauma such as physical assaults, gunshot wounds, stabbings, or pedestrians struck, or from motor vehicle crashes, a fall down the stairs, or work-related injuries. The use of a forensically trained SANE can identify accidental versus inflicted injuries, improve documentation and treatment, and provide a variety of testimony, as necessary.

Considerations for this type of expansion include, but are not limited to—

1. Which types of patients can be seen given the setting and what is the scope of services that can be delivered (e.g., will deceased patients become the legal responsibility of the coroner or medical examiner)?
2. What response time will be required, and can the program handle the expectation? Where will the services be provided (e.g., in the ICU when the program typically functions in the ED)?
3. What training of program staff will be necessary?
4. What collaborators will need to be part of the program?
5. How will others (departments and staff) be trained in the use of the SANE program?