For most applications, the camera can be kept in automatic mode, which will choose the correct settings and capture desirable images. For close-ups, the mode dial should be set to the macro setting. For initial settings, file format should be set to JPEG, image quality to fine, and image size to largest.
Explore This IssueACEP Now: Vol 36 – No 02 – February 2017
Prior to taking photographs, a picture of the patient’s identifying information should be taken. This should include the patient name, medical record number, date, and time. A hospital ID sticker is ideal. Next, a picture of the photographer’s ID should be taken.
A facial image or full-body image can be taken to identify the patient. When taking pictures of an injury or other finding, a “forensic series” of images should be taken:
- Overview (includes two anatomic landmarks for orientation)
- Mid-range (closer, includes one anatomic landmark)
- Close-up (one with and one without a reference scale)
The overview and mid-range shots may include more than one finding. However, the close-ups should each include a single injury.
A reference scale should always be used. The most popularly used scale is the American Board of Forensic Odontology scale (ABFO-2). This has the advantage of showing the distortion of the photograph. If an ABFO scale is not available, a small ruler or coin can be used. The scale should not obscure the finding(s) and should be positioned on the same plane as the finding and at an equal distance from the camera.
Make sure your camera is oriented 90 degrees to the injury. This ensures the most accurate representation of the injury. Also, make sure the background is free of clutter.
Take as many pictures as needed to best represent the finding. Never delete a picture no matter how bad it is. Also, photographs should not be manipulated, and if photographic software is used to enhance an image, the original image should be saved, and for each altered image, documentation of how it was altered should be provided.