Design and implementation of a local Health Alert Network.

The Centers for Disease Control and Prevention began implementing a national Health Alert Network (HAN) to act as a communications infrastructure for response to bioterrorist events and other emergencies. State and local health departments are starting to use this communication system. The implementation and use of the HAN at the local level is different from use at the state and federal level. At the local level, the users are often responders in the field rather than in office settings and they may be in direct contact with hazards and agents. Monroe County, New York, developed a local HAN by forming an extranet among four county existing networks.

Impact of color blindness on recognition of blood in body fluids.

BACKGROUND: Color blindness is a common hereditary X-linked disorder. OBJECTIVE: To investigate whether color blindness affects the ability to detect the presence of blood in body fluids. METHODS: Ten color-blind subjects and 20 sex- and age-matched control subjects were shown 94 photographs of stool, urine, or sputum. Frank blood was present in 57 (61%) of the photographs. Surveys were done to determine if board-certified internists had ever considered whether color blindness would affect detection of blood and whether an inquiry on color blindness was included in their standard medical interview. RESULTS: Color-blind subjects were significantly less able to identify correctly whether pictures of body fluids showed blood compared with non-color-blind controls (P =.001); the lowest rate of correct identifications occurred with pictures of stool (median of 26 [70%] of 37 for color-blind subjects vs 36.5 [99%] of 37 for controls; P<.001). The more severely color-blind subjects were significantly less accurate than those with less severe color deficiency (P =.009). Only 2 (10%) of the 21 physicians had ever considered the possibility that color blindness might affect the ability of patients to detect blood, and none routinely asked their patients about color blindness. CONCLUSIONS: Color blindness impairs recognition of blood in body fluids. Color-blind individuals and their health care providers need to be made aware of this limitation.

Getting involved in the legal system: choice or chance?

The legal system and the laboratory are becoming involved with each other on a daily basis today and the technologist is, willingly or unwillingly, being drawn into this unfamiliar arena. This article will explain some of the manner by which a part of that arena operates, specifically the trial courts. Whether civil or criminal, these courts are governed by rules and methods of operation for the persons in them. In the case of the laboratorian, the role is that of witness, and this article attempts to dispel any fears of that role and teaches how to best prepare for it.

Characteristics of silenced firearms and their wounding effects.

The rate of seizure of illegally held silenced handguns has risen dramatically in recent years. Despite this, there are apparently no reports of wounds caused by these weapons. The efficiency, in terms of noise reduction, of silenced handguns is largely determined by construction, and homemade weapons are frequently more efficient than their commercially manufactured counterparts. Wounds are likely to be inflicted at either contact or close range. Muzzle imprints are erythematous rather than abraded and disproportionately large for the size of the wound. Close-range wounds frequently exhibit atypical entrances. Examination of wound edges by energy-dispersive analysis of X-rays may demonstrate the presence of unusual elements, sometimes associated with components of the silencer. Also, inspection of recovered bullets with the naked eye may reveal damage indicative of modifications to the barrel or misalignment of the device. With these criteria it should be possible in many cases to support or refute the suggestion that a silenced weapon had been used to inflict a given wound.

Characteristics and wounding effects of a black powder handgun.

Commercial exploitation of the recent increase in interest in American history has led to an increased availability of weapons designed to use black powder (gunpowder). In some states, controls on these weapons are poor or nonexistent. In this study a .44-caliber black powder revolver is described and compared with a .45 ACP modern revolver. The kinetic energies of their missiles were very similar. In addition to the usual wound appearances determined by range and direction of fire, it was noted that the soot associated with wounds from the black powder handgun was much greater than from the control and had a characteristic sulfurous smell. Much more true tattooing was present around the black powder wounds. The spherical shape of the missile and the presence of black powder in crypts in the missile base were both characteristic of a black powder revolver. Striations were well represented on the ball but were easily destroyed during recovery because the lead was so soft. Swabs from around the wounds and from the shooter's hand revealed a large deposit of barium but little antimony. Wounds inflicted by black powder handguns may be detected more or less reliably.

Professional responsibilities and liabilities of the pathologist concerning the problem drinker.

The single area of operation in which the clinical laboratory is involved with the law most frequently is that concerning blood alcohol levels. Whether drawing a specimen at the request of a police officer or analyzing it for a blood alcohol level, the laboratory is involved in the legal process. This article discusses the various legal theories and problems surrounding this procedure to give the pathologist and technologist the knowledge required to respond to a request by a police officer. The legal problems surrounding the analysis of such a specimen are also elaborated upon. Since court testimony may be required, the article discusses how to prepare for such testimony and what to expect in court as a witness.