Alternate Light Source ( ALS ) Detection Does Not Confirm Occult Bruises

ABSTRACT Almost all victims of assault and strangulation who seek medical care receive their initial medical care in the emergency department (ED), and many patients are referred to forensic nurses during or immediately after the ED evaluation. While providing medical care to the patient, one important purpose of the forensic examination is to accurately identify and document injuries sustained from the assault and clearly differentiate observed findings that are unrelated to the allegations. Alternate light sources (ALS) have been promulgated by many forensic nurses for the enhancement or detection of bruises, including clinically occult bruises, in patients after physical and sexual assault. The published literature, however, does not support this conclusion. We discuss the reasons for this controversy and the medical and legal implications of practitioners continuing to promote ALS as a tool to diagnose clinical occult bruising. This article is categorized under: Forensic Medicine > Forensic/Sexual Assault Nurse Examiner Jurisprudence and Regulatory Oversight > Expert Evidence and Narrative Forensic Biology > Interpretation of Biological Evidence