ACEP Forensic Medicine Section Spotlight: Practical Skills for Trauma-Informed Care, Documentation, and the Legal Realities of EM

In this ACEP Early Career Physicians spotlight, Dr. Laurel Barr talks with Dr. Monika Pitzele (Chair) and Dr. Lauren Hudak (Vice Chair) about how the Forensic Medicine Section equips emergency physicians with practical, integrated skills to care for patients affected by trauma and violence—while strengthening documentation, systems of care, and legal readiness.

What the Section offers

Forensic emergency medicine shows up in everyday practice: sexual assault, domestic violence, child and elder abuse, strangulation, trafficking, firearm and stab wounds, and other injuries where how we document and how we communicate matters for both care and downstream processes. The section’s work focuses on helping ED clinicians deliver trauma-informed care, document accurately, and collaborate with forensic/legal systems.

Why this matters for early-career physicians

Both Drs. Pitzele and Hudak had similar “aha” moments where they realized that a lot of us get only minimal forensics training, basically a learn it as you go situation, even though these cases come up all the time in the ED. The FMS can be a “home” for mentorship and practical tools like job descriptions, protocols, and program models that you can bring back to your department without reinventing the wheel.

Resources you can use now

• Two free e-books (sexual assault care and domestic violence), available through the section website for ACEP members
• “Forensic Facts” quick pearls with clear “do/don’t” guidance (short, accessible, and archived)

Program building: trauma-informed, interdisciplinary forensic care
A key section priority is expanding interdisciplinary forensic services in emergency departments, including forensic nursing programs and patient advocacy support, particularly in high-volume trauma centers. These programs distribute time-intensive forensic responsibilities across trained team members, reducing reliance on a single emergency physician to conduct an hours-long exam while simultaneously managing overall ED throughput.

With trained forensic examiners and advocates in place, departments can provide more standardized, trauma-informed workflows. This includes setting expectations for the patient, offering continuous support during prolonged visits, and using consistent methods for evidence collection, photography, and medical record documentation. The result is more reliable clinical and forensic documentation and a care process that is more structured for both patients and clinical teams.

“What do I do when I get subpoenaed?”

A reality many clinicians face: you can handle a case today and still get a subpoena two or three years later, when the details aren’t fresh. The section helps demystify that process with webinars on testimony, including the difference between being a fact witness (sticking closely to the medical record) and an expert witness (broader questions, sometimes with requests for your CV or publications.)

Documenting with care and clarity

Write it down in detail, but keep it objective. Describe wounds clearly, note observations and affect, and avoid wording that sounds like you’re taking sides. And when it’s appropriate, take photos. If your EMR supports it, add images with a ruler for scale when you can. Years later, even a basic photo can be more helpful than trying to rely on memory.

Closing takeaways

Forensic medicine isn’t separate from emergency care. It shows up in the ED every day, and having the right skills can make a real difference for patients and for your team. This spotlight highlights three practical themes: using trauma-informed approaches that support patients without adding to their experience, documenting injuries and findings in a way that holds up over time, and leaning on a community of mentors and resources when cases move into the medical-legal space.

Get involved

Start by joining one of the section’s quarterly virtual meetings (and keep an eye out for the May meeting and webinar), then connect in person at ACEP26 to meet mentors and other members. If you’d rather begin on your own time, the Forensic Medicine Section webpage has archived resources and content you can browse anytime.