Crit Care Nurs Q Vol. 33, No. 2, pp. 190–199 Copyright c  2010 Wolters Kluwer Health | Lippincott Williams & Wilkins CSI: New @ York Development of Forensic Evidence Collection Guidelines for the Emergency Department Peter J. Eisert, BS, RN, SANE-A, SANE-P; Kelli Eldredge, MSN, RN, CCRN, SANE-A; Tami Hartlaub, BSN, RN, CEN; Emily Huggins, MHA, RN, SANE-A, SANE-P; Geneva Keirn, BSCJ, RN, SANE-A; Patti O’Brien, RN, SANE-A, SANE-P; Heather V. Rozzi, MD, FAAEM, FACEP; Linda C. Pugh, PhD, RNC, FAAN; Karen S. March, PhD, RN, CCRN, ACNS-BC Emergency department (ED) nurses care for victims of trauma almost daily. Although preserva- tion of evidence is crucial, the ED is chaotic when a trauma patient arrives and staff members must do everything possible to save the patient’s life. However, an integral responsibility of the staff nurse is collection and preservation of forensic evidence. This article provides insight into the process undertaken by a multidisciplinary team to develop a set of evidence-based guidelines for forensic evidence collection. The team compiled evidence from more than 20 articles and consultations with law enforcement officials and forensic experts. This information was used to develop a set of guidelines for forensic evidence collection in the ED or operating room. Staff edu- cational needs presented some challenges. Training was designed to specifically address the roles of three major groups of staff: patient representatives and emergency and trauma nurses. Educational topics included evidence recognition, handling of clothing, gross/trace evidence, documentation, packaging of evidence, and use of the “chain-of-evidence” form. Practice modifications included development of a new “chain-of-evidence” form, a forensic cart in the operating room, and use of a collapsible plastic box for collection of clothing in the ED. Key words: chain of custody, evidence-based practice, evidence collection, forensics, forensic guidelines T HE “trauma alert” page goes out to the trauma team, indicating the pending ar- Author Affiliation: York Hospital, York, Pennsylvania. The authors have not received funding for this project form the National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI), or oth- ers. We thank Nicole Shue, BS, RN, and Heidi Wilkerson, BSN, RN, ATCN, of York Hospital, York, Pennsylvania. Corresponding Author: Peter J. Eisert, BS, RN, SANE-A, SANE-P, Neonatal ICU/Sexual Assault Forensic Exam- iner Team, York Hospital, York, PA 17403 (peisert@ wellspan.org). rival of a gunshot victim that will be arriving by ground transport within 5 minutes. The team gathers in the trauma resuscitation area and prepares for the arrival of the ambulance. The patient is transferred from a gurney and remaining clothing is quickly removed and dropped onto the floor, only to be stepped on and kicked out of the way by staff. Medics leave, tossing the litter sheet into a hamper on their way out. The patient is evaluated, sta- bilized, and prepared for surgery. Afterward, a staff member picks up the clothing and places it all in a single paper or plastic bag, which is then handed off to the police. 190