Photography in Clinical Practice - Summary

Advice for Examiners

Example of the J88 Form

Advice for examiners

• Photographs are “visual evidence” and therefore need to conform to the principles of maintenance of the chain of evidence.
• The process of safekeeping, transporting, downloading, printing and saving the files should be streamlined and conform to the confidentiality agreements that are standard in health care practice.
• Document in your clinical notes or on the J88 form if photos are taken, describe or add the type of consent obtained, and indicate that photos will be stored on a password-protected computer.
• In criminal cases, when injuries/wounds are extensive or severe, typical of certain clinical presentations (e.g. physical child abuse), or have individualising features, it is very important to record this photographically:
  • Contact the Local Criminal Record Centre (LCRC) of the SAPS and ask that a competent police photographer be dispatched.
  • If a police photographer is unavailable, and the clinician is taking the photograph, use the following guidelines:
    • Ensure proper identification or marking of the photograph (E.g. Patient name, date)
    • Use a ruler/other measuring device (placed next to the wound, to give an idea of the size of the wound)
    • Take close-up photos of wounds (e.g. bruises, lacerations, abrasions, etc)
    • Take mid-range photos of the injuries in relation to the patient’s body
    • Take care with regards to custody of the photographs
    • Note in report and J88 that photographs were taken
• Photographs should as far as possible be taken with a good camera:
  • A resolution of 8 MP (with the camera set at its highest resolution) should be the bare minimum.
  • Take the photograph at a perpendicular (90 degree) angle to the surface.
• Be very careful when using a cell phone to capture photographs.
  • If you do, install applications or software that will “lock” the photo albums and password protect it. 
  • Do not use a cell phone if you are not perfectly comfortable to download images completely and safely to your computer.