Features of organization of medico-legal expert researches in the cases of the mass injuring of victims in the salon of bus

Abstract

The article deals with certain medico-legal aspects of trauma in the salon of bus as one of the types of road traffic accidents with a large number of dead and injured. Are shown the typical causes of such incidents and the nature of the victims injury. Was developed and proposed a modern approach to optimization of expert research in case of appearance a large number of victims in the bus.
 Circumstances of injury in case of personal injury people in the bus are very diverse:− rollover of the bus when transporting a large number of people while driving;− bus falling from height;− a massive collision with a fixed roadside objects;
 − collision with other vehicles; among the latter is the most fatal bus collision with a moving train.Naturally, in these cases, the massive injuries have affected depends on the intensity of injury to passengers in the bus, and the mechanism of damage is determined by the specific form of an accident involving a bus. In such cases, the experts faced, usually with mechanical trauma inside the cabin, and mixed types of injuries passengers (e.g. in case of fire). For in-car trauma characterized by formation damage from the following mechanisms:− shock bodies on the inner part of the interior (interior);− injuries from the shards of broken glass.Basically, the nature of injury is determined by the structural features of the bus, the presence of foreign objects, the location of the victims. If the vehicle rolls over, the occupants people are numerous additional impact. Formed characteristic for the driver damage to the hands, fractures of the sternum fractures of the hips, legs and feet. For passengers is characteristic fractures of the lower limbs, bruised head wounds, fractures and dislocations of the cervical spine when using the seat belts − stripe-like bruises and abrasions ofthe chest and abdomen, broken ribs, collarbone, sternum, in the projection of the belts. Shards of broken glass caused by the multiple linear abrasions and (or) surface or deep cut wounds mainly in the face and upper extremities. In the case of deformation of the bus body can be compression of the bodies are formed by damage to several areas, primarily the chest, abdomen, extremities, accompanied by multiple bilateral rib fractures, ruptures of internal organs. If in the future there is a fire or explosion of the vehicle, the nature of thedamage detected on the bodies will correspond to the combined injury.In cases of injuries in the bus to work with the bodies of the victims begins at the scene. Thus, the Protocol of inspection of the scene and of the corpse in the first place should reflect the data about the mutual position of bodies and (or) their fragments relative to the vehicle and other parts, the distance between them; the condition of clothing, odors from it, the presence of different overlays, damage; contamination of the skin; localization and nature of the injuries on the bodies, the presence of deformations of its individualparts; the presence of traces of biological origin on the vehicle in comparison with the nature of the deformation (damage) of the body.Be sure to note the results of the inspection of the road where there was a traffic accident, a bus traces of blood, and fragments of various things, etc.
 Despite the small percentage of bus injured in world General statistics of fatal injuries, it presents certain difficulties in planning, organization, execution and coordination of forensic work on multi-step liquidation of medical consequences of the accident, usually associated with a large number of victims, gross impact of factors affecting on the bodies of the victims, the need to quickly address some specific issues: establishing at autopsy pathological symptoms that indicate the status of the health of drivers in the period priorto the tragic event; the existence of facts pointing to the use of intoxicating and medicinal substances that depress the nervous system and many others), early identification of all victims. According to the results of the analysis made it impossible to offer modern, optimal, evidence-informed, and until only itremains to be reliable in practice the system approach to the organizational model of forensic activities, while ensuring the interests of the investigation of an accident involving a bus and a large number of victims:1. The preliminary stage of organization expert services. It can conditionally enough be divided into 2 phases:− advance (pre-) phase;− the immediate phase.To the basic questions of the early phases include: early development, coordination and approval of the optimal legislative and other regulatory framework; preliminary methodological, administrative and organizational, theoretical-practical, logistical, software and applied training; exercise reasonable estimates of projected short and long term needs and costs with regard to the peculiarities specified by the tragic events; creation, storage, use and replenishment of the trust reserves, logistical and financial resources areinviolable, is intended solely for use in such emergencies. It also includes the creation, maintenance and continuous improvement of a Single centralized situation center on a temporary or permanent basis, with a good system of departmental and interdepartmental cooperation, primarily containing a - operational information-Supervisory and analytical center for the collection, processing, storage, information exchange and joint action with the threat, occurrence and prevention of emergencies with a large number of victims.Immediately with the receipt of the news of the accident involving a bus and a large number of victims for forensic services begin immediate phase, the main elements of which include:− prompt notification and collection of employees and expert institutions;− an emergency conference call to discuss the organizational, theoretical and practical questions and short specialized trainingon occupational safety, including use of personal protective equipment depending on the nature of the accident and actions are potentially dangerous to health and life of employees and expert institutions factors.All plans of measures are necessarily coordinated and agreed with appropriate representatives of structures of fast reaction, especially when conducting urgent investigative actions in the emergency areas, primarily the inspection of the scene.
 2. The inspection of the crime scene it is advisable to start with a preliminary review («intelligence»), which finally determined the necessity of application of those or other technical means, and the number of specialists who will participate in the inspection.The static phase of scene examination with the participation of forensic doctors is accompanied by clear mapping; mapping, photo - and video fixing of vehicle, various objects; it is noted the exact relative positions of the bus (its parts) and discovered the corpses, fragments of human remains and other biological material. During dynamic examination of the scene produce a detailed external examination of the human remains, their fragments, biological material, perform primary medical sorting, their careful packaging,clear detailed marking. Then performed the proper loading, transportation and unloading. In case of need in a temporary Deposit of biological material, can be used in railway wagons refrigerators, refrigerated trailers, mobile camera with a refrigeration unit, and in the absence or lack of volume for the total number of remains and the biomaterial deploys heat-resistant boxes, fit the space with the use of outdoor mobile air conditioning systems, large amounts of ice obtained from specialized industrial ice makers, etc., which is especially important for braking processes of rotting corpses, their fragments and biomaterial in the warm season.3. After the initial registration and a secondary sort examine corpses, their fragments and biological material collection for postmortem identification of significant information, determine the cause of death, nature, mechanism and prescription of formation damage and address other special issues. At this stage also produce the identification of fragmented body parts and (or) tissues that or another body. In expert identification work on the fragments of human remains or biological material, preference is given to genetic research providing highly accurate results. Depending on the extent of influence of damaging factors on the bodies of the victims and their degree of preservation, only after the completion of the necessary is judicial-medical research with a full range of fence material for additional research, producing restoration of the exterior, embalming, sanitary and cosmetic processing of human remains and give them to relatives (relatives, authorized representatives, etc.) for burial.
 4. Issued the final results of examinations; establishes data that may be useful for later investigative and judicial actions aimed at gathering and verification of evidence in a criminal case.5. The penultimate stage consists of conducting sanitary-and-hygienic, treatment-and-prophylactic, rehabilitation (including a full psychological) of interventions for physical and mental health of employees and expert institutions involved in this work.6. After the conclusion of the criminal proceedings in general, with the official opening of data access, it is advisable to analyze the material, and publish the relevant data in the scientific literature, with the goal of widespread study and use of gained experience.CONCLUSIONS.1. Research platform forensic activities in cases of accidents involving buses and a large number of victims to date have not been developed.2. The effectiveness of forensic medical groups in this situation is in direct proportion to the degree of readiness for quick response and timely quality completion of tasks.3. Based on this, very urgent is the development of modern optimal evidence-based systemic approach to the organizational model of forensic activities in the presence of a large number of injured persons in the bus; the solution to this problem and sent the above recommendations.4. The recommendations, in principle, can be applied not only in cases of injuries in the bus, but also to similar situations in which there is a massive injury and loss of life.5. It is necessary to continue scientific and practical research aimed at improving this algorithm works experts.