Medico-legal documentation of non-fatal injuries in emergency departments: a scoping review and evidence-informed pragmatic framework for evidentiary quality
Abstract
Introduction: Emergency departments (EDs) are frequently the first institutional setting in which violence-related or trauma-related injuries are described, interpreted, and transformed into records that may later acquire judicial significance. The present scoping review aimed to map the literature on the medico-legal documentation of non-fatal injuries in EDs, with emphasis on recurrent quality gaps, downstream forensic consequences, and feasible interventions to improve evidentiary value.
Methods: A structured search was undertaken in PubMed, Scopus, and Web of Science from database inception to 9 March 2026, with no language restriction. Original research involving living patients, emergency or trauma settings, and the documentation, reporting, description, photography, or medico-legal interpretation of non-fatal injuries was eligible. Reviews, editorials, case reports, post-mortem-only studies, and highly specific subdomains outside the review focus were excluded from the analytic core. Twenty-six full texts were assessed and 13 studies were included in the final synthesis. Because the objective was to map a heterogeneous evidence base and recurrent practice problems, findings were charted descriptively and synthesized thematically rather than meta-analytically. The review is reported in accordance with the PRISMA extension for Scoping Reviews.
Results: Across the included studies, documentation problems were recurrent and remarkably consistent. Administrative and…
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