7.5 Viewpoint and technique Although it is advisable to check for any previous images the patient has had taken of their wound (and for any relevant notes on the request form) with effort being made to achieve repeat views, it must be noted that patient positioning can be an extremely difficult variable to control, especially for patients with limited or changeable mobility. With this in mind, a good starting point for photography is for the patient to be comfortably positioned in the correct anatomical position (if achievable) with the camera being held perpendicular to the wound.
If the patient has had previous photography and the camera settings and magnifications are known, the desired magnification should be pre-set and the camera moved until the area of interest is sharp. For subjects such as sacral pressure sores that may require staff assistance for patient manual handling, the patient should be rolled on to the same side as they were previously so that the photograph is comparable, providing the patient is able to do so.
If given a choice, it may be easier to photograph the patient in a lying position as some wounds (particularly those on the buttocks) distort easily and slight movements such as the flexing of a muscle or a slight change in the patient’s position may significantly alter the appearance of a wound. Additionally, the natural curvature of the patient’s body can be an issue, especially where wounds extend around a limb (e.g. pressure ulcer on the heel or elbow). It may be helpful to photograph such wounds in a ‘relaxed’ position and then again with assistance by nursing staff.
7.6 Recording people present during photography For patients that present with suspected non-accidental injuries, it is vital to record the details of any chaperones and nursing staff present so that they can be called upon should the images be required for legal purposes. 8. Photographs taken by other healthcare professionals Medical Illustration Departments will provide superior clinical photography in wound management as they have professionally-qualified staff, specifically trained to carry out this task.
It is acknowledged however, that other healthcare professionals may also be involved in recording the occurrence and progression of wounds (although the images would normally be managed post-capture, by the Medical Illustration Department). In Community settings, Trust-registered electronic devices e.g iPads, tablets or other devices capable of imaging, may be used to take photographs in accordance with local Trust policies. The photograph should be uploaded to the patient’s electronic record, before being deleted from the device.
A measurement scale should be used, and information stating the date the photograph was taken, the patient’s hospital number and the location of the wound on the body should be included in the upload. This may either be included on the measurement scale, as some have space incorporated for imaging information, or it may be written on a separate piece of paper, photographed and uploaded to the patient’s record along with the image of the wound. Steps should page 20