Gunshot injury

A gunshot injury occurs when an individual is shot by a bullet or other type of projectile from a firearm. Gunshot injuries cause direct injury through the tearing, cutting and abrasion of tissue in ways similar to other penetrating injuries, and the shattering of bone and organs and other damage can be similar to that caused by blunt force trauma.

They are the most common form of homicide in the United States.^[1]

In some locations, are responsible for more deaths than motor vehicle accidents.^[2]

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Assessment of Severity

When assessing the likely severity of gunshot wounds, there are numerous variables which include the following, considered either singly or in concert:

• the particular type of weapon used; rifles are generally more destructive than handguns. For example, a close-range abdominal wound inflicted by a G3 rifle will be much more severe than one inflicted by a .38 revolver from the same distance.

• the calibre of the weapon; eg a wound from a .22 handgun will generally be less severe than a wound inflicted by a .357 Magnum handgun.

• the type of the bullet used and its propellant charge ie a standard velocity 9mm NATO FMJ bullet is generally less destructive than a high velocity 9mm hollowpoint bullet.

• the range at which the victim was shot; ie wounds inflicted by 7.62x39mm bullets fired from a distance of 5 metres will invariably be more severe than those fired from a range of 500 metres. The velocity of a bullet (and therefore its destructive potential) gradually reduces as it travels from the muzzle of a firearm.

• the site of injury. For example, though serious, a gunshot wound to the buttocks is unlikely to be fatal, unless the femoral artery is severed. This is in marked contrast to a gunshot wound to the side of the head which penetrates both cerebral hemispheres: such a wound is almost invariably fatal.

• the number of wounds inflicted. Frequently, gunshot wound victims have been hit multiple times. For example, whereas a .22 calibre bullet is one of the less destructive bullets used, it is an entirely different matter if someone were to suffer ten separate abdominal wounds inflicted by this particular calibre. In much the same way, an individual shotgun pellet is comparatively small, though since victims are usually hit by large numbers of pellets simultaneously, the degree of injury is severe, particularly when the wound is inflicted at close range.

It is important to emphasise that non-fatal gunshot wounds frequently have severe and long-lasting effects, even after the victim makes a successful recovery. Typically, the consequences involve some form of major disfigurement and/or permanent disability. As a rule, all gunshot wounds are medical emergencies which require immediate hospital treatment.

Destructive Effects

The immediate damaging effects of the bullet are typically a loss of blood, and with it, the potential for shock, an inadequate amount of blood in the circulatory system. More immediate effects can result when a bullet strikes a critical organ such as the heart or damages a component of the central nervous system such as the spine or brain. Common causes of death following gunshot injury include exsanguination, hypoxia caused by pneumothorax, heart failure and brain damage. Non-fatal gunshot wounds can result in serious disability.

The direct injuries inflicted by a bullet can then cause a wide variety of secondary effects, depending on the body systems that have been damaged, and can often result in death. A 1995 study of gunshot injuries in Oklahoma showed a 30% mortality rate.^[3]

Gunshot injuries can vary widely from case to case since the location of the injury can be in any part of the body, with wide variations in entry point. Also, the path and possible fragmentation of the bullet within the body is unpredictable. The study of the dynamics of bullets in gunshot injuries is called terminal ballistics.

Gunshot injuries are a common method of suicide and attempted suicide in countries with wide availability of firearms such as the United States; in these cases, the weapon is typically aimed at the head or heart. In countries with lower rates of gun ownership, such as the United Kingdom, gunshot injuries are a relatively uncommon form of suicide although there is no correlation between gun ownership and suicide rates.

Attempted suicides by gunshot can result in serious permanent injuries, including continued survival with massive brain damage, paralysis, or disfigurement.

See also

• Physical trauma
• Battlefield medicine
• Emergency medicine
• Multiple gunshot suicide
• Terminal ballistics

References