Ballistics

Question 1

Types of gunshot wounds

Answer 1

Penetrating - bullet enters and becomes lodged in the body

Perforating - bullet enters and goes all the way through the body

Question 2

Ballistics

Answer 2

energy created and dissipated by the object into surrounding tissues

Question 3

energy within a projectile is dependent on:

Answer 3

velocity, weight, distance, deformation, fragmentation, type of tissue struck

Question 4

Contact Range

Answer 4

when a gun is held against the skin’s surface

searing of the edges of the wound secondary to flame/hot glasses

Question 5

Intermediate Range is characterised by:

Answer 5

tattooing on skin - fragments and non burned gunpowder penetrating skin
Stippling - fragments abrade the skin but don’t penetrate the skin

Question 6

Intermediate (distant) range

Answer 6

no gunpowder hitting the skin, only the bullet

Question 7

Kinetic Energy

Answer 7

KE = 1/2 MV squared

greater the speed, greater the damage

Question 8

Primary Damage

Answer 8

crushing and laceration of tissues as the bullet impacts and pushes its way through
a permanent cavity or tunnel is created

Question 9

Secondary Damage

Answer 9

temporary cavitation occurs as shockwaves exerted outwards from the bullets trajectory
temporary vacuum causing internal burns

Question 10

Tertiary Damage

Answer 10

the bullet may create multiple fragments by impacting into and shattering bone

Question 11

Treatment of ballistics

Answer 11

stop visible haemorrhage, monitor and consider spnial, IV access and fluid, VSS

Question 12

High order explosions

Answer 12

produce a defining supersonic over-pressurisation shock wave

Question 13

Low order explosions

Answer 13

create a subsonic explosion wave

Question 14

Factors that affect severity of blast injuries

Answer 14

magnitude of the blast, composition of explosive, environment of the blast, distance between victim and blast, structural collapse, available medical resources, triage efficiency

Question 15

spalling

Answer 15

shock wave moving between tissues of different densities

Question 16

Implosion

Answer 16

entrapped gases contained in hollow organs compressing and then expanding to rupture

Question 17

shearing

Answer 17

tissues of different densities respond differently to moving at different speeds

Question 18

irreversible work

Answer 18

forces exceeding tensile strength of the tissue

Question 19

Primary blast injuries

Answer 19

unique to HE, results of the over-pressurization wave

Question 20

secondary blast injuries

Answer 20

struck by falling debris

Question 21

tertiary blast injuries

Answer 21

pts thrown by blast wind

Question 22

quaternary blast injuries

Answer 22

all explosion related injuries, illnesses or diseases not cue to primary, secondary or tertiary

Question 23

most common injuries

Answer 23

TBI and concussion. tympanic membrane rupture, middle ear damage, abdo haemorrhage and organ perforation, blast lung

Question 24

Blast lung patho

Answer 24

tearing of lung tissue - oedema, haemorrhage

lungs show lacerations and have increased weight due to tearing leading to V/Q mismatch

Question 25

Signs and symptoms of blast lung

Answer 25

tachypnoea, hypoxia, cyanosis, apnoea, wheezing, reduced breath sounds, haemoptysis, cough, chest pain, dyspnoea, haemodynamic instability

Question 26

treatment of blast lung

Answer 26

high flow O2, CPAP, ETT, fluid

Question 27

common trauma in secondary blast injuries

Answer 27

blunt and penetrating to head, neck, chest, abdo, extremities
fractures
soft tissue trauma
traumatic amputations

Question 28

common trauma in tertiary blast injuries

Answer 28

head injuries and fractured skull

fractured long bones

Question 29

common trauma in quaternary blast injuries

Answer 29

burns, head injury, asthma and COPD, resp problems, angina, hypertension, crush injuries

Question 30

management of blast injuries

Answer 30

DANGERS

promote safety, calm, efficiency, hope