Gunshot Wounds

Question 1

Important factors affecting tissue damage

Answer 1

Mass
Velocity
Configuration/shape
Tissue struck

Question 2

KE of a missile

Answer 2

KE = 1/2 mv^2

Question 3

Low velocity weapons

Answer 3

680 - 1500 fps

Question 4

High velocity weapons

Answer 4

2200 - 3300 fps

Question 5

KE of wound ballastics

Answer 5

KE = m(v1^2 - V2^2) / 2

Question 6

What determines the wound created by a bullet?

Answer 6

The amount of energy absorbed by the body tissue

Question 7

What is the significance of bullets jacketed?

Answer 7

Outer layer of another metal with a higher melting points to maintain shape

Maintains diameter
Less altered
Pass through thissue

Question 8

Significance of partially jacketed bullets?

Answer 8

Increase diameter in shape

Mushrooming effect

Question 9

What do hollow point bullets do?

Answer 9

Increase the mushrooming effect and don’t exit the body

Question 10

What does a higher specific gravity of the tissue do?

Answer 10

More retardation effect on the bullet leading to more tissue damage

Question 11

3 Mechanisms of tissue damage?

Answer 11

Laceration of crushing
Shock waves
Cavitation

Question 12

Direct force of bull moving through tissue

Answer 12

Laceration and crushing

LOW velocity wounds

Question 13

Created by high velocity weapons that is due to compression of tissue ahead of the bullet due to sound waves

Answer 13

Shock waves

Question 14

Caused by bullets traveling faster than 100 fps. Moves the tissue forward and lateral

Answer 14

Cavitation

Question 15

Cavitation creates what?

Answer 15

Temporary cavity that pulls air and foreign material into the wound

Question 16

The temporary cavity pulsates inward to form what?

Answer 16

Permanent cavity

Question 17

Important thing to focus on once patient is medically stable?

Answer 17

Tetanus status

Question 18

Must be suspicious of what serious injury?

Answer 18

Compartment syndrome. Perform fasciotomy when pressures above 30-40

Question 19

Treating low velocity wounds

Answer 19

Surface debride
Local wound care
Stabilization of fractures
Antibiotics

Question 20

High velocity wound treatment

Answer 20

Decompress
Debride
Lavage
Antibiotics
Stabilize fractures
Manage neurovasculature issues
Reconstructive procedures
Delayed wound closure