Gunshot Wounds

Question 1

low velocity ballistics speed and firearm type

Answer 1

<2,000 ft/sec, all handguns

Question 2

high velocity ballistics speed and firearm type

Answer 2

> 2,000 ft/sec, all military rifles and most hunting rifles

Question 3

shotgun wound potential factors (3)

Answer 3

chote (shot pattern), load (size of individual pellet), distance from the target

Question 4

kinetic energy equation

Answer 4

ke=1/2(mv^2)

Question 5

relationship between kinetic energy and velocity

Answer 5

directly proportional to square of its velocity

Question 6

relationship between kinetic energy and mass

Answer 6

directly proportional

Question 7

relationship between degree of injury and specific gravity of traversed tissue

Answer 7

higher specific gravity = greater tissue damage

Question 8

type of injury in the permanent cavity left by gunshot

Answer 8

crush injury with direct passage of the missile

Question 9

type of injury with temporary cavity (cone of cavitation)

Answer 9

stretching injury from dissipation of imparted kinetic energy (i.e., shock wave)

Question 10

low-velocity gsw treatment (2)

Answer 10

anbtibiotics/tetanus toxoid/antitoxin, irrigation and debridement

Question 11

low-velocity gsw antibiotic of choice

Answer 11

first-generation cephalosporin

Question 12

indications for operative debridement of low-velocity gsw (8)

Answer 12

retention in subarachnoid space, articular involvement, vascular disruption, gross contamination, massive hematoma, severe tissue damage, compartment syndrome, gastrointestinal contamination

Question 13

high-velocity gsw treatment (4)

Answer 13

antibiotics/tetanus ppx, extensive and often multiple operative debridements, fracture stabilization, delayed wound closure with possible skin grafts/flaps

Question 14

complications of gsw (4)

Answer 14

retained missile fragment, infection, neurovascular disruption, lead poisoning