Lecture 7 Bullet Wound Management Dr. Dayton Flashcards
Internal balistics vs external ballistics?
Internal ballistics are dynamics deallin with the bullet in the chamber such as the casing and caliber.
External ballistics is how the bullet flies through the air. Spin, Yaw, Range and velocity all taken into account.
how does the density of the target relate to ballistic damage?
The more dense the target the greater increase in energy transfer that will occur.
Compare and contrast the energy transfer of jacketed vs non jacketed bullets.
Non jacketed transfer more energy as they deform more than jacketed that are likely to pass through a target.
what is a soft point bullet?
The excact same as the hollow point. Meant to expand on impact.
Describe the speeds between low velocity, mid velocity, and high velocity.
Low velocity <1000 Feet/second
Mid Velocity 1000-2500
High Velocity >2500 feet/sec
What is indirect tissue damage following a gunshot wound?
Indirect deals with the concussion zone and secondary missiles.
What does low velocity do to surrounding tissues?
Lower velocity allows pushing of vital structures aside.
What is teh most important determinant of survival for life threatening gunshot wounds?
Rapid transit to definitive care facility.
What is the most important part of preventing infection in gunshot wounds?
Debridement and wound care.
When is antibiotic prophylaxis indicated?
For high energy, shotgun and intra-articular injuries.
why is lead intoxication uncommon with bullets?
Because the bullet becomes encapsulated by fibrous tissue.
Under which circumstances should bullets be removed?
If….
Intraarticular
Adjacent to vital structures
Expected functional compromise.
What is the debridement reccomendations for bullet wounds?
staged debridement similar to open fracture management.
Previously thought that wide excise was best idea. No longer the thought.
Describe the velocity and energy of a shotgun wound.
Low velocity but high energy.
Type I Shotgun wound?
Penetrating subcutaneous greater than 7 yards away. Uses small shot.
