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Ballistic trauma
Classification and external resources
Male skull showing bullet exit wound on parietal bone, 1950s.
ICD-10	T14.1, W34, X95
ICD-9	E922.9
DiseasesDB	5480
MeSH	D014948

The term ballistic trauma refers to a form of physical trauma sustained from the discharge of arms or munitions.^[1] The most common forms of ballistic trauma stem from firearms used in armed conflicts, civilian sporting and recreational pursuits, and criminal activity.^[2]

Destructive effects[link]

The degree of tissue disruption caused by a projectile is related to the size of the temporary versus permanent cavity it creates as it passes through tissue.^[3] The extent of cavitation, in turn, is related to the following characteristics of the projectile:

• Kinetic energy: KE = mv²/2 (where m is mass and v is velocity). This helps to explain why wounds produced by missiles of higher mass and/or higher velocity produce greater tissue disruption than missiles of lower mass and velocity.
• Yaw
• Deformation
• Fragmentation

The immediate damaging effect of the bullet is typically bleeding, and with it the potential for hypovolemic shock, a condition characterized by inadequate delivery of oxygen to vital organs. In the case of traumatic hypovolemic shock, this failure of adequate oxygen delivery is due to blood loss, as blood is the means of delivering oxygen to the body's constituent parts. 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, catastrophic injury to the heart and larger blood vessels, and damage to the brain or central nervous system. Additionally, gunshot wounds typically involve a large degree of nearby tissue disruption and destruction due to the physical effects of the projectile. Non-fatal gunshot wounds can result in serious disability.

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.

Non-fatal gunshot wounds frequently have severe and long-lasting effects, even after the victim has made a successful recovery.^[4] Typically, the consequences involve some form of major disfigurement and/or permanent disability. As a rule, all gunshot wounds are considered medical emergencies that require immediate hospital treatment. Hospitals are generally required to report all gunshot wounds to police.^[5]

See also[link]

Death portal

• Battlefield medicine
• Emergency medicine
• Hydrostatic shock
• Multiple gunshot suicide
• Penetrating trauma
• Stopping power
• Vincent Di Maio

References[link]

Wikimedia Commons has media related to: Gunshot wounds

Bibliography[link]

1. Mahoney, P. F. , Ryan, J., Brooks, A. J., Schwab, C. W. (2004) Ballistic Trauma – A practical guide 2nd ed. Springer:Leonard Cheshire
2. Krug E. E., ed. World Report on Violence and Health. Geneva: World Health Organization; 2002.
3. World Health Organization (WHO). Small arms and global health. Paper prepared for SALW talks. Geneva: July 2001.

External links[link]

• Virtual Autopsy – CT scans of fatal gunshot wounds
• http://www.patient.co.uk/showdoc/40001334/