Gunshot wounds
April 8, 2010
| Abstract Title: | Gunshot wounds |
| Authors: | Puticiu Monica |
| Affiliation: | “Vasile Goldis” Western University, Arad, Romania Emergency Departament, Clinical County Hospital Arad, Romania |
| Abstract text: | Gunshot wounds become a reality in Romania. Last year we give emergency medical assistance in four situations of gunshot wounds. The patients present thoracic and parietal, abdominal, facial and hand gunshot wounds. The emergency physician is in the ideal position to evaluate and document the state of a gunshot wound before it is disturbed, distorted, or destroyed by surgical intervention. Such evaluation requires a basic understanding of ammunition, ballistics, and relevant forensic terminology. Documentation of gunshot wounds should include the anatomic location, size, shape, and characteristics of the wound. Clinicians should not describe wounds as “entrance” or “exit,” but should document a detailed description of the appearance and location of a wound with the use of appropriate forensic terminology without speculating on an interpretation or the caliber of the bullet. Despite common belief, exit wounds are not always larger than the entrance wound, and wound size does not correspond to bullet caliber. The size of any wound (entrance or exit) is determined by five factors: the size, shape, configuration, and velocity of the projectile at the instant of its impact with tissue and the physical characteristics of the impacted tissue itself. If the projectile is slow and its shape unchanged on exiting the skin, the exit wound may be equal to or smaller than its corresponding entrance wound. If the projectile increases its surface area by fragmenting or changing its configuration while maintaining substantial velocity, the exit wound may be significantly larger than the entrance wound. If the bullet strikes bone, fragments may extrude from the exit wound and contribute to the size and shape of the wound. Tissue elasticity also affects the wound size, so entrance or exit wound size may be smaller, equal to, or larger than the projectile that caused it. |
| Keywords: | gunshot wounds, emergency physician |
| Presentation type: | Oral |
| Correspondence: | Emergency Departament, Clinical County Hospital Arad, No 1-3 Victoriei St., Romania |
| Email: | puticiumonica@yahoo.com |
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