GUNSHOT WOUNDS

Gunshot wound (Vulnus sclopetarium)

A gunshot wound (GSW) is psychical trauma caused by a projectile from a firearm.

In medicine, we distinguish four types of gunshot injuries, namely non-penetrating gunshot wound, gutter (graze) wound, non-perforating gunshot wound, and perforating gunshot wound.

The type of gunshot wounds (from a medical perspective)

1. Non-penetrating gunshot wound - where the bullet, due to its low energy, does not even penetrate the skin cover, hits the surface of the body and falls freely to the ground.

This is particularly the case with projectiles specially designed for this purpose, such as the various rubber bullets used by the security forces and so on.

In the case of conventional weapons using conventional ammunition, the projectile may be non penetrating fired if the energy of the projectile is reduced in some way. This usually happens after rebounding off a hard material.

In particular, full-coverage projectiles bounce after impact with steel, concrete and similar surfaces and retain enough energy to cause injury even after the bounce.

Another possibility is a projectile fired from a long distance that hits at the very end of its trajectory (it should be noted, however, that this cannot be relied upon as most projectiles retain sufficient energy throughout their flight path).

A projectile slowed by penetration of some material such as a car body, a tree or even a bulletproof vest can also cause a projectile to hit. … For a car, the only two places that can be covered with some success are the engine block or the steel wheels…

And the last option is missiles fired into the air. Very often we see footage on TV of various countries celebrating some victory by shooting into the air. And, you know, it's really interesting that nobody even thinks that it doesn't stay up there...and when, for example, a few hundred meters away, in a seemingly perfectly safe area, children are playing, such a falling missile can cause them very serious injury, if not death.

Otherwise, the consequence of being a non-penetrating shot maybe only a major or minor abrasion or blood bruise. However, a large and heavy projectile, which has great energy by its mass rather than by its speed of flight, can, for example, break ribs or cause internal injuries from which death is possible. The most dangerous is when such a projectile hits the skull - if the skull bones are fractured, it is always life-threatening.

It is also necessary to recall the phenomenon called "commotio cordis", a concussion of the heart. - A sharp blow to the cardiac landscape can cause cardiac arrest - sometimes this happens to boxers or other fighters, but being shot can also cause this phenomenon. And it doesn't have to happen as a result of a special bullet either; it can happen when the cardiac landscape is hit by an ordinary bullet through a bulletproof vest.

2. Gutter (graze) wound - in which the projectile hits the surface of the body tangentially, so the bullet channel is open along its entire length and communicates with the external environment.

It usually occurs on those parts of the human body that are rounded, i.e. head, shoulder, buttocks, hip, etc.

Of course, even sharpshooting can be life-threatening, especially on the head, where again there is a risk of damage to the skull and brain. There, mere millimeters really make the difference between a bloody gash or a shattered skull bone. Sharpshooting sometimes occurs in suicides, where the suicide unconsciously jerks his hand at the moment of the shot and the bullet then flies somewhere other than he intended.

3. Non-perforating gunshot wound - this means that the bullet penetrates the skin of the body but does not have enough energy to penetrate completely and remains at the end of the bullet channel.

Non-perforating gunshot wounds often look like a near miss and we find the bullet on the other side under the skin. This is because the skin is relatively very resistant to penetration. Muscle tissue is elastic, but it tears easily, and bone shatters easily on impact. Skin, however, contains flexible and strong collagen fibers that behave a bit like Kevlar in a bulletproof vest.

Of course, a direct hit usually doesn't last - not counting the cases I've mentioned for bulleting - but after penetrating the skin layer and the whole body, which is usually muscle and other tissue and often bone, the bullet often doesn't have enough energy to leave the body, and we then find it on the opposite side from the bullet under the skin.

4. Perforating gunshot wound - where the bullet passes through the entire body, so we find the opening of the bullet, the bullet channel and on the other side the opening of the shot.

The area around the bullet hole is divided into several zones.

A - there is the projectile bore itself, which is usually smaller than the diameter of the projectile. As we have already noted, the skin is elastic, so that on penetration the skin around the projectile expands somewhat and then contracts again slightly as the projectile passes through it. The bore of the projectile may therefore be as much as a few tenths of a millimeter smaller than the caliber of the projectile.

B - Around it, there is a zone of contamination where we find oil from the barrel, remnants of clothing and the so-called metallization, i.e. the wiped metal residue from the bullet.

C - there's the bruising zone, which is caused by the rapid expansion and subsequent shrinkage of tissue as the bullet penetrates - like throwing a rock into the water and sending waves crashing around it.

There is virtually no place on the human body that cannot be killed by a firearm hit.

We had a case where the victim was shot in the knee "as a warning" - but the bullet hit the popliteal artery and the victim bled to death in a very short time.

And it doesn't even have to be such a critical hit - the victim of even an otherwise not very dangerous gunshot can easily die of post-traumatic shock, especially if no help is given.