Gunshot Wounds

According to the National Safety Council over 1,600 people died in firearm related accidents in 1989, and 900 of those accidents happened in or near the home.

Gunshot wounds can range from minor, superficial skin wounds to major organ injury and death. The severity of a gunshot wound is based on the location of injury and the type of weapon used.

LOW VELOCITY gunshot wounds (most hand guns, nonmilitary rifles, and low caliber hunting rifles) which do not involve organ damage, bone fracture, body cavity penetration, major blood vessel or nerve damage, can often be managed conservatively, with removal of debris from the wound and aggressive cleansing.

Wound tracks must have local debris removed from both exit and entrance sites. Aggressive cleansing, wound irrigation, and sterile dressings should be applied. Lower velocity weapons (.22cal, .32cal, .38cal, and .45cal), for the most part, result in sterile wound tracks. For this reason, secondary infection occurs more commonly at the entrance, or exit site. Bullets will often be left inside the body if they are not wedged within an organ, or interfering with the function of an organ.

HIGH VELOCITY weapons (AR-15, AK-47, M-16, or hunting rifles) result in a contaminated wound track, requiring (open) surgical debris removal in the operating room.

Evaluation must include an accurate history, including type of weapon, caliber, and range. Physical exam for potential chest or abdominal penetration will be undertaken. Limb examination for nerve and vascular integrity (pulses, feeling, and movement) is crucial. X-rays will aid the physician in revealing any of the above possibilities, as bullets "show up" well on x-rays.

Potential vascular injuries can be diagnosed with the use of an angiography. Using a radiopaque contrast injected into the patient's blood stream, this test allows the condition of vessels to "show up" on x-ray studies.

Treatment includes debris removal, cleansing, irrigation, tetanus shot update, and preventative antibiotics for low velocity limb injuries, without vascular damage. Major wounds will be treated surgically. Observation in the hospital for high velocity weapon injuries is advised. The greater tissue destruction seen in these cases lead to delayed swelling that can compromise blood flow to an injured limb. The patient who is discharged from the hospital should closely observe the wound for SIGNS OF INFECTION: increased pain, fever, discharge from wounds, and increased swelling or redness. Close follow-up is necessary with a General Surgeon.

12 Hip Dislocation
12 Hip Fracture
12 Insect Stings and Spider Bites
12 Human and Animal Bites
12 Shoulder Injury Fracture
12 Toxic Inhalations and Carbon Monoxide Poisoning
12 Facial Injury Jaw Fracture and Dislocation
12 Kidney Injury
12 Knee Injury General Considerations
12 Knee Injury Contusion
12 Knee Injury Fracture
12 Knee Injury Sprain
12 Stab Wounds
12 Leg Injury Fractures and Contusions
12 Leg Injury Shin Splints
12 Lightning Injury
12 Oral and Tongue Injuries
12 Nasal Fracture or Contusion
12 Neck Injury General Considerations
12 Neck Injury Fracture
12 Neck Injury Spinal Cord Injury
12 Pelvic Bone Fracture
12 Puncture Wounds
12 Chest Injury Rib Fracture
12 Back Injury Sacrococcygeal Injury
12 Scorpion Bites
12 Abrasion Injuries
12 Shoulder Injury Clavicle Fracture
12 Shoulder Injury Strains and Sprains
12 Snakebite
12 Neck Injury Spinal Cord Injury
12 Abdominal Injury Ruptured Spleen
12 Foot Injury Toe Fracture and Sprain
12 Vaginal or Vulvar Injury
12 Drowning and Near Drowning


Abdominal Injury
Abdominal Injury: Contusion
Animal Bites
Ankle Fracture
Ankle Injury
Ankle Injury: Contusion
Ankle Sprain
Back Injury
Back Injury : Sacrococcygeal Injury
Back Strain
Carbon Monoxide Poisoning
Chemical Burns
Chest Injuries
Chest Injury: Aortic Rupture
Chest Injury: Hemothorax
Chest Injury: Myocardial Contusion
Chest Injury : Pneumothorax
Chest Injury: Pulmonary Contusion
Chronic Back Pain
Clavicle Fracture
Compression Fractures
Decompression Sickness
Disc Disease
Gunshot Wounds
Hand Injury: Fingertip Amputations
Head Injury
Liver Injury
Marine Stings
Muscle Strains
Rib Fracture
Ruptured Spleen
Shoulder Injury: A-C Separation
Spider Bites
Spinal Cord Injury
Sternum Fracture
Testicular Injury
Wrist Injury
hi Scuba Related Injuries
i Hand Injury Finger Amputaion
de Lecerations
de Cold Injury and Hypothermia
dd Dental Injury
xs Facial Injury
sdf Neck Injury
e Shoulder Injury Dislocation
e Ear Injury
ed Elbow Injury
de Elbow Injury Fracture
dfe Elbow Injury Nursemaids
ee Electrical Injury
de Eye Injury
ed Facial Injury General Considerations
fr Facial Injury Contusion
ed Hand Injury Finger Sprains
ded Fingernail and Toenail Injuries
dd Hand Injury Fractures
23 Head Injury Skull Fracture and Concussion
44 Chest Injury Myocardial Contusion
fde Heat Illness
ed Hest Injury Hemothorax
y Back Injury Disc Disease
;l High Altitude Illness

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