I need your help.
I'm developing a lecture, anywhere from 1-2 hours in length, that I'm thinking of calling Wound Ballistics: An Idiot's Guide to Firearms Injuries.
I'm going to cover all the standard stuff - velocity, bullet expansion and fragmentation, sectional density, penetration, wound channels (temporary and permanent), cavitation, yaw, tumbling and all that noise - while at the same time trying to dispel some of the common firearms myths out there.
This is not intended to be a RKBA or political screed in any way. It's supposed to be an educational offering for EMS and ER providers in assessing and treating gunshot wounds. I'm trying to give practical, real-world knowledge to people who wouldn't know a ballistic coefficient from a barrel shroud.
If that happens to demystify firearms in general and refute the bullshit prevalent in most media reports, so much the better.
The idea occurred to me after doing a paid review for the new edition of a prominent paramedic textbook. I was given the thoracic trauma chapter to review, and I was struck by the impression that the chapter's author a) didn't know beans about firearms, and b) seemed to take his teaching points directly from the Brady Campaign's press releases. To make matters worse, some of the information on terminal ballistics was just flat-out wrong.
More distressing was the fact that such misinformation had already been promulgated among many thousands of paramedic students through previous editions of the textbook. I got to reading other EMS and nursing texts, and the pattern repeated itself. The misconceptions weren't limited to one author, or one publisher. The textbooks are full of fuzzy or incorrect information, and blatant hoplophobia thinly disguised as public health education.
So it is to this end I seek your assistance.
To the Gun Bloggers:
- In your view, what are the most common myths among the firearms community about "stopping power" (now there's a fuzzy term if ever I've heard one), penetration, velocity, caliber, bullet weight and construction, firearms accuracy and reliability? If there are other points of contention I haven't mentioned, by all means let me know.
- In your view, what are the most common myths among non-firearms enthusiasts about the same subjects? What are the biggest misconceptions among non-shooters about the destructive power of firearms?
- Aside from the obvious (the ability to put multiple rounds through a bad guy's left ventricle while under extreme stress), what do you feel are the most important determining factors in rendering someone quickly and decisively dead or incapacitated? I'm talking about the tools here, folks - the weapon and its projectiles - not the training and mindset of the shooter.
To The Med Bloggers or health care providers (and I especially want to hear from the ones who hate and fear guns):
- What scares you about firearms? About gunshot wounds? Anything in particular?
- For those of you who are knowledgeable about firearms, have you ever heard or read something about firearms, in an educational setting, that made you groan and roll your eyes? Ever see something blatantly incorrect or biased in a textbook or continuing education lecture? I'd like to hear your personal anecdotes.
- What do you think are some of the most commonly held misconceptions among emergency health care providers about gunshot wounds? An example: "A .22 is deadlier than a .45, because it ricochets all through the body cavities like a squirrel in a cage. A .45 just punches a big hole and only damages what's in its direct path."
- Do the terms "assault rifle" or "sniper rifle" hold any particularly ominous connotations for you? Do the terms "deer rifle" or "hunting rifle" conjure the same fear?
- In your estimation, what type of weapon renders the most serious wounds: rifle or handgun? What caliber, or does the caliber even matter to you?
- What, if anything, were you taught about wound ballistics when you received your initial medical education? If you received none initially, how about in continuing education
If any of you Gun Bloggers know of some decent video of various bullet strikes on ballistic gelatin (or even real live flesh), I'd love to see it. I'm looking for something that can easily be exported into Powerpoint, and I'm not having any success with Youtube videos. Apparently they require serious geek skillz at encoding video that I do not possess.
Also, I'd love to hear your opinions on this article.
I await your comments.
57 pithy observation(s).:
You gotta post this for the laymen's reading here, your lecture, that is. I'm damned curious myself, frankly!
If you're looking to grab embedded videos from YouTube, you can use the Fast Video Download plugin under Firefox (https://addons.mozilla.org/en-US/firefox/addon/3590)
this will save a .flv video file that should be easy to convert. I hope that helps a bit.
I'm neither gun nor medblogger, but this sounds interesting.
From my gun-deprived European point of view, deer rifle and hunting rifle sounds scarier than assault rifle for the simple fact that there are more of them around, they are not normally weilded by trained personnell and they can wreak a whole lot of damage when used against a person.
On the other points, I sadly have no experience or opinion... only that generally in Europe, it's very hard to understand the USA's insistence on no gun regulation. It's not that it's hard to get a gun here, or that you can't get a license really easily, despite regulation - but people just don't seem to see the same need for them, somehow... so we're much less exposed.
;)
You might want to check out Jim MacDonald at Making Light as a MedBlogger.
Index to Medical Posts: http://nielsenhayden.com/makinglight/archives/009176.html
Oooh boy.... I've got a lot of pages on this... maybe 30,000 or 40,000 words...
Category: Mythbusting
Lies, Damn Lies, and Ballistics
Mixed Drill
The Golden Triangle
Golden Triangle
Serious Chamberings for Serious Purposes
Check your e-mail K.
I am not a gun enthusiast, but I own guns. I have some background as a first responder, but no experience treating GSW's. I am an expert in neither field. I am studying home defense options, so I'm learning much about what you are asking. Gun Blogs are a big help. One thing that seems to be fundamental about personal defense is selecting a combination of firearm and ammunition that will stop a bad guy and put him out of commission, without going through walls and harming other family members or neightbors. As for stopping power, it's all about energy transfer. The optimum situation for stopping is a round with enough energy to stop a person, that stays in the body and depletes all the kinetic energy without exiting the bad guy's body. This is frequently a lethal action, and in the heat of battle defending your home this is what you want to happen. You don't want the bad guy to get up and kill you. The round you select to make this happen is also the round that does the most damage, obviously, as the bullet mushrooms upon impact. Lots of experts will wade in on the discussion, so consider this just basic stuff from a learner, based primarily on handgun awareness. Shotguns are a whole different issue.
Keep up the fine writing, I love it!
Well...as a med person...
1) I'm a pacifist with a moral objection to violence of any kind against humans (yes, even in defense - I'm not open for debate on that so y'all don't "shoot" me).
2)not applicable
3)None, only dead body I've ever seen with a .22 slug in it had 6 of 'em...though we coded one that had a .22 in his liver, but - duh.
4) The connotations would be an assumption that they are used for their stated purpose. A "deer rifle" certainly carries an assumption that it would have a legitmate use more so than something that has a name that indicates a use for hunting humans.
5) No assumption regarding which one causes more damage. A bullet is a bullet is a bullet and if it destroys human flesh in a manner that is incompatible with life, then that's pretty much that.
Oh, yeah. No training on projectile wounds. Ever. All OJT.
AD, check out our 'thank you post' at MDOD, will answer this in detail a bit later but this site here is doing good work making sure that assault weapons do not jump up and kill people like SUVs do. Hope we send some new visitors your way and thanks.
I sent you an email via my work address with a Powerpoint presentation attached. Not sure how helpful it will be but use whatever you need.
What scares you about firearms? About gunshot wounds? Anything in particular?
FIREARMS IN HANDS OF FELONS OR DRUNK PERPS. FIREARMS WITH THE SERIAL NUMBER BUFFED OFF.
For those of you who are knowledgeable about firearms, have you ever heard or read something about firearms, in an educational setting, that made you groan and roll your eyes? Ever see something blatantly incorrect or biased in a textbook or continuing education lecture? I'd like to hear your personal anecdotes.
THE DIRECTOR OF EMORY'S E-MED RESIDENCY IS HUGELY AGAINST OUR SECOND AMMENDMENT RIGHTS AND PUBLISHES REGULARLY ON IT. I CONFRONTED HIM ON THE STATS FROM THE 'MANDATORY GUN OWNERSHIP' STATUTE IN KENNESAW, GA AND HE HEMMED AND HAWED AND THE INCREDIBLE DROP IN VIOLENT CRIME THERE. DR. KELLERMAN I BELIEVE.
What do you think are some of the most commonly held misconceptions among emergency health care providers about gunshot wounds? An example: "A .22 is deadlier than a .45, because it ricochets all through the body cavities like a squirrel in a cage. A .45 just punches a big hole and only damages what's in its direct path."
Do the terms "assault rifle" or "sniper rifle" hold any particularly ominous connotations for you? Do the terms "deer rifle" or "hunting rifle" conjure the same fear?
I PERSONALLY DO NOT THINK IN THOSE TERMS. I EXAMINE THE PATIENT, IF THE BULLET BROKE THE SKIN IT COULD BE ANYWHERE IN THE BODY AND YOU HAVE TO FIND IT. THEN THE DIAGNSOTIC WORKUP PROCEEDS WITH 'WORST POSSIBLE' RESULT ASSUMED. SEEN PLENTY OF GSW'S BUT DO NOT PUT A PARTICULAR CALIBER OR TYPE OF GUN TOGETHER WITH A PARTICULAR OUTCOME. TRAJECTORY OF BULLET IS KEY, THAT'S IT, GOTTA FIND IT AND TREAT THE PATIENT.
In your estimation, what type of weapon renders the most serious wounds: rifle or handgun? What caliber, or does the caliber even matter to you?
MOST SERIOUS WOUNDS FROM THOSE WITH MOST SERIOUS INTENT AND MOST SKILLED MARKSMEN.
What, if anything, were you taught about wound ballistics when you received your initial medical education? If you received none initially, how about in continuing education.
LOTS OF EDUCATION ON BALLISITCS, IT'S NOT VERY HELPFUL TO ME FOR ABOVE REASONS.
OK, AD, I'll weigh in on this one. I apologize that it will probably be long. so readers may want to skip and you may want to delete it. First...let me say I liked Chris' posts. Informative.
Where do I start? Fear of guns. I grew up in Michigan. Deer hunting season was annually. I knew people who hunted. Every year my friends came home with stories of injuries or deaths from the guns. That's where the fear began probably. From their stories. I lived in fear that I would lose one of my friends to a gun.
Fast forward to college--one day, about 27 years ago today now (gack!) a young man who was unhappy lit fires in the hallway then, from behind his mostly closed door, opened fire on the boys fleeing from the fire. He killed two and injured others. Both dead were friends of mine. Just expanded my gun fear. I do not recall, from this point in time, if anyone with a gun outside the room could have gotten to him. I believe that from where he was standing, he was protected by the cinder block walls and the only reason more weren't killed is that he only had 6 bullets for the gun and ran out of ammo...or jammed the gun. I really don't remember.
Forward again...I get to know some policemen and they show me their service revolvers and talk about their training. One allows me to hold the gun. Heavy sucker, too. The fear starts to abate.
I meet more men who hunt, different from those in my childhood. These men respect what guns can do to themselves and others, not just "will it kill the deer". Fear abates a bit more.
2007-2007--Virginia Tech and NIU. Family at both places. Fear again. Not of guns, per se, but fear of what a gun can do in the hands of a nut.
And that is the base now, of my fear. Not of the gun. Of many who have them. I would readily trust many (and do) who own guns. From his writing, I would be able to trust Chris (although we would not agree on many other things). I would be able to trust you.
But being caught in the middle of a gunfight would terrify me, not knowing who the good guy(s) were.
I still stand by my strongest desire. NOT to make guns illegal. But to make them more regulated and to make training required for ownership.
I know that won't stop the crazies. It won't stop the illegal use. But it may cut down on the stupidities. I'll take that as a step forward.
And yes, I have seen gunshot wounds. Been a long time, but I used to work as a receiver for the "Saturday night Knife and Gun Club" members in Detroit...However, I've pretty much forgotten anything I knew. There was a reason I went into OB... :)
AD, having been shot (more than once) and having shot people, I guess I can offer a fairly informed opinion, both subjectively and objectively. Give me a call when you get home and we'll put our heads together.
The military has had an abiding interest in putting holes in people and patching holes in other people. You may find the following links of some use.
Emergency War Surgery
Chapter one covers general wound mechanisms and so on.
A more detailed look at how bullets (and other high-velocity nouns) interact with tissue is here:
Ballistic, Blast, and Burn Injuries
These texts may have some images that are NWS in a non-medical or clipboard-medical workplace.
I like what you wanted me to read, am interested in what you come up with, and am far enough from an expert on anything - except good weapons and good marksmen will hit and hurt their targets. Who dies is not predictable.
AD, what you are searching for may be found in the varied and voluminous studies and after action reports generated from the FBI shootout in Florida in 1986. I don't have a good reference because there's a LOT of material. So many sacred cows were gored after that we're still eating hamburger 20 years later.
Barney
As a Canadian medical student, reading this has been interesting.
It'd also be great to try to add some discussion of hearing protection and firearms.
I don't really have anything to add in regards to your questions (good idea, BTW) but I can offer some advice.
If you wish to take a still from a YouTube video (I assume that's what your trying to do) simply pause the video on the frame you want, hit "Print Screen," then go into Paint or whatever other image editing program you have, hit Paste or Ctrl+V, and you've got yourself a screenshot, including the still frame from the video.
From that screenshot you can use the selection tool to cut out just the video image, at which point you will have a 320x240 pixel image.
If that's not what you're trying to do, disregard everything I just said. :)
Started to post a comment, then shameless realized linking to my own blog would drive up my own hits. No! I needed content! No, actually, I didn't want to waste your bandwidth with my ill-informed drivel. So I put up my own post here.
I ran across this link some time ago and bookmarked it, knowing someday a very intelligent and articulate person would one day dare to ask for information and I, both meek and humble, would be able to copy and past this for him/her.
http://www.theboxotruth.com/index.htm
Use it in Good Health AD! and let us see the results of your research!
welp, I'm a gun guy, and an EMT, so I can't help with the hoplophobic stuff, however, in my EMT class they tried to tell me a smaller fsater bullet makes a bigger wound channel than a big, slow one.
I put an end to that argument by bringing in two deer hearts-one of which I shot with a .35 rem, and one shot by a .243 win.
Common gun-blogger myth: There's a magic bullet (or shotgun shell) that will reliably stop an attacker, but won't be dangerous once it passes through ordinary home walls.
Non-shooter myths (limiting it to ballistics-related) Assault weapon cartridges are more dangerous than hunting weapons. Shooting someone once or twice should be enough (even with a handgun), more than that is no longer self-defense. Hollowpoints are evil. "Just shoot them in the leg, you don't need to kill them".
I believe immediate incapacitation other than due to a direct CNS hit is mostly psychological. If the first shot doesn't stop them, they aren't likely to stop until they bleed out or take a CNS hit. Diameter and depth of the wound channel are key.
"In your view, what are the most common myths among non-firearms enthusiasts about the same subjects? What are the biggest misconceptions among non-shooters about the destructive power of firearms?"
The most common misconception? that semi-auto 'assault weapons' are more powerful than a 'deer rifle'.
Mythbusters actually has done several episodes where they have fired various weapons into ballistic gel bodies to get similar info. Maybe they would have somethig on it on youtube?Please post whatever you get, I'm verrrrrry interested to see it!
I would've checked out the links mentioned in the comments here, but since BEMS gets its' Internet access via Boston Medical Center, I can't. BMC's web filters block EVERYTHING related to firearms (even vehicular equipment sites) and/or politics. Wow. Talk about "PC"...
In our Academy (and during in-service), we were taught some basic ballistics theory: muzzle speed, projectile mass, etc. I don't remember the formula, 'cuz I don't think it really matters: "A hole where it don't belong is bad, period."
I'm a brand new EMT-B and the only thing I learned about a GSW was to check for an exit wound when we trauma roll the victim onto the stretcher. IT was always assumed that ALS would be there and provide the needed care. There was no discussion about caliber, velocity, or the difference in trauma between a handgun and a rifle. I feel my education is sadly devoid in this respect and my first run area covers an "economically repressed" section of the city where GSWs are not that uncommon.
Check here a lot of info
http://www.firearmstactical.com/tactical.htm
I've used a lot of the info on this site
also http://www.tacticalanatomy.com/
Interesting course material
I did a ballistic vest shoot with a variety of weapons and posted the results - http://fateoflegions.blogspot.com/search/label/Part%203%20-%20Ballistic%20Vest%20Live%20Fire%20Test - most of this was to mythbust the "armor piercing" stupidity. I used militant looking "assault rifles" as well as hunting rifles. I even shot thru a tree to show how powerful a Wal-Mart deer rifle is.
There is are also short primers on ballistic vests and how a cartridge works, the latter having a cartoon that I made that makes me proud. I also have hundreds of pictures that I didn't post if you need them, and I will shoot and test stuff if you need it as well.
One of the more common mistakes is to confuse "killing power" with "stopping power". While a .22 might kill someone sooner or later a .45 is far more likely to stop them from doing whatever it was they were doing before they got shot.
For hunting or self defense you want something that will stop the target from continuing their activities. For hunting the ultimate goal is to kill the animal, preferably with as little suffering as possible. Also, with as little traipsing about in the woods as possible for the hunter whilst trying to finish off said animal.
For self defense, you want the person who is attacking you to stop doing that as quickly as possible. Which means hitting him with as many times as needed with something that will stop him. Killing the person is not the goal, stopping them from killing you is. Unfortunately sometimes that results in the attacker dying.
It's funny how the anti gun forces try to frame the discussion. A bullet doesn't care what type of gun it comes out of. Most military and sporting rifles vary more in appearance than in caliber or function. Jokergirl's comments are a good example of making a distinction without a difference. Her comment that people firing military style weapons are used by better trained than sporting or hunting shooters is typically ignorant.
You're trying to do a good thing AD, I wish you luck.
Gary
Since it's so hard in my area to find a place to run my own CHP class, I generally help out instructors at some of the gun ranges near me to maintain my certification with the NRA. As a result, I spend a great deal of time correcting various myths that some of these guys have picked up after decades of doing this.
The biggest ones are that there is a magic handgun round that will always kill with one shot. The next is that there are magic calibers that will knock a guy on his ass with one shot. When I question them about these things directly after the classes, they usually realize that they're just repeating rumors that they've heard, and have no real direct knowledge that these things are true. Yes, a .357 magnum is a powerful round. But that's not that useful if the bullet can't expand enough to deliver all of that energy to the attacker.
With the students I have for private lessons, I tell them that there are three things to consider for firearm choice.
1. Get the biggest caliber you can control, that is still small enough that you'll always carry it. More than one gun is acceptable to cover this rule. Put simply, a well placed shot from a .22 is worth a hundred misses with a .45.
2. When you're buying a gun, don't get something cheap (e.g. High Point). Your life depends on that gun, so get one that you know will work.
3. The best model of firearm is the one that you don't have to think about much to use properly. People can rave all they want about particular brands. But, when it comes down to it, once you pass a certain level of quality, it's nothing more than personal preference.
Some other things that I know to be true.
1. You can shoot a man in the heart and lungs more than once, and not necessarily stop him.
2. You can shoot a man in the head more than once, and not necessarily stop him.
3. If you break his pelvis with a couple of rounds, he will drop.
I don't blog...I read them. But, I'm a shooter and an ER Doc so.....
First of all, I assume you or the original writer already have read one or more of the texts on firearms injuries? Like Ballistic Trauma, by Mahoney et al?
There are all sorts of myths, and you've probably heard them. Guns will go off by themselves...criminals use 9mm handguns because they're especially dangerous (they use them because thats what is stolen most). That the higher the velocity of the projectile, the more damage it causes (not always, light fast bullets tend to blow up). That the police are experts in firearms knowledge (I need to stop, I'm laughing so hard - they're generally as expert as the "Glock-fohty" DEA agent).
FWIW, the only thing I'm especially concerned about when I see a GSW (and I work at a very major trauma center in Los Angeles, so I see a few) is occasionally when a person is shot with a high-performance bullet, the fragments may be a risk to me plugging the hole with a finger. Considering the folks who get shot are usually scum of the earth (drug dealers, for the most part) I'm more than a little worried about blood-born disease transmission. Double-gloving helps, and I've never been cut yet but I have had gloves ripped.
Personally, when I carry (even in Los Angeles, but I actually live in a free state) I carry a .45ACP (usually a Glock-30). Why a .45? I have faith in the ability of the round to stop a bad guy from being a threat. Not killing him, just stopping him. Seems to work better than (say) a 9mm or .40SW.
As for different names for rifles, I suppose that in modern cant 'hunting rifle' and 'sniper rifle' have become just about equivalent.
And, Fackler is the man.
AD: I recommend that you visit tacticalforums.com and have a look through the "stickied" posts at the top of the Terminal Effects forum, and in particular, read the "Recomended Duty/Self-Defense Service Pistol Loads" post. Dr. Gary Roberts ("DocGKR") is a genuine expert in the science of wound ballistics and has gone to great trouble to supply scientifically reproducible ballistic tests for those interested in the subject. There is a great deal more valuable information and debate in the archive at that same source.
Here is a good resource on Wound Ballistics.
If you want to see what different types of rounds actually do, then the site
http://www.theboxotruth.com/index.htm
is good to peruse.
A site that has trauma info and photos is
http://cut-to-cure.blogspot.com/
Bottom right corner "Tales from the Trauma Service"
As far as stopping power, it's all physics and the type of round. The higher the velocity, the more energy upon impact. What happens at this point is determined by the type of projectile, and whether it stays together or breaks into pieces.
Both sites might give you some info you can use.
Jon
All handgun rounds are lethal; the question is when.
An interesting bit of info would be a chart of how long it takes someone to bleed out (i.e. terms of useful consciousness) when struck in particular areas.
Crack(ed) Pot,
Not wanting to debate you, but as someone who comes at the question of defense from the absolute opposite side as you, I'd love to hear your take on the following:
1) How do you handle the free-rider problem? People of your point of view are a tiny minority (in the US, and even a minority in Europe.) You are thus surrounded by, and benefit from, the violence offered against wrongdoers by the military, police, and (depending somewhat on your location) most of your fellow citizens. So what do you do about this? Is it enough to not be personally offering violence? Do you engage in individual self-help in this regard (e.g. put up a "Weapon- and Violence-Free Household" sign outside your house so you don't accidentally benefit from the general police presence?) Not just advocate against the military, but also in favor of your city disbanding its police department?
2) How do you deal with the philosophical questions about the implied equivalence between the guilty and innocent that your position implies? To clarify by contrast, in my case I believe the person walking down the street minding their own business, or the person sitting quietly in their own home, deserves to be free of violent assault initiated by another person, but that the person who does initiate unwarranted violence against another does not, and should not, have that same right.
Again, I'm not interested in a debate--you won't get any kind of reply from me trying to talk you out of any of your positions. I'd just like to hear the underpinnings of your position.
(Apologies to our host if this seems too off-topic...)
AD,
one of the things that I have seen too much of in non-shooter EMS types is that they concentrate on what type of weapon it is, and not what caliber it is.
For example, I listened to one of our MICUs call med. control on a gunshot wound. The medic kept saying the pt. had been shot with an AK-47. He made special emphasis on it several times. Turns out it was actually a .22 that was made to look like an AK-47. This medic thought that the gun itself gave some magical properties to the bullets I guess.
They need to know that the weapon, and the ammunition are separate, and not necessarily related to one another.
I have seen AR-15's in .22, .223, 7.62X39, and even one .50 cal version. They have to learn it is the cartridge/bullet that does the damage, and it has nothing to do with what it is fired out of.
After that, some of the misconceptions about various rounds are sometimes different from local to local. I know it can sometimes be from something they heard or thought they learned when younger. Some people think that 9mm is strongest bestest thing ever because the military uses it (they wouldn't use it if it wasn't the best right?), and some think it is great because they hear about it in a rap song.
I truly think that the misinformation comes from too many sources to set straight. In fact you should know that some misinformation contradicts other misinformation. I think the only way to get people to start to understand is to get them shooting.
i'd like to second gary's amusement at Jokergirl's statements --- i too think the notion that the type of weapon is somehow paramount to "danger level" or the amount of damage that will be dealt is something that needs addressing.
too, there's that european conviction that the USA "insists on no gun control". Jokergirl, we have plenty of gun control here in the states, we just happen to have less than you've got in the old country. "less" is not "none". maybe a quick run over federal gun laws could be useful, just to impress the fact that they exist?
How was it again... possibly relevant, common myths that should be corrected or adjusted...
First, it's not the gun, it's the projectiles, that are relevant to any wound. The gun may provide a clue but this is not always reliable - and in any case, for example with the various 7.62 mm rifles from .30 M1 Carbine to the silly .300 Magnums, they should have the same terminal effects with the same bullet if they hit the same target at the same velocity. That velocity will just happen to be at different distances from the rifle.
Second thing, that the same bullet at the same velocity would ALWAYS cause the same kind of wound - that happens only in a calibrated, uniform, testing medium.
In a live patient, this may be very different depending on how and were they were hit. Bones, internal organs, and ESPECIALLY clothing and things in pockets may make a lot of difference.
The ultimate example may have bee the soldier who had a mini-mortar round embedded in his kidney. Had a shred of his uniform stick between pieces of the detonator so it didn't go off... similarly, cloth and especially buttons or such, or a bone hit, can cause an ordinarily non-deforming bullet to fragment or expand, or cause a normally expanding bullet to not expand.
Hunters get this problem too, with hair and feathers and ... after all, it's generalizable all the way between birdshot and artillery.
And then, the old thing about the plural of "anecdote" not being "data". Except that if something happens once, it is probably possible that it happen again too. It's just that there may be a thousand other, more probable, results too.
(BTW, in this part of Europe, guns aren't anything like rare. At least, long guns aren't - and "assault rifles" are usually just too wimpy to hunt moose with, and only rarely accurate enough for anything smaller.)
AD,
Box O' Truth, at http://www.theboxotruth.com/index.htm
Takes a lot of the hype and mystery out of things.
That being said, the difference between pistols and rifles should not be underestimated.
One of the biggest fallacies, for me, is the "bigger is better". So, you hear that 9mm is worthless and .45 ACP will stop a charging bull with one round. Then you hear the same thing about .223 vs .308. Looking at ballistics, a .233 at 1000yds still has more energy than a .45ACP at the muzzle. So which is it? Good shot placement, with enough energy, stops them. But a guaranteed one shot stopper? Nothing kills, or even stops, a determined attacker every time.
The flip side to that is that a .22 will kill someone through heartbreaking negligence all too often.
Good luck, I'll be interested in seeing what you post about it.
AD, will this be for the Fort Worth conference?
As a semi-medblogger, I don't have much to add. When I was in nursing school, GSW's weren't really covered.In EMS classes, they covered the basics (jacketed hollowpoints worse than solid lead, cavitation). I do remember hearing about the "22's rattle around inside" myth.
I don't think of a large amount of difference between assault rifles and hunting rifles... If I had to guess, the assault rifle would carry more bullets and be designed for shooting a shorter distance. I guess the name doesn't make much difference...
There wasn't any anti-gun bias where I got my medical training, my EMS instructors were hunters, and my nursing professors were A.) ex-military or B.) a hunter. (downstate Illinois, if it matters).
This video:
http://www.dailycupoftech.com/2007/08/21/youtube-in-powerpoint-offline
will teach you how to embed a YouTube video into a Power Point presentation for offline use.
The only difference is that you need to use the FireFox add-on mentioned above to download the video. YouTube does not have 'direct links' to all videos anymore.
The basic steps are:
1. Download the video to .flv
2. Convert from .flv to .mpg
3. Embed in Power Point.
I know it works 'cause I just helped my niece do it this weekend.
Obviously, I answered the "Medblogger's Questions"
1. The only thing that "scares" me about firearms is unsafe handling by uneducated/untrained individuals. GSW's don't scare me - unless of course they would be to myself.
2. Nothing that I can recall off-hand
3. "High-caliber handguns and rifles always leave big, nasty exit wounds" - I call BS on this one. There's a multitude of factors that come into play including velocity, type of bullet, etc. They can just as easily leave an exit wound no bigger than the entrance that can be easily missed during an assessment.
4. None of those terms conjure up anything. I was raised in SW Louisiana and learned how to handle and respect guns at a very young age. The Sniper and Assault rifle terms are often way to over-used when describing many sporting rifles.
5.Neither - close range shotgun blasts tend to bring to mind some very vivid images from calls past. Caliber is pretty irrelevant as any correctly placed bullet(whether through skill or luck) will kill you no matter the caliber.
6.Most of my wound ballistics ed. came from EMT, Paramedic and PHTLS classes. I consider what I have received thus far as being "adequate but not exceptional."
Here's some video that may help...more later.
http://www.theboxotruth.com/docs/theboxotruth.htm
Several years ago I visited the Museum of Pathology at Walter Reed Army Medical Center. They have a very large room dedicated to the study of terminal wound ballistics (wound terminal ballistics?). The staff there would probably be more than willing to help you with that part of your presentation.
Please post your presentation or a link to it here so that I can see the finished work.
AD: Given how clean and concise your writing style is (not to mention entertaining), if you do compile an educational guide, I would dearly love to see it/read it.
To answer your questions (med-student-blogger)
I'm mostly scared of the person holding the gun, at least in theory. I spent a great deal of time working with stage guns (real, but capped), and I've seen stupid people come very close to injuring themselves with those. So yeah.... people are scary enough on their own... people with guns? potentially terrifying.
Likewise, in terms of GSWs, I'm most scared of what part got hit, what blood vessels are involved, and so on. I know piss-all about GSWs, so that's a fear based on no reality whatsoever.
I grew up in a hunting state, and live in a different, but equally hunting-oriented state, both of which also have "big bad cities of gang violence and death" in them. My completely uninformed opinion has always been than more hunting accidents are caused by dumb mistakes than gang-ones (debatable, I suppose, depending on your take on things), but that they're no more or less deadly than any other GSW. I, personally, fear "deer rifle" far more than "assault rifle" because I hear more people talk about injuries relating to the former than the latter (which only seems to be a common term in the news cycle).
As for medical education, I'll admit, I'm still in it, so I can't say with total authority (especially as I'll be in the "big bad city" for a rotation in the fall). However, given that my classroom time is about over, I can safely say that the only textbook lessons on GSWs we've received here were part of our lectures on forensic pathology and involved lovely images of horrible hunting accidents and a few murders. Compared to the other gruesome things we were shown, the GSWs were pretty unremarkable. And the text was about a paragraph long, basically saying that different guns and ranges if you want to know the specifics of a wound, ask the pathologist. We were tested on general range/impact information ("what range would cause a gunpowder halo" and etc..), but only one question on a much longer multiple guess exam.
Out of curiosity, because there are a lot of bow hunters up here in the Northland, have you ever seen a bow-hunting injury? Are they treated more as a knife wound or a gun wound?
I've got another category for you: the LE side.
It is generally taken as an article of faith that medical first responders will do whatever it takes to contaminate and obfuscate a crime scene, making crime scene reconstruction a very difficult thing.
Please: If you arrive and find a very dead guy there, don't disturb him or the room. I'm begging you. And, when you find a guy with his head blown off by a party or parties unknown... YES, I know that you might be able to bring back a heartbeat to harvest organs, but we'll have a lot better chance of figuring out what happened if you'll just call it there and request the ME, and not disturb the body.
Please don't clean up the body of a gunshot victim, unless he's going into surgery. Ever. Let us document it.
Please don't disturb the clothing any more than is necessary on a gunshot victim, or save it as intact as possible.
Please make note of the presence and location of HVIS. Does it appear to be expirated, or forespatter or backspatter from the shooting?
Please take note of any transfer of blood that you made, or swipes or smears that you made of the blood. PLEASE make a note of any that you made, in the course of attempting to treat the victim. It's okay that you did (well, we'd rather we could get the body untouched, but it's understandable if some blood was smeared)-- but documenting your own contribution to changes in the evidence can help keep the CS reconstructionist from going down a false trail. (And it's unlikely that your mentioning such a thing will land you in court.)
What was the condition of blood on scene? This is important medically as well as criminalistically. Pools of blood were clotted? You've get an older shooting scene (at least an hour). Blood is black from losing oxygen? Even older.
Please don't declare a wound the "entry wound" and another wound the "exit wound." You'd be surprised at how often that gets things futzed up.
Understand that extremely high-velocity, high-powered projectiles may not exit.
Myths:
Rock Salt loads.
First, that they exist. In all my years around gun culture, and visiting gun shows, and being a gunny cop's son, and being a moderator of two firearms bulletin boards, and being a gunny cop myself, I've NEVER seen one.
Second: That they're not deadly. Push even light rock salt out of a shotgun barrel at 1300 fps, and it very well could kill a person.
Cop Killer Bullets indicate that the shooter was vicious. Look-- if you're shooting a gun at someone, you've gotten to the gravest extreme. Anything that helps put the bad guy down fastest means that you'll be less likely to be firing more potentially dangerous, liability-rich bullets. Anything that increases the ability of a handgun to stop a threat is to be chosen, as handguns are inherently inferior weapons, compared to shotguns and rifles.
Myth: Hydrostatic shock from pistol bullets. Nope.
Surprising fact: that bullets that fail to exit gunshot victims' bodies often are found just barely inside of the skin on the off side. Hunters see this all the time, and so to pathologists. Apparently that hide is stronger than it looks, and a deformed, mostly spent bullet will apparently hit the off-side hide interior, stretch it out, and come to rest just under the skin. Occasionally, it will even partially exit, which can result to spent bullets simply falling from the body of the victim.
Myth: that a bullet fired from a man-portable handgun, rifle, or shotgun can actually knock a man backwards, even lifting him from his feet. Newton says that this is impossible without the shooter doing likewise. If you find a guy piled up against the wall or the like, understand that there may be other reasons that sent him back like that. The bullet didn't "knock" him back there.
Estimating internal damage of a non-perforating wound by the entry wound alone is folly.
Matt g,
You'll probably be amused to know that when I was on the street full time my partners and I had a "crime scene kit". It included one roll of genuine yellow crime scene tape, several paper bags of various sizes, and expired burn sheets, still in their packages.
We'd also been trained in crime scene preservation by the homicide guys, as is everyone in our department.
More than once we had the scene taped off, the body covered with the sheets and bags ready for the police before they got there. Of course the most important part of crime scene preservation is to keep the fire department OUT!
Don't know if this fits your needs or not, but I blame the movie "Shane" and a certain special-effects harness for the myth that humans hit by gunfire fly dramatically backwards (often through plate-glass windows).
Such cinematic depictions maybe over-emphasize shock (in a non-Newtonian way!) and de-emphasize the more gradual fatal internal bleeding from a solid hit?
I will ask some dudes who have been shot to see if they can take a few moinutes to describe the experience.
I've been prosecuting for some 14 years in the South so have seen a mess of shootings, some justified, some not. Regardless, a few observations.
One, any round can kill you. I had a thug (not being mean, but he had "thug" tattooed on his arm) get shot under the right arm with a .22 short from a RG revolver. Bullet passed through and hit his heart. EMS was there so quick that no one had a chance to steal his shoes and he was already dead.
Two, if you want to kill someone, use a 12 gauge shotgun. Trust me on this one.
Three, if you REALLY want to kill someone, use a rifle. A .30-30 works very well.
One last thought, AD: It has been some years since I looked at a copy of The Journal of Forensic Pathology and Medicine, but I assume that it still carries articles on gunshot wounds.
I guess I watched too much "A team" when I was young, so one of my pet peeves is someone using a table or even a garbage can for cover.
Once a friend of mine and I found a portion of a concrete wall that had every cell poured full of concrete with a re-bar in every cell also. It took 5 shots with a .223 to put a grapefruit size hole in that wall.
I have never looked at cover the same again.
1) I'm a pacifist with a moral objection to violence of any kind against humans (yes, even in defense - I'm not open for debate on that so y'all don't "shoot" me).
Not even in defnese? In other words you're calling for rule by whomever is the most brutal since thugs, by definition, will be thugs and people of goodwill will be acting as sheep. We'll just list you as an Eloi and move on.
As to bullet effects, shot placement is most important (I'd rahter be shot in the pinky-toe with a .44 Magnum than in the heart with a .22 Short.
Next is penetration. In real life people don't stand there like a B-27 Silhouette Pistol Target. The FBI requires a foot of penetration. (Jr. High level jokes go here.)
Bullet width is third. That's the wound channel you can be sure of. On a related note, a popular bit o' snark has it that while 9mm hollowpoints might expand, a .45 FMJ ain't gonna shink.
Anything else is just gravy.
This guy may have some useful information for you.
http://www.theboxotruth.com/
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