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Ballistic trauma
Classification and external resources
ICD-10 T14.1, W34, X95.
ICD-9 E922.9
DiseasesDB 5480
MeSH D014948

The term ballistic trauma (generally referred to by the type of weapon; gunshot wound, etc. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings S00-T14 - Injury (S00-S09 Head ( Superficial Injury of head ( Superficial injury of V01-Y98 - External causes of Morbidity and mortality (V01-X59 Accidents ( Unintentional Vehicle and Traffic The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books ) refers to a form of physical trauma sustained from the discharge of arms or munitions during conflict or otherwise. Treatment of physical trauma is described here and in First aid. Ammunition, often referred to as ammo, is a generic term derived from the French language la munition which [1] The most common forms of ballistic trauma are those which stem from small arms fire, namely semi-automatic pistols, light machine guns, sub-machine guns and assault rifles used in armed conflicts, civilian sporting and recreational pursuits and illegal activity. Small arms is a term used by the Armed forces to refer to Infantry Weapons such as the Firearms that an individual soldier can carry For other uses of the phrase see Machine Gun (disambiguation. A submachine gun (SMG is a Firearm that combines the automatic fire of a Machine gun with the cartridge of a Pistol, and is An assault rifle is a Selective fire Rifle or Carbine (not to be confused with a semi-automatic only replica firing Ammunition with muzzle [2]

In terms of public health, it is estimated that over 500,000 injuries are sustained annually from the use of firearms; 300,000 or more relating to those occurring in situations of armed conflict, with the remainder of 200,000 or more being sustained in non-conflict situations. Public health is "the science and art of preventing disease prolonging life and promoting health through the organised efforts and informed choices of society organisations A firearm is a Tool that projects either single or multiple Projectiles at high velocity through a controlled explosion War is an international relations Dispute, characterized by organized Violence between National Military units [1]According to reports from the World Health Organization in 2001, these injuries represent roughly a quarter of the estimated 2. Year 2001 ( MMI) was a Common year starting on Monday according to the Gregorian calendar. 3 million deaths which have occurred due to violence[3]; 42% being suicides, 38% homicides, and 26% related to war and armed conflict. [4][1]

Contents

Introduction

Although there are several causes for ballistic trauma depending upon the situation in which they occur, priorities for physicians lie in ascertaining the likelihood of survival for the patient based upon damage caused by the bullet on entry -- whether a bullet strikes or shatters a bone, and if shattered bone or shrapnel has punctured vital organs or has damaged the spinal cord of the patient. Shrapnel is the term originally applied to an anti-personnel artillery shell which carried a large number of individual bullets to the target and then ejected them forwards relying [1] Alongside estimation of the patient's survival, another key determinant is if the future health of the patient dependant upon the severity of the injury so that preventative measures can be approximated, due to the benefits of preventing death or injury outweighing those of a purely treatment-based approach. [1]

Alongside physical and medical measures used to prevent injury and death, there are two main approaches of harm reduction and public health. Harm reduction is a Philosophy of Public health, intended to be a progressive alternative to the prohibition of certain potentially dangerous [1] The perspective of harm reduction operates under the premise that by their very nature, arms and munitions are entities which are used to kill, harm or threaten other beings which translates within most modern societies as the reduction of harm rather than their banning in entirety due to their utility within society. In Economics, utility is a measure of the relative satisfaction from or desirability of Consumption of various Goods and services. [1] The latter public health perspective on firearms centers around scientific approaches to illustrating and examining issues and ultimately the causal factors of firearms injuries including other routes, such as psychological, criminological, economical and educational means. Causality (but not causation) denotes a necessary relationship between one event (called cause and another event (called effect) which is the direct consequence Psychology (from Greek grc ψῡχή psȳkhē, "breath life soul" and grc -λογία -logia) is an Academic and Schools of thought In the mid-18th century criminology arose as social philosophers gave thought to crime and concepts of law Economics is the social science that studies the production distribution, and consumption of goods and services. Education encompasses both the Teaching and Learning of Knowledge, proper conduct, and technical competency [1][2]

Assessment of severity

When assessing the likely severity of gunshot wounds, there are numerous variables which include the following, considered either singly or in concert:

Even non-fatal gunshot wounds frequently have severe and long-lasting effects, including disfigurement and/or permanent disability. Disfigurement is the state of having one's appearance deeply and persistently harmed Medically as from a Disease, Birth defect, or Wound. As a rule, all gunshot wounds are medical emergencies which require immediate hospital treatment. A medical emergency is an Injury or Illness that is acute and poses an immediate risk to a person's life or long term health

Destructive effects

The immediate damaging effects of the bullet are typically a loss of blood, and with it, the potential for hypovolemic shock, an inadequate amount of blood in the circulatory system. Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from More 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. The heart is a muscular organ in all Vertebrates responsible for pumping Blood through the Blood vessels by repeated rhythmic In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. In Human anatomy, the vertebral column ( backbone or spine) is a column of 34 Vertebrae the Sacrum, Intervertebral The brain is the center of the Nervous system in animals All Vertebrates and the majority of Invertebrates have a brain Common causes of death following gunshot injury include exsanguination, hypoxia caused by pneumothorax, heart failure and brain damage. Exsanguination (also known colloquially as bleeding out) is the fatal process of total Hypovolemia (blood loss Chronic Hypoxia is a pathological condition in which the body as a whole ( generalized hypoxia) or region of the body ( tissue hypoxia) is deprived of adequate Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply Brain damage, or Acquired brain injury, is the destruction or degeneration of Brain cells. 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. A bullet is a solid Projectile propelled by a Firearm or Air gun and is normally made from metal (usually Lead) The study of the dynamics of bullets in gunshot injuries is called terminal ballistics. Terminal ballistics, a sub-field of Ballistics, is the study of the behavior of a Projectile when it hits its target

See also

References

  1. Mahoney, P. Treatment of physical trauma is described here and in First aid. Battlefield medicine, also called field surgery and more recently combat casualty care, is the treatment of wounded Soldiers in or near an area of combat Emergency Medicine is a speciality of Medicine that focuses on the Diagnosis and treatment of acute illnesses and injuries that require immediate medical attention Multiple gunshot suicide occurs when an individual commits Suicide by Firearm and succeeds in inflicting two or more Gunshots upon himself before incapacitation Terminal ballistics, a sub-field of Ballistics, is the study of the behavior of a Projectile when it hits its target The term hydrostatic shock describes the theory that a penetrating projectile produces remote wounding and incapacitating effects in living targets in addition to local effects in tissue 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. Available from http://www5.who.int/violence_injury_prevention/main.cfm?p=0000000675#Appendix%204.
  3. World Health Organization (WHO). Small arms and global health. Paper prepared for SALW talks. Geneva: July 2001. Available from http://www5.who.int/violence_injury_prevention/download.cfm?id=0000000158

Notes

  1. ^ a b c d e f g h Mahoney, P. F. , et al. (2004). Section 1 : Introduction, Background and Science p4
  2. ^ a b Mahoney, P. F. , et al. (2004). The International Small Arms Situation p6
  3. ^ World Health Organization (WHO). Small arms and global health.
  4. ^ Krug E. E. , ed. World Report on Violence and Health.

External links

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