Placement and Effectiveness

[LAK]

Most "practical" shooting targets are a gross over simplification to begin with. They assume an upright and squarely facing attitude. A badguy may be presenting a 90 degree side view. In any scenario involving a presented fiream (by the BG), the actual weapon - handgun or long gun - supported by both hands and arms may be blocking a direct shot to a large portion of the upper torso, especially if they are leaning forward.

I am not suggesting in such cases one aim below, as in the split second demands of a gunfight this is not a good idea, but not necessarily a bad thing if it is instinctive and immediate.

 

[Loosedhorse]

so technically a descending aorta shot would take longer for brain bp to decrease

I doubt that. Techically it is an hydraulic system. Put a big hole anywhere in the big central pipe and the pressure in the entire system drops. It does not just drop beyond the big hole.

If you can postulate a reason someone would be emotionally invested in promoting this

Sure: because it is orthodoxy. I've heard it for many years, always based (so it seems to me) on the same anatomic drawings of supine cadavers; and assumptions of effectiveness, rather than any tabulated data about effectiveness.

It is therefore a safe choice; it is comfortable; it is easy. Whether or not it is right may be immaterial to whether or not it is popular.

There is also cognitive dissonance. That's a large concept, but one aspect of it is that, if we've decided on a course of action, we tend to ignore evidence that suggests we're wrong, and latch on to evidence that suggests we're right. I'm in no way suggesting that cognitive dissonance doesn't also apply to those (like me) who favor a lower COM; but I am suggesting that being aware of it--and therefore discounting the "evidence" of "well, a lot of people seem to say so"--may be helpful in evaluating the theory that a high COM is more likely to stop an attacker quickly than a lower COM shot.

(I have at least one other theory about "emotional"--since you asked about it--reasons why some particular trainers might feel "safer" teaching a high COM aiming point; but as getting support for that would take in-depth interviews that no one has done, that's best left alone.)

I also note that if I were to fire multiple shots at an attacker, and if the point of impact were to climb during that series due to recoil (neither assumption seems unreasonable) that starting with a "low COM" aiming point will quickly translate to a higher COM. And as LAK suggests, a "right in the middle" aim-point might be very instictive (especially on a moving target).

Don't get me wrong: I think a top-of-the-heart aiming point is ideal for a precision hunting first shot on a still quarry for almost all animals. I'm just not convinced this translates well to being somehow a clearly superior choice for stopping a moving human attacker.

"have a plan to kill everyone you meet."

In some ways, this quote belongs (IMHO) more in the "mindset" thread than this one. However, I've always found it interesting that, even though killing someone should be Plan F (or Z) on our lists, this quote is listed far more often than Plan A: "have a plan to run away from everyone you meet."

Interesting how much more we often stress killing than stopping, and how much more we stress lethal force than ADEE.

 

[Al Thompson]

Plan A: "have a plan to run away from everyone you meet."

Sig line worthy right there.

It's always more intriguing to read stories about violent human interaction than it is to read "well, he looked suspicious, so I drove away and enjoyed the rest of my week".....

 

[qwert65]

Loosedhorse - the difference I was talking about is a small difference, further your analogy is an over simplification, a hydraulic system does not have vasoconstriction and chemical messengers to cause blood to shunt away from less vital areas., also where on the descending aorta would matter, take a hose and cut it 10 feet from the end, take another one and cut it 20 feet which takes longer to run out of water? Note this is an oversimplification as no counter-mechanisms are used.
Pressure will drop immediately but not to the same pressure everywhere

 

[Loosedhorse]

vasoconstriction and chemical messengers to cause blood to shunt away from less vital areas

You are perhaps suggesting that peripheral vasoconstriction works better with a descending aorta shot than a more proximal shot?

Pressure will drop immediately but not at the same time

I disagree. Cartoid artery pressure would not immediately go to zero with a proximal aorta shot unless the aorta were severed; likewise, if you sever the descending aorta at the level of the top of the liver, carotid pressure cannot be maintained, even for the few extra seconds you claim.

Recall also that much of peripheral vasoconstriction is mediated by epinephrine: if there is no blood to carry the epinephrine to the periphery, it can't get there. That system doesn't deal well with interruption of the aorta (nothing does).

Any info on how many folks hit in the lower 1/3 of the mediastinum continue to attack?

if shot COM above the nipple line only 3 out of 10 survive (based on ER stats from SOP9).

That seems to be a "no" answer to my question. "Below the nipple line" includes the big toe, which is not my suggested point of aim.

Also, if there are SOP9 ER stats, they are keeping them very secret. To me, unverifiable sources are not sources. YMMV.

"well, he looked suspicious, so I drove away and enjoyed the rest of my week"

 

[Odd Job]

ER stats can be difficult to fathom, so many variables:

1) The time it took for the patient to be brought to hospital
2) The quality of care on the scene and in transit
3) The experience of the team on duty in the ER
4) Whether exact trajectories can be plotted for each projectile injury
5) The effect of other injuries
6) Pre-existing pathology, condition of the patient (including medications)
7) Medical misadventure
8) The quality and consistency of medical records with variations between staff members on the same unit and variation between staff members of different units in the same hospital
9) Variables to do with projectile differences (construction and velocity)
10) Clothing variables (this one is BIG)

Of course a big issue with ER stats for some lines of enquiry is that they exclude those cases that went straight to the mortuary.
What would be really good is to have a research protocol involving all the police departments, appropriate pathologists and major trauma units in a large jurisdiction, where detailed data could be collected on wounds involving the deceased and the living.
The major obstructions would be:

1) Ethics clearance
2) Cost
3) Time
4) Issues to do with standardisation
5) Uncertainty and missing data (unrecovered projectiles, false or erroneous statements and simple mistakes in the handling of what is a very stressful situation)

 

[JustinJ]

A&P was a long time ago but if anybody looks at a diagram of the cardiovascular system the upper chest is full of important pipes which are located between the heart and head. Severing any one of them would cause rapid loss of blood loss to the brain. Arguing about which part of the heart is best to shoot assumes a higher level of accuracy than would seem practical in a high stress situation. The benefit to hitting the upper chest is the density of arteries and large veins. For the most part the only good artery to hit below the heart runs down the center of the body.

 

[qwert65]

Loosedhorse -bp drop does not mean zero( though it shortly would be there)
There are many reactions going on not the least of which is constriction of any cut vessel(not a 100%)
My point is this-cerebral blood pressure will drop faster with a heart or ascending aorta hit then with the same hit on the descending aorta.
If you can bring any scientific reason for this not to be true I'd like to hear it

 

[Loosedhorse]

My point is this-cerebral blood pressure will drop faster with a heart or ascending aorta hit then with the same hit on the descending aorta.

And my point is that you have no scientific support for your point.

If you can bring any scientific reason for this not to be true I'd like to hear it

Ditto: if you have any scientific (I'd prefer experimental data) reason why I should conclude your claim is true, I'd like to hear it. You are setting your opinion up as accepted, and requiring me to provide my reasons.

There are many reactions going on

This is what is usually refered to as a hand-waving argument. It is not persuasive.

Let me help you out. There is no available experimental evidence that will help us distinguish whether a high COM point of aim (which does not guarantee a high COM point of impact) stops fights more quickly than a low COM point of aim.

I can make argument that an even higher aiming point at the level of the top of the sternum is ideal: on target you hit the aorta, miss laterally and you can get the subclavian artery and brachial plexus (immoblizing the arm) or even the carotid origins, miss low and you're still in aorta or heart, miss high for cervical spinal column.

But that is argument, not to be confused with "scientific reason"--experimental data.

 

[Old Fuff]

Well I see a lot of disagreement...

But on the other hand it seems generally accepted that bullet placement is important.

That in itself is progress, as too many think that if they carry a certain handgun loaded with particular ammunition, where the bullet hits is of no consequence because of the supper tactical properties and extra-lethal attributes the projectile offers.

Which is nonsense. :banghead:

Carry on.

 

[qwert65]

Um no when a blood vessel is severed it starts a cascade of events some of which we domt know yet(on a chemical level) I stated a fact if you want to dispute it please show me in any accepted medical text of your choosing.
I tried to explain why bp would drop quicker. You pointed out there is no study. You are correct. However when there is no study you can still come up with a logical answer based on known physiology. I stated my case.

 

[Loosedhorse]

I stated a fact

No, you stated a claim: that what you think is true is a fact; but you have not shown that it is indeed a fact. So, prove your fact is a fact; then you can ask me to disprove it.

I tried to explain why bp would drop quicker.

Yes, you did try. You succeeded in explaining why you think it would. You have not succeeded in showing that what you think is in fact so. You yourself have not, as you have tasked me to do, referenced "any accepted medical text of your choosing" to support your claim.

I am eager for you to show us which "accepted medical texts" address the differences in cerebral blood flow produced by devastaing aortic injuries, depending on whether they are placed immediately before or immediately after the carotid origins.

So, yes: you have explained why you believe you are correct, and I have explained why I believe your claim is incorrect. There we are.

I don't mind at all your having a belief that is different than mine, as you might well be correct (absent experimental evidence to determine which theory is correct). But if you're going to claim your belief is a fact rather than an assumption, well, prove it.
_______

Just for giggles: determining whether a particular point of aim will be more effective in stopping an attack is an interesting problem. It would involve comparing the calculation:

The probability of "immediately" incapacitating if POA is struck X probability of POA being struck + probablity of "immediately" incapacitating if this structure near POA is struck X probability of that that structure being struck + probablity of "immediately" incapacitating if this other structure near POA is struck (etc...)

for each of the points of aim being compared.

Note that one reason we don't prefer high aiming points is that human targets tend to drop lower to avoid being hit; the higher the aim point, the more likely that target drop will result in a miss high. True, if human attackers start standing up very tall when under fire then we can expect more misses low (which still hit the body somewhere), but for now I'd be more concerned about missing high.

A low COM point of aim might allow a valuable anatomic hit even if the attacker dips low, and might do that better than a high COM point of aim.

 

[qwert65]

The fact is this, when any blood vessel is severed a cascade of events happens by the body to maintain blood pressure. This is a fact.
I would appreciate you not just quoting part of a statement.
I explained that you can make factual statements without a study for example, I propose that you bleed to death just as quick from a right carotid injury then a left carotid injury. There are no studies on this, however the facts that we know about how the circulatory system works allows us to come to the correct conclusion.
When deciding on studies one of the things you look at is will this tell us anything new?
I stated my medical opinion in my first post with my credentials. I am not a MD. I am a DVM so I don't treat humans, however the circulatory system's response to trauma is the same. My point is this I gave my opinion on what would happen, which with my credentials is allowed in a court of law.
If you want to quibble that's fine though your time may be better served in the libary with any first year cardio text. I will reiterate that the time difference would be seconds.

 

[Shadow 7D]

Loosed study up on shock trauma
there is lots of info certain actions that happen globally and locally when a vessel is severed, alot depend son the type of injury, but the body does try to clamp down and save it's self, I rather don't get the pissing contest that's going on.

shoot center of mass.
AS FOR HANDWAVING
Loose, YOU HAVE YET TO SOURCE YOUR ARGUMENT

 

[Loosedhorse]

Loosed study up on shock trauma

You are making the assertion that I have not; please prove it.

when a vessel is severed, alot depend son the type of injury, but the body does try to clamp down and save it's self, I rather don't get the pissing contest that's going on.

Strawman. I haven't argued the body doesn't react "when a vessel is severed". I have argued that carotid pressure drops whether you put a big hole in the aorta after the carotid origins or before them, and I have argued that the body's reactions to a severed vessel don't accomplish much of anything when that severed vessel is the decending aorta.

Study up on that.

YOU HAVE YET TO SOURCE YOUR ARGUMENT

Sure. But why (I ask again) is there a requirement that I must source my argument, but you and qwert65 don't have to?

By the way, which argument would you have me source: the one I made, or the strawman you claim I made.

shoot center of mass

Well, at least we agree!

 

[Shadow 7D]

http://emedicine.medscape.com/article/432650-overview
http://en.wikipedia.org/wiki/Shock_(circulatory)
Skip the words part of the wiki article if you like and just go to the citations

Why don't I, well for 7 years I had how to treat a GSW drummed into my skull along with a bunch of other stuff.

Let me quote the cover page to the SF medical handbook (they also have a very good section on veterinary medicine)
Firepower superiority is the best medicine.

I advocate hitting what you shoot at.
shooting what you can hit
and trying to hit something critical

Now lets go play with Courtney and Courtney and hydrostatic shock..... (please don't, I'll be the first to flag the resultant poo slinging)

There are many things your body can compensate for, and a number of things it can't, a ragged tear is almost impossible (note, I said almost as there is ALWAYS the exception)
for the body to constrict through venous spasm, where a clean slice, even to major vessel, you body can, for a while clamp down, and limit the blood loss, but open a vein like a zipper and it's over quick.

there is so many different mechanisms, and PERSONAL tollerences (physique, build, condition etc.) You can't come and say one fits all, but you can say a shot to the upper torso is more likely to be fatal, with possible quicker incapciation. A liver shot is fatal, but they can, in pain, still function for 10-15 minutes on their feet, don't count on pain. A lung shot is similar, but ask any hunter how far a deer can make it, some go a long ways. Hell there was a post last year where a dear was shot in the heart and still made it ~100yards.

so to sum it up, there are more critical structures in the center of the body, and more critical (immediate) structures in the upper chest than the abdomen, and most 'center of mass' shots are aimed to the upper abdomen.

 

[Shadow 7D]

The curved line in the middle is about where the diaphrame is located, ie, upper abdomen

The fist is right about upper abdomen, the chin is about inline with the upper chest.

something I was told in a different lifetime (when I was in the service)
the breast pockets are great aiming aids, shoot to the center (of the body) of them.

 

[JustinJ]

Since mortal men tend to be far less accurate when under extreme stress shouldn't the discussion be more along the lines of what area has the highest density of structures that cause rapid incapication when damaged? The upper chest would meet this criteria.

 

[Doghandler]

Since mortal men tend to be far less accurate when under extreme stress shouldn't the discussion be more along the lines of what area has the highest density of structures that cause rapid incapication when damaged? The upper chest would meet this criteria.

Use the stress to your advantage. When the time is slow, where the noise is far off in the background, where your vision is efficiently concentrated, and you are unsure if you can actually feel your own body.

Once you've caught the ball and are headed down field, once you've juked two guys into the turf and have one left to beat, have a stiff arm ready. Now is not the time to suddenly hear the roar of the crowd or feel the ground under your feet. Now is the time to take it across the goal line, Brother!

 

[qwert65]

If you read your posts I was replying to your statement that a wound to the descending aorta would have the same effect as the same wound to more cranial organs.
If you read my first post that is what I was replying to.

You make assumptions I said study the cardiovascular system. I did not state that you hadn't studied it. My point was that your knowledge in that area could use some help.

To the OP I'm sorry this thread has drifted this way, I shoot low personally because I tend to shoot high (that's why I aim more at the stomach)

 

[Loosedhorse]

a wound to the descending aorta would have the same effect as the same wound to more cranial organs.

Wow. Please show me where I mentioned "more cranial organs." I do think a wound to the aorta before the carotid origins would have the same effect on carotid pressure as a similar wound to the aorta after the carotids take off. And that's based on lowering the resistance in a hydraulic circuit. Hey, I could be wrong, and as I've said repeatedly, I invite your experimental evidence (as opposed to your suppositions) that I am wrong.

My point was that your knowledge in that area could use some help.

I am happy to return your supposition: your understanding needs a lot of help.

Skip the words part of the wiki article if you like and just go to the citations

Still, there is nothing in your references about proximal versus distal aortic trauma, or about the "effectiveness" of the body's reactions in delaying incapacitation after transection of the descending aorta. Tisk, tisk.

However, I'm sure your references debunk something you're about to tell me I said, even though I didn't. Nothing like a good strawman.

BTW, given your 7 years of--what was it--being told about GSWs, perhaps you recall this:

Death occurs immediately after traumatic rupture of the thoracic aorta 75%–90% of the time since bleeding is so severe

You, too, can skip the text and go right to the references. You'll find no distinction made between pre-carotid and post-carotid aortic trauma--well, that I could find. Anywhere.

So, educate me: I would welcome a reference comparing alertness or survival intervals (in seconds! ) between ascending and descending aortic bullet wounds.

 

[Shadow 7D]

No it doesn't
Sorry, but immediate death is, well intimidate
secondly, carotid???
as in the ascending vessels feeding the brain?
as for immediate, please, find me that definition

As a former EMT and Army Medic, to me it means ONE THING and that's Dead Right There.

Even decapitation isn't DRT, close, but go back and read accounts of executions where the victim was looking around, blinking, even trying to speak.

Massive trauma can do it (think train v pedestrian) apricot shot and similar.

BTW, my dad died of a bisecting Aortic Aneurism (go to medical text or even your wiki)
He survived for a day (cause the Dr. was stupid and ASSumed it was just a heart attack)
he wast transferred 8 hours post event to one of the top heart hospitals in the country and operated on by Dr. Jarvic.

As to PRE brain, vs. Post brain supply, well everybody's different, but you tell me, really, how do you think your body will react, you can survive with out blood flow to the legs, how long for the brain (3-5 minutes possible with out damage, but damage can occur in as little as 30 seconds)

Pre carotid, you interrupt the flow to the brain, post you are working through GENERAL shock (hypoglycemic) methods, which can be quick, but importantly is how quick.

And come back with something other than an OPINION
as in this subject seconds count, and I've never even entered the fray that you are attempting to say I have, rather, READ MY POSTS

I advocate hitting what you shoot at.
shooting what you can hit
and trying to hit something critical

 

[LAK]

Just one observation RE: major blood vessels in the torso. People that suffer ruptured aortas that are not necessarily due to severe trauma generally collapse quite quickly. So the blood pressure loss must be quite rapid.

 

[Shadow 7D]

depends where the rupture is, lower, the loss is less, but aortic arch, superior vena cava, yeah, it don't get much larger than that, and if it goes there ain't much coming back from that.

Both are located in the upper chest

 

[Loosedhorse]

And come back with something other than an OPINION

Why must I counter your simple opinion with "something other than an OPINION" (is it really necessary to shout? ), especially in an arena where--I think it's agreed--we have no experimental data. Without data, neither you nor I can have anything except opinion.

...aortic arch, superior vena cava, yeah, it don't get much larger than that, and if it goes there ain't much coming back from that.

Both are located in the upper chest

And most of the the inferior vena cava and decending aorta are located in the lower chest and upper abdomen. Are you suggesting that these are not also large vessels, or that there is "a lot of coming back" when those are perforated or interrupted?

how do you think your body will react, you can survive with out blood flow to the legs

Here, again, is the unsupported assumption that transection of the aorta after the carotid origins only affects bloodflow to the lower body; it affects bloodflow, immediately and profoundly, in the carotids as well. Again, it is an hydraulic circuit with a sudden, catastrophic loss of resistance; pressure drops everywhere, not only in the portion after the break.