View of Gunshot Wounds By A Surgeon

[braxton14]

Great video (WARNING: There is some gore)
http://youtu.be/tku8YI68-JA

Edit: If someone knows how to embed the video, would you help me out please?

 

[threefortyduster]

Interesting video...can't think of the last time I watched a half hour worth of internet video.

 

[The-Reaver]

Very good presentation.

 

[Ryanxia]

Kind of interesting. Comes off as a little anti though in my opinion.

 

[Alaska444]

Interesting presentation. If you saw the bloody mess that the surgeon encountered in the video about 3/4ths the way through, that is not an easy job at all. It takes a special sort of person to do trauma surgery well.

Trauma situations, they use scissors to open both the abdominal and thoracic cavity. For a thoracic injury, at times they use a "clamshell" incision exposing all of the thoracic contents. One of my friends is an ER doc who has saved people with knife wounds directly to the heart. He opened up one kid, placed his finger in the wound, sutured around it and sent the kid to the OR.

A few days later he walked out of the hospital hopefully not going back to his gang banging ways, but who knows. On the other hand, I have seen folks with a clamshell incision who didn't make it to the OR. Bleeding is the issue with handguns.

The presenter, an anesthesiologist and not a surgeon, noted the new guidelines on giving fluids after gunshot wounds. This information of NOT giving Normal Saline or other "crystalloids" was promoted by the IDF where they noted better survival among soldiers if they didn't have large amounts of fluid diluting the blood that remains.

In this case, a low blood pressure allows the injured blood vessels to clot off. Giving the fluids in this situation can increase the risk of further bleeding. Very interesting concept that is slowly becoming adopted here in the US. Israel adopted these guidelines nearly 10 years ago already.

 

[Mikhail Weiss]

Curious video from an anesthesiologist with an accent.

I found this comment interesting: “There's no magic how bullets kill. Bullets kill by damaging vasculature and patients bleed to death.”

Other points of interest: A handgun wound is a handgun wound. About 6 of 7 shot with handguns survive. 1 in 7 die. Those shot by rifles die more often or suffer greater wounds. Good thing rifles represent only 4% of gunshot wounds.

Also of interest: the .40 caliber shot that penetrated the survivor's sternum mushroomed as designed, losing most of its energy during deformation and penetration. Frontal X-Ray looked like a fatal wound. Side X-Ray showed shallowness of penetration.

And this: There's often no way to tell, during a handgun shooting, that you've hit the target, and in fact the target often runs.

 

[Alaska444]

Kind of interesting. Comes off as a little anti though in my opinion.

From a medical perspective, gun shot wounds are tragic. I would say most of my colleagues are now anti-gun in their views. Not too surprising since the medical community is the place where the try to put these people back together, not an easy task.

I didn't actually pick up a lot of politics in his presentation. Mainly just straight forward medical evidence from the literature on these types of injuries. When you care for gun shot injuries, you learn pretty quickly that they ain't pretty. That can certainly taint your view point of the 2A.

However, a large portion of these gun shot wounds come from criminal activities especially among gang members. The risk of gun shot injury is actually quite low for those that do not engage in high risk or illicit activities. If you live by the sword, you shall die by the sword applies.

 

[Inebriated]

*Disclaimer... I'm not a Doctor, nor an expert on terminal ballistics.*

The .40 S&W to the sternum is a good example of why I tend to side with penetration a little more than expansion. Yes, if shots were going to be where you intended, a .45 ACP expanding to .72" would be preferable to 9mm that expanded to .5". But often times, they aren't exactly where the shooter intended. After all, it's very hard to be the good guy, and be offered the luxury of a shot straight towards vitals from the front (about the shortest possible way to them)... You're usually dealing with different angles, making what needs to be hit even more protected. So again, penetration seems to be more important to me.

If the shooter had the velocity that .357 offers, or perhaps even the extra momentum of a 230 grain bullet, could that shot have done what was intended?

 

[Reloadron]

That was really good and enlightening. Thanks for sharing that.

Ron

 

[WNTFW]

Braxton,
Thanks for sharing.

 

[fatcat4620]

Tag to watch at work
Watched and enjoyed. Very informative.

 

[La Linea]

Very interesting, I sent it to an EMT bro.
I also did not detect an anti attitude, but who would really blame the guy if he had one. And he is obviously European to boot, so I thought he was professionally non-judgemental at least 2nd Amendment wise.

 

[flyskater]

I've worked in ER on occassion at one of the busiest Level 1 trauma in the nation. It's very depressing sometimes working there since I'm a gun owner/ccw. It makes me think many times about gun safety when I'm shooting as well as using a gun against someone that endangers my life. In my mind, I don't want to have to pull a trigger on someone unless my life is in imminent danger.
I remember one time when someone who was shot 9 times with a .40 in the abdomen and chest literally walked in the ER, signed his consent papers, then talked to us what happened. I'm glad he survived.

 

[Ignition Override]

The lady next door is an ER surgeon and works at a few Memphis hospitals.

Will ask her about this topic.

 

[nneely]

Great video! I think it's interesting that the number of viewers is so low for such a good piece. As this video shows, guns do not kill someone everytime they are used. At the time I watched this video it had 534 views. Too bad it doesn't get as high as some of the videos like a "panda sneezing" and maybe some of the "anti gun" people would change their mind.

 

[murphys_law]

Very interesting, thanks for sharing.

 

[ATBackPackin]

Good video, but it only proves what we already knew. A handgun is for fighting your way to a long gun, but I still enjoyed watching it.

I too did not find it to have anti undertones.

 

[MachIVshooter]

Comes off as a little anti though in my opinion

I didn't perceive that. There seemed no bias of any kind to me, just a no-BS assessment of GSWs from several perspectives, and a summary that most of us already understood:

-Gun shot wounds can be quite nasty
-Handgun wounds are most often survivable
-Rifle wounds are more devastating
-The key to surviving trauma (GSW or otherwise) is receiving medical attention quickly.
-Changes in ER/OR doctrine are increasing GSW survival rates

 

[braxton14]

No problem...I'm just surprised that so many people watched this 30+ minute presentation. I only kept watching it because it caught my attention from the beginning.

 

[Trent]

I watched it start to finish yesterday right after you posted it, was good stuff. Didn't get back on here to post afterwards though, work got in the way.

Lot of good information in that video.

 

[ccsniper]

I wonder how pistol caliber rifles do? The increase in velocity isn't much and probably not enough to inflict much more serious damage than a handgun.

 

[Skribs]

CCS, someone in another thread showed me this link: http://www.ballisticsbytheinch.com/calibers.html

Even the 9mm in 90-grain bullets didn't get over 1800 FPS in a 18" barrel, still short of the 2000 FPS that's oft-cited as the point where the cavitation starts to stretch beyond the elastic point. Your standard 124-grain were around 1300 and 147-grain about 1100 FPS.

125 gr .357 magnum rounds seem to get just to barelly 2000 FPS in the 18" barrel. Might be a nice nod to the lever-action if someone wants to go that route.

 

[skiwi]

a video well worth watching. I need to send this to a friend who is an ER doctor and shooter

an interesting correlation between caliber and potential wound size (depending on ammo type -video assume hollow points), ie, bigger caliber can result in larger wound cavity -makes sense, but discounts the number of wounds causing bleeding. The premise is that the most damage is from bleeding/blood circulatory system-arteries tissue damage, or spinal chord damage. It can be argued that a larger caliber, say 1911 in .45 ACP would result in more damage, but equally, more rounds in a smaller caliber can result in more arterial damage. It all depends on the accuracy of the shooter. Let the caliber wars/debates continue!!

Since the critical factor in a handgun shooting, not to the head, is how quickly the shooting victim gets to the OR is the main factor of survivability.

The video does make a clear difference between rifle and handgun shootings. It reinforces the maxim of "handgun is for fighting our way to a long gun"

I'm not sure it changes many strong/personal opinions on caliber choice though, but that was not the point of the video.

If anything it should change what you target on a figure target -head/ocular cavity, heart and central spine...

 

[Big Mike]

Interesting, thanks for the link.

 

[unlimited4x4]

Does make me question hollow points vs FMJa bit. Due to the fact to putting a man down with a handgun seems to depend on hitting a major artery or vein. The video shows how vital shot placement is vs caliber and bullet type. I currently use .45 HP because I don't want over penetration if I need to use the pistol at home. The video has got me thinking a 12 gauge would be a better HD choice. Very good video. I too am shocked more have not viewed it.