Gunshot wounds

Traumatic Dementias. Traumatic brain injury can also result in dementia. This can result from a single massive head injury such as in a motorcycle accident or a gunshot wound. Repeated small head injuries can also cause dementia. The best example is dementia pugilistica, the dementia observed in professional boxers after many years and many prizefights. 

Pectoral muscle from adult Leghorn chickens was obtained from a local supermarket (the main source) or dissected immediately after sacrifice. Human skeletal muscle was obtained four hours post mortem from the pectoral and iliopsosas muscles of a 70-year-old black male who died of a gunshot wound to the head. 

Vincent J. M. Di Maio, Gunshot Wounds (New York Elsevier Science). 

Many health care practitioners have the knowledge and skill sets required to care for blunt and penetrating trauma from motor vehicle accidents, falls, gunshot wounds, and the like however, few have cared for survivors of an explosion. Whether the result of an industrial accident or a terrorist attack, explosions produce casualties that will present with blunt and penetrating... 

A woman suffered a gunshot wound just below the left side of the neck. A ceaseless leakage of fluid issued from the unclosed wound. After eating, the leaking fluid became milky. The patient lost 5 pounds per week over the course of 1 month. What structure had been ruptured (Consult Crandall et al., 1943.)... 

An increase in the number of deaths of all body packers in New York has been associated with an increase in deaths among opiate body packers of 50 deaths among body packers from 1990 to 2001, 42 were due to opiates (260). Four were related to cocaine and four to both opiates and cocaine. In 37 cases open or leaking drug packets in the gastrointestinal tract resulted in acute intoxication and death. Five cases involved intestinal obstruction or perforation, one a gunshot wound, one an intracerebral hemorrhage due to hypertensive disease,... 

HPI While on duty, FD, a 42-year-old policeman, sustains a gunshot wound to the stomach and colon. He is admitted to the hospital and within 1 hour he undergoes an emergency laparotomy. During surgery there is spillage of gastrointestinal contents into his peritoneal cavity. 

H18. Hunter, J., A Treatise on Blood, Inflammation and Gunshot Wounds. Nicol, London, 1794. 

This is untrue. During WWI, the mortality in mustard gas casualties was of the order of 2% over 8% of gunshot wounds resulted in death. High concentrations of lethal agents, such as nerve agents, would likely produce inevitable death, but again this is a criticism of mode of use rather than the weapon. 

Bell C. A Dissertation on Gunshot Wounds. London, England Longman 1814. 

C. Wound botulism occurs when the spores contaminate a wound, genninate in the anaerobic environment, and produce toxin in vivo that is then absorbed systemically, resuiting in illness. It occurs most commonly in intravenous dmg abusers who skin pop (inject the dmg subcutaneously rather than intravenously), particularly ose using black tai heroin. It has also been reported rarely with open fractures, dental abscesses, lacerations, puncture wounds, gunshot wounds, and sinusitis. Manifestations of botulism occur after an incubation period of 1-3 weeks. 

In 1944 Cause and Brazhnikova discovered Gramicidin S, a cyclic peptide [49], and used it in the treatment of septic gunshot wounds during the Second World War. 

You should be able to identify a potential cause of the attack (nerve agent exposure, cyanide poisoning, multiple gunshot wounds, explosion syndrome, etc.) by the number and types of injuries or by the signs/symptoms of patients. 

Special incidents require even more thought. Firefighters wonder Is this a fire in a residence, or in a manufacturing facility with many other potential hazards EMTs consider I am about to treat a gunshot wound is the shooter still here Special circumstances require extra factors in the scene survey. 

The most common non-occupational exposures to lead were from shooting firearms remodeling, renovating, or painting retained bullets (gunshot wounds) and lead casting. 

Pare, Ambroise (c. 1510-1590) A French royal surgeon, Pare revolutionized battlefield medicine, developing techniques and instruments for the treatment of gunshot wounds and for performing amputations. He greatly advanced knowledge of... 

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