Missile wounds

Catheter angiography Jugular vein cannulation Missile wounds Neck/oral Injury or surgery Blow to the neck... 

Stahl CJ and Davis JH (1969). Missile wounds caused by tear gas Pen guns. Am J Clin Pathol, 52, 270-276. 

Near 100% fatality from serious missile wounds 483-689... 

By the basic ballistic principles discussed elsewhere, one can expect a significant pattern of secondary injury from a suicide blast. Of particular importance is the risk of casualties sustaining missile wounds from biological material originating from either the bomber or another victim. 

To test how long it would take to dissolve the cyanide, I held it under blood warm water from the faucet. In 15 seconds it was gone. When a missile penetrates the flesh the flesh tightens on it as Nature s way of decreasing loss of blood. Also, great amounts Uood flows to the wound area to carry away any foreign matter. So the dart head in the flesh should be free of cyanide in 15 seconds and in 90 to 80 seconds the enemy should be as dead as a door nail. 

Very small to large filament wound cases have been fabricated for use on rockets and missiles. As an example, a racetrack filament winding RP fabricating technique was used to fabricate a very large tank (rocket motor case) for NASA. See Chapter 5 Filament Windings, Racetrack and Other Winders. 

Spirally wound cylindrical or rectangular flat plates Military, missiles etc. 

With high-energy missiles, a temporary cavity is formed, causing extensive damage distant from the wound track. This cavity later coUapees, leaving extensive tissue contamination. 

The effects of a missile will clearly depend on the nature of the tissue. Even a low-energy wound to a vital structure such as the heart will almost certainly be fatal. Other tissue factors affecting wound severity include ... 

The most striking feature of gunshot injury is its unpredictability. The path of a missile is almost impossible to predict and attempts to do so will lead to injuries being missed. The position of the body at the time of impact is a key determinant of wound track (Fig. 3.7) and is unlikely to be known to clinical staff in hospital. If a missile strikes bone (or passes sufficiently near it) secondary bony fragments may be generated, each of which will create its own track. Fragmentation of the missile may also occur, further complicating the clinical picture. 

Fig. 3.7 The unpredictable trajectory of modern small arms ammunition within the body. Wounds of entry may give little clue concerning a missile s path within body cavities.

As a result, the only effective approach is to follow the standard ABCDE protocols combining an initial primary survey for immediately life-threatening injury with a secondary survey designed to ensure that no injury, however trivial, is missed. Radiographs should be taken as appropriate to identify retained missiles or fragments, and to exclude significant occult injury wounds should be marked with radio-opaque markers. 

With small fragment wounds, evidence suggests that there is no need to excise retrocolic wound tracks or remove missile fragments in colon-penetrating fragment woimds. Such procedures result in considerable tissue damage, are likely to prejudice colonic wound repair and do not appear to improve retrocolic infection rates. 

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