Injuries to any part of the body inflicted by a bullet or shotgun pellets
- More common in young adults
- More common in males
- Living in urban areas is a risk factor
- Genetics is not a significant factor
The effects of a gunshot injury depend on the site of the injury, the type of weapon and bullets used, and the range from which the weapon was fired. In addition to tissue damage, there is a high risk of infection. Wounds to the head or trunk are often life-threatening. In the UK, injury due to the use of guns is not common. However, when such injuries do occur, the victims are usually young men living in urban areas.
What are the types?
A gunshot injury to a limb may damage muscle only or cause a fracture. Such limb injuries are often not serious. However, damage to vital organs may be life-threatening. For example, a gunshot injury to the chest will probably cause breathing difficulties and may result in a pneumothorax, in which air enters the space between the two-layered membrane that surrounds the lungs. If the spleen or the liver is damaged, life-threatening bleeding may occur, leading to loss of consciousness and shock. A gunshot injury to the intestines may cause their contents to leak into the abdominal cavity, which can cause infection (see Peritonitis). Gunshot injuries to the heart or the brain are often fatal.
What can I do?
If you are with someone who has been shot, call an ambulance immediately. Find a trained first-aider to check the victim’s breathing and pulse, and to deal with any external bleeding or any signs of shock (such as a rapid pulse, greyish-blue lips, and sweating with cold, clammy skin). Do not leave the victim alone, except to call an ambulance.
What might the doctor do?
Anyone with a gunshot injury needs to be taken to hospital, where initial measures may include controlling blood loss and administering oxygen and intravenous fluids. If a lot of blood has been lost, a blood transfusion may be needed. An injection to prevent tetanus (see Vaccines and immunoglobulins) and antibiotics to prevent infection are given if necessary.
Following initial measures, the extent of internal tissue damage is investigated using imaging techniques, such as chest X-rays, CT scanning, and MRI. Almost all gunshot injuries require surgery to repair damaged organs and remove fragments of the bullet, shreds of clothing, and other debris in the wound. Once the wound has been cleaned and bleeding has been stopped, the wound is covered with sterile gauze for 4–5 days to help to prevent infection. The wound is then closed.
Certain injuries may need additional treatment. For example, if a pneumothorax develops, a chest drain is inserted into the space between the two membranes to allow the air to escape. If breathing difficulties occur, mechanical ventilation may be necessary (see Intensive therapy unit).
With prompt treatment, many gunshot injuries do not lead to long-term physical damage. If vital internal organs are affected, the injury may be fatal.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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