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36 Cards in this Set

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Key Points
Studies suggest that wounds from rifle bullets are from two to four times more lethal than wounds from handgun bullets.
Ballistics
The study of projectile motion and its interactions with the gun, the air, and the object it contacts.
Trajectory
The path a projectile follows.
Drag
The forces acting on a projectile in motion to slow its progress.
Cavitation
The outward motion of tissue due to a projectile's passage, resulting in a temporary cavity and vacuum.
Profile
The size and shape of a projectile as it contacts a target; it is the energy exchange surface of the contact.
Caliber
The diameter of a bullet expressed in hundredths of an inch. (.22 caliber = 0.22 inches); the inside diameter of the barrel of a handgun, shotgun, or rifle.
Yaw
Swing or wobble around the axis of a projectile's travel.
Key Point
While body armor protects against penetration, impact may result in less lethal but still serious blunt injury.
Factors Affecting Energy Exchange Between a Projecting and Body Tissue
Velocity
Profile
Stability
Expansion and fragmentation
Secondary impacts
Shape
Key Point
The damage caused by high-energy rifle bullets can extend well beyond the actual track of the projectile.
Key Point
The extent of damage is often difficult to assess with wounds caused by low-velocity, low-energy projectiles such as knives and arrows. Suspect internal hemorrhage and/or injury to body organs.
Factors Associated with the Damage Pathway of a Projectile Wound
Direct injury
Pressure shock wave
Cavitation
Temporary cavity
Permanent cavity
Zone of injury
Key Point
The severity of injury in cases of bullet wounds usually depends on the organs damaged by the bullet's passage.
Resiliency
The connective strength and elasticity of an object or fabric.
Key Point
Be alert to the possibility of severe hemorrhage if you suspect that a projectile has damaged a solid organ.
Pericardial Tamponade
Filling of the pericardial sac with fluid, which in turn limits the filling and function of the heart.
Key Point
Injury to lung tissue in cases of penetrating trauma is generally less extensive than can be expected with any other body tissue.
Key Point
Suspect the possibility of pneumothorax when there has been a significant disruption of chest wall integrity.
Body Regions Deserving Special Attention with Penetrating Trauma
Extremities
Abdomen
Thorax
Neck
Head
Key Point
Some 90 percent of penetrating trauma mortality involves the head, thorax, and abdomen.
Key Point
Consider any penetrating projectile injury to the abdomen to be serious and to have the potential to cause severe internal hemorrhage.
Key Points
Monitor the airway closely in any patient with a penetrating wound to the neck.
Key Point
Bullet wounds to the head, particularly those that penetrate the skull, are especially lethal.
Key Point
Suspect the possibility of airway compromise in patients with projectile wounds to the head and face.
Key Point
An exit wound may more accurately reflect the potential damage caused by a bullet's passage through the body than an entrance wound.
Key Point
In cases involving shootings or stabbings, always be sure that police have secured the scene before you enter it.
Key Point
Consider the possibility that the patient may be carrying a weapon and have the police search him if necessary.
Key Point
Make every effort to preserve evidence at a crime scene, but remember that care of the patient takes priority.
Key Point
Provide rapid transport for patients with bullet wounds to the head, chest, or abdomen and treat aggressively for shock.
Key Point
If endotracheal intubation cannot be accomplished in a patient whose airway landmarks have been destroyed by a gunshot wound, emergency cricothyrostomy may be necessary to create a route for ventilations.
Cricothyrotomy
A surgical incision into the cricothyroid membrane, usually to provide an emergency airway.
Cricothyrostomy
The introduction of a needle or other tube into the cricothyroid membrane, usually to provide an emergency airway.
Key Point
Anticipate a developing tension pneumothorax if your assessment reveals frothy blood in a patient with a bullet wound to the chest.
Prognosis
The anticipated outcome of a disease or injury.
Key Point
Immobilize impaled objects in place. Only remove those that have lodged in the cheek or those that interfere with the airway or that prevent CPR.