Classification of wounds from an air rifle. Is it possible to kill with a pneumatic pistol: what will the result of shooting a person with a pneumatic pistol?
We began studying peacetime weapon wounds (WWW) in 1990. This is due to the fact that before 1990, no more than two wounded patients were admitted with WWW per year, which is why they were not of problematic interest. After 1992, the number of such wounded people increased sharply, which required focusing on the features of diagnosis and treatment of such victims.
Gunshot wounds. Gunshot wounds mean injuries inflicted from any firearm or device (pistol, shotgun, cannon, mine, homemade firing device, etc.), the projectile from which (regardless of its type: bullet, gas, shot, fragments (primary or secondary, etc.) are ejected through the explosion of an explosive (gunpowder, plastic, dynamite, etc.).
Weapon wounds. Weapon wounds mean wounds inflicted from any non-firearm weapon or device (bow, crossbow, blowgun or pistol, speargun, industrial device (dowel), etc.), the projectile from which, regardless of its type (bullet, arrow, metal rod, etc.), released by any throwing device not associated with an explosion (spring, bowstring, compressed air).
We explain the sharp increase in the number of such victims by the criminalization of Russia, when disputes between individual groups of “business” began to be resolved not on the legal, but on the criminal field, and the stratification of society into the very poor, the poor and the very rich gave rise to thriving banditry. Acquiring firearms (including service weapons) is not difficult.
In peacetime, in the first two hours after injury, 78.8% of the wounded are admitted to the neurosurgical hospital, and after 7 hours from the moment of injury they do not arrive at all, or such admissions are rare and amount to tenths or hundredths of a percent.
This leads to two fundamental provisions:
The rapid delivery of the wounded to the neurosurgical department within the first hours leads to the fact that wounded people who die on the battlefield in wartime are admitted to a specialized hospital. These are usually comatose victims with radial, diametric (complete or incomplete) wounds, as well as injuries to the posterior cranial fossa. These wounds (especially the posterior cranial fossa) are classified as very severe. In addition to unusually severe gunshot head wounds inflicted from service weapons, other features of gunshot wounds are also encountered in peacetime.
Peculiarities of peacetime gunshot wounds include wounds from a gas pistol. Shots are usually fired either at point-blank range or from a short distance (1-2 meters). Moreover, especially if the injury is inflicted in the area of the scales of the temporal bone, it can be penetrating and be accompanied by damage to the brain not only by charge particles (wad-type pads) or bone fragments, but also by the charge itself (gas). The degree of brain damage from the charge depends on the composition of the gas (tear, nerve agent, etc.). Such a wound may be accompanied by the development of specific encephalitis, and an associated purulent infection can significantly aggravate the condition of the wounded person.
Also specific are OCMRs applied from a smooth-bore: long-barreled - hunting rifles or short-barreled - converted to the shot charge of a gas pistol, or a foreign-made shotgun. The charge of such a pistol most often contains shot No. 9 - “snipe”.
Wounds inflicted from a short distance (up to 2 meters) can be penetrating and accompanied by damage to the dura mater and brain matter, both by the charge itself and by bone fragments. The shot charge usually does not penetrate deeply into the brain and is located compactly in the cortical parts of the brain, although individual pellets can penetrate quite deeply into the white matter.
The severity of gunshot wounds inflicted on hunting long-barreled non-rifled weapons depends on the caliber of the gun, the drilling of its barrel (cylinder, choke, payload) and charge (shot, bullet). Here they use shot of different calibers, most often No. 3 and larger, up to buckshot. Such a charge, fired from a short distance, when it enters the human body, behaves like an explosive bullet, causing a deep, lacerated wound with massive damage to the brain matter.
Other injuries are also possible, inflicted from self-propelled guns, usually made by handicrafts and by teenagers. Such a device is a metal smooth-bore tube, tightly sealed on one side (breech) and having a hole for the fuse. The powder charge can be either gunpowder (most often hunting or extracted from live ammunition), as well as a homemade explosive (a mixture of saltpeter, crushed coal, sulfur, potassium permanganate powder and other ingredients in arbitrary proportions). The weapon is extremely unstable, dangerous to use, and often explodes in the hands of the shooter. The imperfection of such a weapon leads to the fact that almost equally often both the charge (choke, shot, steel balls) and the breech fly out of it (the latter into the shooter’s head).
When fired at close range, the gunshot wound is complicated by thermal and chemical burns, especially if the explosive mixture contains potassium permanganate. Such burns can lead to toxic encephalitis, which is difficult to treat.
Penetrating wounds to the skull can occur from shots from a “harmless” non-firearm. Such injuries are quite common when fired at close range from a pneumatic (“blow”) weapon, especially if it is loaded with steel balls or lead bullets, and the weapon is automatic and several charges hit the head at once (especially the scales of the temporal bone).
No less serious traumatic brain injuries can be caused by injuries caused by an arrow fired from a bow. An arrow fired from a crossbow can pierce through the chest of an adult moose. When it enters a person's skull, it can cause a diagonal (radial) penetrating wound to the skull.
In the diagnosis of fMRI, two main tasks are solved:
In all circumstances (the ability to quickly provide specialized medical care after injury) is of paramount importance.
The basic principle of surgical treatment of weapon wounds of the skull and brain is their early, radical sanitation through primary surgical treatment with the removal of all foreign bodies, liquid blood and blood clots, brain detritus and necrotic brain tissue with active drainage of the wound, free plastic surgery of the dura mater and suturing of the wound tightly (around the drainage).
During primary surgical treatment of a weapon wound, it must be remembered that the most infected foreign bodies in the brain (during the first six months) are bone fragments and particles of headgear, and not the bullet itself. Therefore, the surgeon’s actions should be aimed at removing everyone foreign bodies Chasing “the bullet” is not the goal in itself of the operation, although its removal (along with other foreign bodies) is desirable. In addition, we should not forget that the wound channel is not a smooth-walled tube. Due to the fact that a temporarily pulsating cavity appears when passing through the brain, cracking of the brain occurs at a distance from the main wound channel. As a result, from the main wound channel, along its entire length, many microcracks extend into the depths of the brain substance. These cracks are infected just like the main wound channel.
It should also be borne in mind that foreign bodies (bone fragments, hair, parts of a headdress, etc.) at the entrance hole are embedded deep into the skull and brain, and at the exit hole, on the contrary, into soft tissues, into the integument of the skull. The bulk of foreign bodies (except for bullets) is concentrated in the cranial cavity at the entrance hole at a depth of 5-7 cm. Chasing individual pellets located deep in the brain, in its nuclei or ventricles, is not always advisable. It should be borne in mind that the surgical intervention itself can cause injury greater than the weapon wound itself. At the same time, the more radical the initial surgical treatment of a gunshot wound is, the less chance of purulent complications (meningitis, meningoencephalitis, brain abscess, purulent ventriculitis) - one of the main causes of mortality in OCMR.
Veterinary clinics located in big cities and rural areas regularly encounter gunshot wounds to animals. The weapons used vary to some extent depending on the terrain. Light firearms are more common in large cities and their suburbs, while rifles and shotguns are more common in rural areas. Gunshot wounds caused by shotguns and rifled airguns are most likely the result of juvenile shootings.
Pointed bullets or spherical bullets (balls) fired by firearms can have different diameters (calibers), mass (weights), material composition, shape, design and speed. Ballistics of a specific bullet, i.e. Its flight characteristics, from its movement down the barrel to its final passage through the target, also vary depending on these variables. As a result, the severity of tissue damage varies depending on the characteristics of the bullet, the kinetic energy absorbed upon impact, and the tissue impacted by the pointed bullet.
Bullets typically contain a lead core and may be made with an outer jacket (or jacket) that controls the deformation of the bullet. Partial jacket bullets contain an exposed section of lead core - the shape and design of the exposed lead end can be altered to increase the bullet's deformation or fragmentation upon impact. For example, hollow areas or grooves increase the bullet's ability to flatten, which slows its movement through the target and increases the absorption of the bullet's kinetic energy, causing greater tissue damage. Bullet fragmentation also increases tissue destruction as the bullet penetrates or moves through tissue.
The destructive potential of a bullet is determined by its kinetic energy.
Kinetic Energy (KE) = Mass x Velocity2/2
Doubling a bullet's mass doubles its kinetic energy, while doubling its speed quadruples its kinetic energy. Bullets can be classified based on their speed: low-velocity (less than 1000 fps), medium-velocity (1000 to 2000 fps), high-velocity (more than 2000 fps). Most light firearms are in the low to medium velocity range, while most BB guns are in the medium to high velocity range. As the speed increases, the destructive ability of the bullet also increases.
When a bullet strikes tissue, it causes damage through several processes: tissue rupture and crushing, shock wave, and cavitation. Low-velocity bullets travel through tissue in a straight line, creating a stable wound channel. Only tissue that comes into direct contact is affected, and the predominant tissue injury is tissue crushing or tearing. High velocity bullets cause significant tissue damage. As the bullet travels through tissue, it transfers energy to adjacent tissue, causing high-frequency shock waves and cavitation.
Cavitation is a short-term rapid expansion or swelling of tissues located near the trajectory of a bullet, and the width of this area can be 30 times the diameter of the bullet.
The shock waves generated during the movement of the bullet compress and stretch the tissue located on the sides and in front of the bullet. This short-term phenomenon also creates a vacuum effect that can suck contaminants deep into the wound. Tissue is destroyed, regional circulation is disrupted, and soft tissue located outside the bullet's path can be severely damaged. The risk of infection is higher with injuries caused by high-velocity bullets due to extensive tissue damage and compromised blood supply.
During flight, bullets can become unstable and deviate from their longitudinal axis. As a result, before impacting an area of the body, the bullet can deviate from its course and begin to tumble, thereby increasing its contact profile as it travels through tissue. The tumbling action of high-velocity bullets increases tissue destruction and can increase bullet fragmentation, further increasing tissue damage. Bullets that bounce off a hard surface (ricochet) can deform and tumble, so they have the potential to cause more severe wounds despite the reduced velocity. Tissue destruction is greater if all of the bullet's kinetic energy is absorbed, compared to a bullet that passes through an area of the body and exits relatively intact.
Shotguns are capable of firing round pellets, the size and quantity of which can vary. The shot dispersion pattern usually expands as it moves away from the barrel and has a conical configuration. Compared to a single pellet, over a similar velocity range, a shotgun is capable of generating enormous kinetic energy and causing massive tissue destruction due to the concentrated pellet density and coverage of a large surface area of the target.
The relative elasticity of tissue influences the severity of tissue damage—elastic tissues that can stretch are better able to withstand gunshot trauma than less elastic tissues. Dense tissues such as bone absorb most of the bullet's kinetic energy; in turn, bone fragments can travel into surrounding tissue as secondary bullets, causing additional damage. The skin and lungs have more pronounced elastic properties and are more capable of absorbing the kinetic energy of a bullet. Although skeletal muscle and liver tissue have the same density, the liver is more elastic, making it more vulnerable to rupture or delamination, particularly due to the cavitation effects of high-velocity bullets.
In many cases, the pet owner is unaware that their pet has been shot. Most injuries occur when a pet runs away from its owner or is left unattended, and they can be mistaken for bite wounds or car injuries. High velocity bullets are more likely to penetrate most soft tissue without leaving obvious metal fragments visible on x-rays. Wounds that are on opposite sides of the animal or that appear to be visually oriented (wound entry and exit) should be the most suspicious.
Most animals with gunshot wounds are admitted through emergency services, so if the patient is unstable (if necessary), emergency measures must be taken. A complete set of x-rays of the affected area of the body should be obtained. If perforating wounds from one or more bullets are detected, additional x-rays should be taken cranial and caudal to the entry and exit holes.
A definitive diagnosis of a gunshot wound is often difficult, unless metal fragments of the bullet remain in the wound. In patients with severe injuries, it is recommended to determine a complete blood count and serum biochemical profile, which will help assess the patient's condition and identify organs that may have been damaged by the bullet.
Depending on the location and nature of the wounds, ultrasonography, pulse oximetry, electrocardiography, and blood gas analysis may be used to further evaluate the critically injured patient.
Once life-threatening injuries have been identified and the patient's condition has been stabilized, a thorough examination of the wound area should be performed. For some wounds, assessing the severity of the injury may be difficult. Initial wound cleansing, minor debridement, and temporary wound dressing are preferable to aggressive debridement because they allow time for the tissue damage to become more stabilized. Immediate aggressive debridement in these cases may result in the removal of tissue that was in fact viable but in a state of vascular stasis. Sedating or anesthetizing a patient for a procedure that may need to be repeated later may create unnecessary risks for the patient. The level of tissue damage can usually be adequately assessed within 24 hours. During this waiting period, wound dressing support and analgesia should be provided and systemic antibiotic therapy should be initiated. The most common bacteria found in external wounds are coagulase-positive staphylococci and Escherichia coli.
For patients with severe injuries or severe pain, sedation may help ensure adequate wound cleansing. Trimming the hair around the wound makes it easier to assess the wound. Placing a sterile water-soluble gel in the wound or filling the wound with a sterile cloth soaked in saline will prevent further contamination of the wound with hair. Hair can be removed from the edges of the wound using scissors coated with a sterile gel to catch the hair. Tap water has been shown to be cytotoxic to fibroblasts, but can be used in cases of severe contamination. If contamination is minimal or moderate, initial wound cleansing can be done using sterile saline or a diluted antiseptic solution (1:9 povidone-iodine or 1:40 dilution of chlorhexidine). Since the physical aspect of rinsing is of primary importance, antiseptic solutions may not be necessary; it depends on the level of pollution. Appropriate pressure (4-15 psi) can be applied using a 20 mL syringe and an 18-gauge needle. Higher pressure may cause debris and bacteria to be pushed deeper into the tissue rather than removed. Small hemostatic mosquito forceps can be used to gently spread the wound to aid irrigation and drainage of the area. Careful exploration (probing) of the wound is necessary to assess the tissue involved and the extent of damage. Wounds overlying body cavities must be examined very carefully to prevent accidental contamination of deep tissue or opening of the pleural or peritoneal cavities. Sterile instruments and aseptic technique should be used during the initial wound examination, regardless of the degree of wound contamination. If possible, the wounds should be covered with a sterile dressing. The frequency of dressing changes depends on the amount and type of discharge. It is not recommended to stitch wounds to ensure drainage while the wound heals. Periodic wound debridement may be required until a healthy granulation bed is formed.
Lead poisoning is rarely seen with trapped bullets in the body because they are usually surrounded by connective tissue over time. Removal of bullets should only be considered if they are readily accessible and their removal does not pose additional risk to the patient.
Most bullets are capable of causing bone fractures depending on the mass and velocity of the bullet, the amount of muscle surrounding the bone, and the area of impact (tubular bone vs. spongy bone). Softer cancellous bone is less susceptible to fragmentation. High-velocity bullets are capable of crushing bone, sending fragments into adjacent soft tissue and increasing tissue destruction. Penetration of bullets into joints requires arthrotomy to remove metal fragments and fragments of cartilage and bone. Lead slowly dissolves in joint fluid and is absorbed into the systemic circulation over time.
In the stable patient, radiography is usually followed by wound exploration, debridement, and copious lavage. Fracture stabilization depends on the individual fracture, but maintaining blood flow to local tissues and bone segments is critical to a positive outcome. Extensive dead space is usually treated using a closed suction drainage system. In cases of extensive limb trauma, amputation may be appropriate.
Most patients with severe gunshot brain injury are routinely euthanized. However, for many patients with minimal neurological impairment, supportive care and broad-spectrum antibiotics may be sufficient.
Patients with suspected spinal injury should be restrained to prevent movement. A complete neurological examination is recommended before sedating a patient, but caution should be exercised when interpreting neurological examination results if the patient remains unstable. X-rays and CT scans are used to assess the severity of the injury and determine whether fracture stabilization or spinal cord decompression is necessary.
Bite wounds
Bite wounds in dogs and cats account for 10% to 15% of all veterinary trauma cases, although the exact incidence is unknown. All bite wounds should be considered contaminated, regardless of whether they are open (piercing the skin) or closed (crushing the skin). The most frequently detected pathogenic organism in culture is Pasteurella multocida. Dogs' jaws can develop pressures ranging from 150 to 450 psi. inch. Dogs' incisors and canines can exert shear forces on the skin when they act perpendicular to the surface of the skin and cut tissue sharply. At angles less than 90 degrees, tensile forces can cause skin avulsion, as well as hernias and death of underlying tissue. Compressive forces are caused by classic puncture wounds left by canine teeth or crush wounds left by premolars or molars.
The unique pathological findings (in the case of bite wounds) are due to the penetration of elastic skin into less elastic underlying tissues with damage to the large direct cutaneous artery and vein and disruption of collateral blood supply. Lifting and shaking the skin often results in seemingly harmless superficial damage with the potential for severe damage to deeper tissues and underlying organs (the so-called "iceberg effect").
Multiple and severe bite wounds can cause systemic inflammatory response syndrome (SIRS), in which excessive activation or loss of local inflammatory regulation results in a generalized immune response. After the inflammatory stage, wound healing will not occur until dead or infected tissue is removed from the wound and the presence of such tissue potentiates SIRS.
Bite wounds, depending on their severity and anatomical location, can cause a wide range of life-threatening problems. All patients with bite wounds should be evaluated for cardiovascular or respiratory abnormalities. It is necessary to determine the degree of hemodynamic disturbances and correct them through intravenous administration of electrolytes, colloidal solutions or blood products. Vessels that continue to bleed despite pressure bandages must be found and ligated. The extremities, head and neck are the most common sites of bite wounds, followed by chest or abdominal tissue. Perineal wounds are the least common. Among small breed dogs, the most common wounds are the chest and abdomen.
Bite wounds should be examined to assess the extent of injury to underlying organs. Before an aseptic surgical operation, the hair on a large area around the bite wound should be trimmed, the skin should be cleaned and covered with sterile napkins. For chest and abdominal wounds, the surgical field should be large enough to allow a thoracotomy or exploratory laparotomy if necessary.
The viability of the bitten limb can be assessed by the color of the damaged tissue, the temperature of the limbs, the presence of bleeding from a cut nail on the hind paw (with sufficient systemic arterial pressure), the results of peripheral pulse oximetry or Doppler ultrasonography, measurement of interdigital membrane temperature, or selective angiography.
Puncture wounds can be surgically excised to create an opening into which a sterile hemostatic material can be placed or a gloved finger can be inserted to spread the underlying tissue to gain access to the skin, fascia, and muscle. Wounds with little or minimal tissue trauma can be left open to drain and heal by secondary intention or closed with skin sutures after careful lavage. For more contaminated wounds, hair and foreign material are removed. Shattered or necrotic muscles, fat and fascia are excised. Ideally, wound sanitation is carried out in one stage. If there is loose skin on the neck or torso, more aggressive debridement is possible. A more conservative approach is necessary for the extremities.
Each bite wound must be assessed individually, taking into account how long ago the injury occurred, the severity of the injury, whether there is a single wound or multiple wounds, the degree of contamination, and the quality of the blood supply. If in doubt, delay wound closure. When closing a bite wound, extensive local excision of all contaminated and traumatized tissue allows for standard closure without dead space, without excessive tension, and with minimal use of absorbable suture material. If there are doubts about the condition of the tissues, then drainage should be installed. An alternative may be delayed primary closure with alternating wet and dry dressings for 3-5 days, which will distinguish viable tissue from nonviable tissue.
Wound healing through secondary intention healing should provide the benefits of granulation, contraction, and epithelialization with optimal wound drainage against the length and high cost of wound treatment, the risk of scar contracture over the joint leading to joint dysfunction, and the potential for poor cosmesis. Drainage is necessary to prevent dead space and seroma formation. Depending on the wound, simple straight incisions, passive drains, or active drainage systems should be used.
In the presence of infection, it is recommended to perform aerobic and anaerobic cultures of the wound discharge to select appropriate antibiotics. Cultures from acute, uninfected bite wounds are not useful for identifying potentially infectious organisms. It is best to choose broad-spectrum bactericidal antibiotics. The antibiotics of choice are intravenous penicillin or penicillin derivatives. Fluoroquinolones can be used against resistant gram-positive and gram-negative infections. Antibiotics are not a substitute for appropriate surgical treatment of bite wounds.
Introduction
Bullet and shot wounds are extremely diverse. The diversity is due to the different types of weapons used, the caliber of the weapon, the type of ammunition, the distance of the shot, and the trajectory of destruction.Often, pellets and airgun pellets in superficial soft tissue on radiographs of cats and dogs are incidental findings of no clinical significance. But there are also cases that require the intervention of a surgeon.
Concept of kinetic weapons
All weapons that affect the target through fired solid destructive elements are called kinetic. The damaging elements transfer their kinetic energy or part of it to the object. Damage depends on the amount of energy transferred.The formula for kinetic energy is known from a school physics course: E=(mv2)⁄2, where m is the mass of the bullet,
and v is its speed. In the SI system, mass is taken in kilograms and speed in meters per second, resulting in energy in Joules.
The initial kinetic energy of a bullet at the moment it leaves the barrel is called muzzle energy. This is a basic characteristic that allows you to evaluate the power of a weapon. During the flight, the bullet moves by inertia, slows down, overcoming air resistance, its speed and kinetic energy decrease.
According to the method of firing a shot and accelerating the striking elements, kinetic weapons can be divided into firearms, pneumatic and throwing weapons. To accelerate the striking element and fire a shot, a firearm uses the pressure of the products of explosive combustion of gunpowder or other propellant. In pneumatic weapons, compressed gas pressure (for example, air) is used to accelerate the striking element and fire a shot. The action of throwing weapons is based on the use of human muscular strength, gravity, and the elastic properties of materials.
Approximate characteristics of various types of weapons are given in Table 1.
Wound ballistics and wounds
The movement of a projectile in body tissues and the mechanisms of damage formation are studied by wound ballistics. The volume and degree of tissue damage depend on many factors determined by the ballistic characteristics of the wounding projectiles. What matters is the speed of the projectile, its mass, shape, stability of movement, deformation, angle of contact with the target, etc. The amount of energy transferred to the tissues is of decisive importance.In the mechanism of wound formation, four factors are important:
1. Impact of a shock wave. At the moment the bullet comes into contact with the affected tissues of the body, the medium becomes compacted, caused by a shock wave that propagates in front of the bullet (at the speed of sound in the tissues - 1465 m/s).As a result of the direct action of a wounding projectile, a wound channel appears, which is a penetrating gap of irregular shape, filled with wound detritus, blood clots, foreign bodies, bone fragments when bones are damaged, as well as fragments of the projectile itself. The consequence of all impact factors is primary necrosis of tissue areas adjacent to the wound defect area. These tissues immediately lose their viability and must be completely excised and removed during primary surgical treatment. Tissues that have received molecular shock due to the effect of cavitation enter the potential area of secondary necrosis. These are tissues with numerous microhemorrhages and intracellular deformations. The extent of this area depends on many factors. In particular, on the amount of energy from the side impact of the projectile transferred to the tissues, and on the nature of the temporarily pulsating cavity in the tissues due to the cavitation effect. Secondary tissue necrosis is a process that dynamically develops over time, the extent of which depends on surgical treatment of the wound and treatment.
2. Direct damaging effect of a wounding projectile. That is, the destruction of tissue along the path of the bullet with the formation of a wound channel.
3. Impact of side impact energy. It is significant at bullet speeds of about 300 m/s or more. When a wounding projectile passes through tissues, the latter are shifted to the sides after it, and a temporarily pulsating cavity (TPC) is formed, the dimensions of which, depending on the kinetic energy transferred to the tissues, exceed the diameter of the projectile by 10–25 times. The duration of existence of the runway exceeds the time of passage of the projectile through tissue by 1000–2000 times. In a fraction of a second, this cavity manages to make several hundred pulsations, throwing out scraps of tissue along and against the direction of the bullet.
4. The impact of the air jet accompanying the flight of the projectile. The vortex air flow following the projectile draws dust, particles of fur and skin into the wound channel.
Due to uneven stretching of muscle fibers, the wound channel in the muscles may not be straight. At the boundaries of tissues with different densities, a wounding projectile can change its trajectory. When a wounding projectile encounters denser obstacles (for example, bone), maximum transfer of kinetic energy to tissue occurs, similar to an explosion. As a result of this, multiple secondary wounding projectiles are formed (particles of the primary and particles of damaged bone), which aggravate the severity of the wound and form additional wound channels.
Gunshot wounds are divided into through and blind. A perforation wound occurs when a bullet with high kinetic energy passes through the body. In this case, the presence of inlet and outlet holes is observed. The entrance hole is small, with smooth edges, smaller than the caliber of a bullet. The exit hole can exceed the caliber of the bullet several times, the edges of the exit wound are torn, uneven, diverging to the sides. Blind wounds occur when bullets from less powerful ammunition hit, bullets pass through bones, or are wounded by a bullet at the end of its life. With such wounds, the entrance hole is also quite small and smooth. Blind wounds are usually characterized by multiple internal injuries.
The laws of wound ballistics apply not only to bullets, but also to fragments, balls, buckshot and shot, but the latter, due to their irregular shape and erratic flight, despite their high initial speed, quickly lose it.
Concepts characterizing ammunition by its effect on the body
Penetrating ability (penetrating action) – the ability of a bullet to penetrate an obstacle. It is determined by the path traveled by a bullet along a ballistic trajectory in an obstacle (that is, inside the target after hitting it). Depends on the mass and speed of the bullet, the type of bullet (geometry, material, design, etc.), as well as on ballistic stability (the ability of the bullet to maintain its position without changing) when moving inside the target.Stopping effect (stopping ability) is a characteristic of a bullet that determines the degree to which the target loses the ability to attack or move. The high stopping effect of a bullet implies, first of all, the rapid incapacitation of the target, but not necessarily a fatal outcome. The stopping effect depends on the speed, caliber, mass, geometry and design features of a particular type of bullet and is most important for melee weapons (pistol, revolver, shotgun). The stopping effect of a bullet is stronger the sooner the functions of a living organism are disrupted after it hits, which directly depends on the degree of absorption of the kinetic energy of the bullet by the target and is therefore most pronounced in blunt-pointed bullets. The ability of a bullet to deform when penetrating tissue is also important: unjacketed lead bullets are flattened and stop before hard jacketed ones.
The lethal effect of a bullet (lethality) is a characteristic of a bullet that describes the likelihood of causing death when it hits a living target. The killing effect is not the same as the stopping effect of a bullet. High-velocity small-caliber bullets have good destructive power against a living target (high penetration and a fairly high lethal effect), but have a low stopping effect. Bullets can be designed so that when they hit soft tissue they are deformed, significantly increasing their diameter, this is done to increase lethality; such bullets are called expansive.
Types of weapons, ammunition and damage features
When shooting from smooth-bore weapons (hunting rifles), shot and bullets can be used. After a shot, the shot charge usually flies as a single compact mass over a distance of one meter, then individual pellets begin to separate from it, and after 2–5 m the shot charge completely disintegrates. The flight range of the shot is 200–400 m. The degree of dispersion of the shot charge determines the characteristics of shot damage at different shot distances. Bullets for hunting cartridges can be round (ball-shaped), turbine (usually a cylinder with ribs or a hole along the axis), pointer (there is a stabilizer in the rear).In rifled firearms, which include hunting rifles and carbines, various types of service and military weapons, bullets with a copper alloy or steel jacket are used. In small-caliber weapons, lead non-jacketed bullets can be used. Small-caliber weapons are called weapons with a caliber of less than 6.5 mm, normal caliber - from 6.5 to 9 mm, large-caliber - from 9 to 20 mm.
Airguns usually use lead bullets or pellets coated with copper or brass as ammunition. Air rifles and pistols of 4.5 caliber are common; 5.0; 5.5; 6.35 mm with muzzle energy up to 7.5 J, such weapons do not require a license and are sold freely. More powerful rifles with muzzle energy up to 25 J are classified as sporting or hunting weapons; their purchase requires permission to store or carry civilian weapons. A bullet fired from a weapon of this class may cause damage virtually indistinguishable from that caused by a firearm containing similar bullets or shot. There are air rifles with muzzle energy above 25 J.
Plastic or rubber bullets are used as a striking element in traumatic weapons. Most of them are radiopaque, but there are bullets made of plastic, which practically does not differ in X-ray density from soft tissue. To increase the lethality, many bullet models are equipped with a metal core. Examples of bullets for various types of weapons are shown in Fig. 1.
Several clinical cases
1. Dog. 8 years. Spastic paralysis of the pelvic limbs with absence of deep pain sensitivity (photo 1).Blind wound to the spinal canal by a bullet from a 5.5 mm pneumatic weapon. The x-ray shows the shadow of a deformed metal bullet in the projection of the arch of the 7th thoracic vertebra. A computed tomography scan reveals a metal bullet in the spinal canal, characteristic artifacts from a metal body. There was no damage to the bones; the bullet entered the spinal canal through the foramen.
Euthanasia. Opening. The wound canal is collapsed, with a small amount of blood. Laminectomy. A small hematoma in the area of the foraminal opening. Rupture of the dura spinal membrane. Bullet and fur particles under the hard shell. Myelomalacia in the wounded area.
2. Dog. Blind bullet wound in the area of the angle of the lower jaw on the right (photo 2).
A round hole in the skin. The head is tilted to the right. Vestibular syndrome. The X-ray image reveals multiple metal particles.
Tomography revealed multiple metal particles along the wound channel. Fracture of the right articular branch and the right condyle of the mandible. Severe swelling with narrowing of the nasopharynx. Fracture of the right pterygoid bone. Fluid in the right tympanic cavity. A small amount of free gas in the interfascial spaces of the neck and mediastinum.
3. Dog, 4-5 years old. Flaccid paralysis of the pelvic limbs. A round hole in the skin of the lower back on the right (photo 3).
X-ray: multiple metal particles were detected. Computed tomography: metal particles along the wound channel in the lumbar muscles and spinal cord; fractures of the L3 arch on the left and right, without displacement of the vertebrae and narrowing of the lumen of the spinal canal.
Hemilaminectomy L3-L4; extensive defect of the dura spinal membrane; extensive hematoma in the lumen of the spinal canal at the L3-L4 level. The spinal cord is lost along the entire length of L3-L4.
4. Dog. Wounded by a traumatic rubber bullet with a metal core (photo 4). This is an 18x45 ammunition bullet used in the Cordon and Shaman barrelless traumatic pistols produced by the A+A company.
Blind shoulder wound. Fracture of the humerus, a large number of fragments. The radiograph reveals the shadow of a traumatic rubber bullet with a metal core in the soft tissues of the shoulder, proximal to the fracture zone. Severe swelling.
Literature:
1. Federal Law “On Weapons”, N 150-FZ dated December 13, 1996.2. Popov V. L., Shigeev V. B., Kuznetsov L. E. Forensic ballistics. – M., “Hippocrates”, 2002.
3. Gumanenko E. K. Military field surgery. Textbook. St. Petersburg, "Foliant", 2004.
4. Ozeretskovsky L. B., Gumanenko E. K., Boyarintsev V. V. Wound ballistics. St. Petersburg, Kalashnikov magazine publishing house, 2006.
5. Avdeev A.I. The nature of damage from pneumatic weapons to biological and non-biological objects. Current issues of medical and forensic examination: current state and development prospects. Scientific and practical materials. conf., dedicated 50th anniversary of MKO BSME Moscow. region, Moscow, 2013.
6. Ozeretskovsky L., Grebnev D., Golovko K., Altov D. Traumatic diagnosis. Magazine "Kalashnikov" No. 8, 2009.
7. Morgan J. P., Wolvekamp P. Atlas of Radiology of the Traumatized Dog and Cat. The Case-Based Approach. Second Edition. Schlütersche, 2004.
8. Les R. Folio. Combat Radiology. Diagnostic Imaging of Blast and Ballistic Injuries. Springer, 2010.
Category: Visual diagnostics
// Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. — P. 55.
On the possibility of causing life-threatening injuries when fired from a gas-cylinder pneumatic pistol
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On the possibility of causing life-threatening damage when fired from a gas-cylinder pneumatic pistol / Breskun M.V., Namakonov A.I., Maltsev S.V. // Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. - P. 55.
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On the possibility of causing life-threatening damage when fired from a gas-cylinder pneumatic pistol / Breskun M.V., Namakonov A.I., Maltsev S.V. // Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. - P. 55.
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/ Breskun M.V., Namakonov A.I., Maltsev S.V. // Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. - P. 55.
One of the conditions that constitute human security is the ability to protect one’s own life and health. One of the ways is the possibility of using special means permitted by law. In 1996, the State Duma adopted the Federal Law of the Russian Federation “On Weapons”, aimed, in particular, at protecting the life and health of citizens, property, and ensuring public safety. The law regulates legal relations arising during the circulation of civilian, service, as well as military hand-held small arms and bladed weapons on the territory of the Russian Federation. Thus, citizens of the Russian Federation have the right to purchase, without obtaining a special license or registration, pneumatic weapons with a muzzle energy of no more than 7.5 J and a caliber up to 4.5 mm inclusive. Such weapons are classified by law as pneumatic and are intended to hit a target at a distance with a projectile that receives directional movement due to the energy of compressed, liquefied or rejected gas (which is its distinguishing feature from firearms).
The availability of legal purchases of air guns is causing an increase in the number of cases of injuries caused when fired from them. In the available literature there is information about the occurrence of damage when fired from spring-piston samples of pneumatic weapons, but there are rare cases of publication of observations of damage when fired from gas-cylinder samples (Lotter M.G., Konovalov A.I., 2003).
We conducted experimental shots from a pneumatic gas pistol of the “A-101” brand, which meets the conditions for its non-registration and unlicensed purchase. This pistol model is intended for target shooting during educational, training and sports shooting in open areas and indoor shooting ranges. The gun is a pneumatic device in which an autonomous source of carbon dioxide (a cylinder with 12 g of CO 2) is used to throw steel (copper-plated) or lead balls weighing 5.5 g with an explosive caliber CAL (4.5 mm). The muzzle velocity of the projectile at an ambient temperature of 18±5 0 C is 140 m/sec, and the muzzle energy is less than 5 J. The magazine capacity is 15 balls. The number of shots from one cylinder is at least 50. The dangerous firing range is 300 m.
In total, we fired 21 shots into the head, chest, anterior abdominal wall and thigh of the corpse of a man of average build with satisfactory nutrition. The distance varied from a tight stop distance to 15 meters.
The shots resulted in blind wounds with signs of gunshot wounds - they had “minus” tissue defects and subsidence bands. The edges of the defects were wavy with multiple radiating breaks. The deposits were ring-shaped and had a diameter of 0.2 cm to 0.4 cm.
Shots to the head were fired from a distance from a tight stop to 2 meters in the left temporal region and in the face. Wounds to the scalp penetrated through the aponeurosis and, depending on the thickness of the bones, either left a round impression on the outer bone plate or pierced it, the diploe and the inner bone plate with the formation of a typical perforated gunshot fracture. In one observation (when fired from a distance of 2 m), the projectile pierced the large wing of the sphenoid bone along the parietal surface, penetrated into the cranial cavity with damage to the dura mater and was found above the bifurcation of the basal artery. The depth of the wound channel was 9 cm, along its course the middle cerebral artery was damaged. In other cases, when projectiles penetrated the cranial cavity, they were located in the epidural space.
When shot in the face from a distance of 0.5 m, the shells penetrated into the cavity of the orbit without damaging its walls, as well as into the maxillary sinus with damage only to the anterior wall.
8 shots were fired into the area of the left half of the chest of the corpse from a distance from a tight stop to 3 m. In all cases, the wounds penetrated into the pleural cavity. When shots were fired from a distance of up to 0.5 m and hit the rib, through and perforated fractures of the ribs, blind and through injuries to the lung tissue were discovered. In one case, damage to the aortic adventitia was recorded in the form of limited hemorrhage under the serosa.
5 shots were fired into the abdominal area from a distance of 6 to 15 m. In three cases, during shots from 6-10 m, through-and-through damage to the anterior abdominal wall was obtained, in one case with through-through damage to the anterior wall of the body of the stomach. In one case, the wound penetrated only into the subcutaneous fat and muscles.
The wound channels in the thigh area were blind and penetrated into the muscles to a depth of 15 cm.
During the experiment, a decrease in the destructive power of projectiles was noted with an increase in the number of shots, which is explained by a decrease in gas pressure in the cylinder. It was also found that the gas pressure in the cylinder decreases when storing weapons.
Thus, taking into account the experimental data, it should be recognized that there is a real possibility of causing life-threatening injuries when fired from an approved air gun.
One of the types of weapons, similar to firearms in design and ballistic properties, is throwing weapons (rifles and pistols), in which the kinetic energy of the bullet is created not due to the combustion of gunpowder, but due to the transfer of mechanical energy of compressed air. Such weapons are called pneumatic. It is fundamentally different from firearms in that it has a container in which air, forced by a piston during charging, is compressed. When the trigger is pressed, the piston is released, and the expanding air imparts forward motion to the bullet located in the barrel of the weapon. The bullet acquires an initial speed (relatively small) and flies at a distance of 30-50 m. Bullets can be in the form of hemispherical cylinders with a diameter of 3-4 mm or metal caps with a sharp head end and a brush (stabilizer) at the opposite end (to stabilize the flight). Lead balls (usually shot No. 2-4) wrapped in paper or cotton wool can also be used as a bullet.
When fired from a pneumatic weapon, even from a distance of several meters, such bullets can cause severe injuries (brain damage through the orbit, destruction of the eyeball, blind wound of the carotid artery, penetrating wound of the chest with damage to the heart, etc.). When shooting from a pneumatic weapon, the damage is always single, the wound channels are blind. A tissue defect does not always form at the entrance wound; the bullet can act wedge-shaped. Components that usually accompany a shot from a firearm (deposits of powder soot, powder particles) are never found around the wound, which can lead to the wrong conclusion about a shot from a firearm supposedly from a short distance.
Throwing devices have nothing in common with firearms, except for isolated cases of external structural similarity. Being the predecessor of firearms (“shoot” - release an arrow), the throwing device is currently used in sports (crossbows, bows, spearguns). The damaging objects (wounding projectiles) are arrows of various designs, darts, harpoons, the kinetic energy of flight of which is created due to the elastic properties of either the structure itself (bow), or its part (rubber on a speargun). Damage that occurs when exposed to arrows and harpoons is classified as puncture damage. The wound canals are mostly blind. In some cases, when the arrow (harpoon) is removed, the tip may remain deep in the wound. Damage can be significant, affecting not only soft tissues, but even flat bones.