An interesting read.
https://gundigest.com/article/a-medi...-lethality/amp
Sent from my SM-G970U using Tapatalk
An interesting read.
https://gundigest.com/article/a-medi...-lethality/amp
Sent from my SM-G970U using Tapatalk
There were some headscratching "conclusions" in that article...
Gietzen continued: “When it comes to multiple injuries, there’s no real case that says more bullet holes in more places cause more bleeding"
...being among the most notable.
The overall point seemed to be about rapid bleeding control but the author cherrypicked quotes and bootstrapped an opinion(and some product placement) onto it.
I think the point there was, "There is no real case that says more bullet holes in more places causes exsanguination."Originally Posted by feudist
In other words, you can shoot someone in the belly twelve times and they still may not bleed out enough to die from blood loss. But you know, put three or four holes into someone's thoracic cavity and hit each lung, the liver, the side of the heart, etc. it increases the chance that death via exsanguination can occur.
I got that from the context of discussing treating gunshot trauma in the ER, "We don't usually know what people are shot with or how many times. We just find the biggest bleeding trauma and start fixing it."
Basically - shot placement matters.
"The only major standout was .45 ACP, where it resulted in about twice the fatality rate as the others, even to extremities"
Damn...between that and the fact that no difference could be found between JHP and FMJ and there's only one conclusion to make....
"They all fall to hardball."
Sent from my SM-A326U using Tapatalk
Twice as many without normalization doesn't necessarily mean much.
The problem with interviewing just ER Docs vs. ER Docs + MEs is that you only get part of the story. Not surprised to see that ER Docs see a lot of handgun wounds and generally view them all as the same. Bearing in mind whatever measured fatality rate an ER doc has, is an order of magnitude below actual fatality rate. Because if you make it to a hospital with a bleeding trauma in the US your outlook is quite good overall. And there are plenty of people that skip the bus ride to the ER and take a bus ride to the Morgue instead.
If we ask the ME, I bet they say, "Rifles and shotguns kill a lot of people. Handguns do too, but usually with lots of holes in lots of places." @Dr_Thanatos
I would definitely think that being hyperfocused on the technical issues of lifesaving surgery would leave little time for contemplating a couple of millimeters difference in a swelling bloody wound that you're essentially ignoring in an effort to stitch up veins and arteries.
Dang it, I was actually being productive today!
The last paragraph is the only important bit. Location matters more than anything else. Rifles and shotguns increase the size of the injury path which increases the chance of hitting something important. Pistols work fine, just hit something important.
Many of our lethal gunshot wounds are single GSW from pistols. We have a great EMS response time, and very good trauma surgeons. I'm sure that a lot of single GSWs go home. But a lot of single GSWs are never transported. They are dead right there from bleeding out or it's a neuro hit.
Everything else in that missive was...interesting. I appreciate her perspective. I think the writer may have done her a disservice. I wouldn't take any part of it as gospel, except that "Location Matters"
We interface with trauma surgeons a lot here. They are great doctors and really know their stuff. They don't spend any real brain power on the details of the wounds. They are trying to stop the bleeding and repair the injuries. They remember the details of what they fixed with astonishing clarity. I'm usually very impressed with them. But they don't do/know what I do. Just like I don't do what they do.
It seems like a lot of badly collected data and anecdotal observations. But a lot of wound ballistics is like that. Well collected data is hard to come by.
Also, she's looking at fatalities. A major question, which I'm sure no one can answer with real authority is, does eventual fatality correlate to quick immobilization? Because the purpose of a defensive shooting is not necessarily to kill, but to stop the attack. They're not the same thing.
I'd love to hear Doc Roberts' take on this article. To me it seems like pseudoscientific gobbledygook.
Bingo!
Technically the 9mm Silvertip fired by the FBI in 86 in Miami caused a fatal wound. But the perp was able to kill two agents and wound more before he became incapacitated.
What happens in the ER, OR, or afterwards really doesn't concern me much.
True enough, although I notice that we still talk about that incident 36 years later. Criminals taking lethal hits and continuing to effectively fight are so rare that if we tried we could probably name every single one.
Even criminals taking ineffective hits and resisting effectively, while far more numerous, are still rare in the extreme.
The most likely outcomes are surrendering, falling down and running off. Sometimes they'll bang off a few rounds over their shoulder into lower earth orbit.
The much maligned and dismissed "Psychological Stop" seems actually to be the primary mechanism that makes a criminal cease his actions in a timely manner much more effectively than exsanguination, which is the stated goal of most shot placement.
Reply With Quote