A Medical Perspective on Ammunition and Lethality

[Yute]

The anonymous medical staff data is pure anecdote and should be treated as such. Without seeing the actual dataset, it can suffer from multiple flaws predominately recall bias and sample size bias.

The cited study is a mixed bag, though the concern about grouping 7.62x39 with handgun calibers is a little overblown; of 183 deaths in the study, only 1 person was shot with this caliber. Methodical flaws aside (mainly overlapping confidence intervals in the medium and large caliber group), the bigger takeaway is that you were more likely to die if you got shot multiple times.

I think we can all agree shot placement is king, but given all things being equal, a bullet that is constructed to maximize tissue expansion and reliable feeding in a caliber that allows for higher capacity and easier control seems like something we should strive for in a self defense role...

[Moshjath]

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

Agreed. My wife is an Emergency Medicine Doc in a large city in the south. She generally notes if it's rifle/shotgun/or pistol in conversation but doesn't fixate on it, with the anecdote that it is very common for folks who have received pistol GSWs to be discharged very quickly. She isn't into guns, I drag her to the range with me on an infrequent basis.

My little brother is a Paramedic in a different mid to large sized southern city, working both the more rural county area and urban areas. His observations on dealing with a LOT of GSWs from everything ranging from NDs to gang stuff to OIS incidents are that fmj rounds can be quite survivable, the modern JHP pistol ammunition used by the local PD is pretty darn effective when combined with multiple shots to the center of mass, rifle is an order of magnitude moreso and shotgun at CQB distances is...decidedly lethal. He is a gun guy, He carries a G19 with HST and despite having multiple nice ARs, his home defense weapon is an LTT Beretta 1301 mounting an H2 based on his observations at work.

[56kobra]

Got to agree with the shotgun.
I have the federal flite control 00 buck in my Mossberg persuader.
This wad keeps the pattern tighter for longer distances.
Shooting at targets at various close range distances and seeing ballistic gel tests, I cannot imagine what this would do but it wouldn’t be good for them.
I know one school of thought with shotguns is more spread with the shot but judging from gel tests and bird shot, it’s not the best penetrator though you would cast a wider net.
I have a 9mm with 147 HST’s (old style) ready to go but I’d grab the Mossberg first.

[DocGKR]

The article initially reference in this thread is a morass of poor information relying on flawed studies.

Paramedics, ED staff, surgeons doing trauma repair, and forensic folks all see different pieces of the pie.

I've been to many medical conferences addressing "gun violence" and have seen a lot of balderdash masquerading as "science", as well as many prominent health care providers with a minimal understanding of wound ballistics offering factually incorrect commentary. One well known trauma surgeon was touting their experience treating victims of "assault weapons" and "military weapons of war" that are purportedly "awash on the streets of America".....yet a review of the police reports regarding the GSW's actually treated showed that all were from handgun caliber weapons--no rifle wounds. Few urban ED's ever seen wounds from hunting rifle expanding projectiles--even experienced military surgeons typically don't see such injuries. Likewise, much of what has been published in the medical literature, let alone that which is available on the public internet is replete with misinformation.

[RevolverRob]

Shooting at targets at various close range distances and seeing ballistic gel tests, I cannot imagine what this would do but it wouldn’t be good for them.
I know one school of thought with shotguns is more spread with the shot but judging from gel tests and bird shot, it’s not the best penetrator though you would cast a wider net.

We could probably have a whole thread on terminal ballistics of shotguns and whether more or less spread is better.

The most important part is being able to put 90%+ (preferably all) of your pellets into a 6-8" circle out to your maximum engagement distance. That circle representing the upper thoracic cavity or the head. That's the great thing about FC and Versatite, they consistently do this almost regardless of which shotgun barrel you put them through.