Trauma surgery: Ballistic trauma
In the third article in our series on trauma, Omar Mukhtar and Kirsten Jones explain how to assess and manage ballistic trauma
Ballistic trauma is a sad and tragic part of everyday life in many parts of the world, from South Africa to Palestine, from Afghanistan to the United States. Yet the perceived glamour of the gunshot wound lures many students to undertake an elective in trauma surgery. Here we explore the basics of ballistic trauma.
Firearms are weapons that require an additional source of energy, usually provided by the ignition of a propellant to fire a projectile--for example, bullets or pellets. Firearms are classically divided into four groups (see box). When a firearm is discharged, a cloud of vapour (gas) and particulate matter (solid) is deposited nearby, on skin and clothes for example. Explosives--such as bombs and hand grenades--behave in a similar manner.
After resuscitation it is necessary to take a full history and complete a thorough examination. It is important to cover the specific points raised last month,1 which dealt