Doctor Talks About Gunshot Wounds

An interesting talk that is definitely worth watching:

Every time I see one of these types of scientific videos where they talk about wounds, I realize how bad I never want to be shot.

The rifle v.s. handgun pictures he shows are especially frightening.

LOL at the zombie target joke at around 13:12.

Summary:

  • Handguns are not as deadly as most people think.  6 out of 7 people survive their injuries
  • It’s impossible to assess injury severity at scene properly
  • There are often no exit wounds
  • Handguns have a very low penetration depth
  • Be concerned about airways
  • The most likely death is due to hemorrhage
  • Quick transport to OR is key

Moral of the story is that if you’re going to get shot you better hope it’s with a handgun.  On the flip side of that Clint Smith’s saying  “The only purpose for a pistol is to fight your way back to the rifle you should have never laid down.” definitely holds true, because you’re going to want a rifle (if you have the option) to stop the threat.

Thoughts?

Hat tip: Arthur

50 COMMENTS

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Frank August 26, 2012 at 02:40 am

Moral of the story? Don’t get shot.

If you do have to shoot, SHOT PLACEMENT, SHOT PLACEMENT, SHOT PLACEMENT.

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bbmg August 27, 2012 at 05:04 am

Sounds like a good argument to use something like this: http://www.cbjtech.com/sida.asp?sida=2_6.5×25%20CBJ

High velocity rounds that will rip straight through a human target whether or not they are wearing body armor, so penetration depth becomes moot.

Being a small light round, you can carry enough to encourage a generous rate of fire which greatly increases the chances of a disabling hit. Lower recoil and higher velocity also makes accurate shot placement easier.

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captain_obvious August 26, 2012 at 03:10 am

“the most likely death [from a gunshot] is hemorrhage”

As opposed to what, stroke?

LOL

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Rydak August 26, 2012 at 04:02 am

Tissue damage, he means bleeding out is the worst thing and needs to be stopped, not so much the wound itself.

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JonMac August 26, 2012 at 01:00 pm

Exactly. As opposed to death via brain, heart, lung or even liver damage. Not so obvious after all, Captain!

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Justin August 26, 2012 at 04:43 am

Just FYI to anyone who hasn’t watched, be warned: explicit and detailed photos of gunshot wounds and surgeries are shown without warning. It’s probably NOT a good idea to watch this if you have a weak stomach.

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Church August 26, 2012 at 10:30 am

Thank you Justin! I’m at work right now and that wouldn’t have gone over very well. I’ll have to watch it later on.

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JonMac August 26, 2012 at 01:00 pm

It’s about gunshot wounds – what did you expect, bunnies and flowers?

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Frank August 26, 2012 at 02:55 pm

@JonMac, you forgot rainbows.

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Ringo45 August 26, 2012 at 01:17 pm

If you have a gun and your stomach is too weak to watch this, then you probably won’t be able to shoot an attacker either.

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Al T. August 26, 2012 at 04:16 pm

Disagree.

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tha guy September 7, 2012 at 05:55 pm

If that stuff bothers you…you have no business int his industry.

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BUTTES September 10, 2012 at 04:42 pm

Lighten up, Francis.

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Jim P. August 26, 2012 at 05:48 am

Watched the whole video. Very interesting. Couple of thoughts I had related to this:

1) I wonder what the “non-damage” damage would look like. What if you hit someone wearing a ballistic vest multiple times. For example, if what if someone had put four rounds into the Aurora shooter, even with a vest? Would that have slowed or stopped him?

2) Did he disregard the difference between a .45 and a 9MM or just group them all in?

3) I’m going to ignore his comparison of shootings and car deaths as a cognitive dissonance. Yes the guy blew a round through his leg. An accident/ND is equivalent to a car accident. The other 98% of shootings are deliberate, in their own way, including the Empire State Building shooting.

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Lazy Bike Commuter August 26, 2012 at 07:37 am

The Aurora shooter actually didn’t have a bullet proof vest, he had one of those Blackhawk tactical vests that are for carrying AR-15 mags. The Box O’ Truth did a test as to whether a loaded magazine does a boos job stopping a bullet (no).

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Jim P. August 26, 2012 at 11:00 am

Thanks. I thought the lame stream media reported it as bullet proof. Then if someone had been armed they would have been able to at least slow him down.

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Ringo45 August 26, 2012 at 01:19 pm

Media says a lot of stupid things. Media also called his ar and ak47.

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M August 27, 2012 at 12:58 am

here’s a vid of a guy taking a 9 to the chest with a BPV on.
http://www.youtube.com/watch?v=6cvZC7tQM8k

and here’s a forty:
http://www.youtube.com/watch?v=VDRRJZ6rJBY&feature=related

while the bullet might not go into you, the force of the bullet is distributed across the armor to a larger area. This makes it feel like being kicked in the chest from the accounts that i’ve heard. broken ribs are pretty common.

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Jim P. August 27, 2012 at 10:27 pm

I’m going to take from this that a plate armor along with the Kevlar is probably better than a straight Kevlar in the results.

That out of line?

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Sid August 28, 2012 at 07:22 am

Jim P.,

Plate armor is not a single construct. Metal, ceramic, and Kevlar plates add significant protection. The US military is using vests and plate carriers that have lower level protection as the base and plates that should over protection to most of the vital organs. Pistol rounds should be defeated by the vest or carrier and plates should stop rifle rounds.

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wizardpc August 26, 2012 at 07:29 am

Mike,

Thanks for linking to this. I took a class earlier this year from the late Paul Gomez on treating gunshot wounds. “First Aid for Gun-Toters” was the name. My partner reviewed it here: http://gunscarstech.com/2012/02/12/traumatic-injuries-course-review/

The scariest thing he said in that class was that if paramedics are called out to a shots-fired situation, they will sit at the perimiter until the cops tell them all the bad guys are accounted for.

That means that if you’re hurt, you’re gonna wait. I think everyone needs to take a class like that, and carry a blowout kit. After the class, I put together one for my car and one for my wife’s car since I’m not likely to be somewhere without a vehicle. I describe my kit here: http://gunscarstech.com/2012/04/05/basic-gunshot-wound-kit/

Also I want to thank you for posting that video of “Tex” shooting himself in the leg last year. It really got me thinking about this stuff, because all of the ranges I shoot at are at least 20 minutes away from an ER. A couple are an hour or so. Like the Doc said, the faster you get treatment the more likely you are to survive.

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ENDO-Mike August 26, 2012 at 02:11 pm

Good articles! Thanks for sharing Wizard.

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hnl.flyboy August 27, 2012 at 05:08 am

Which is why during the safety brief prior to shooting, it must be stressed that when calling EMS, they should specify that “An accident (or firearm accident) occurred at _________ Range,” and that saying, “There’s been a shooting at _________ Range” means EMS will take a LONG time until everything is settled.

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Al T. August 27, 2012 at 08:48 am

Good point. Also, it’s good to have the actual address (123 Rose street) as opposed to a generic “Carolina Shooting Range” sort of statement.

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Weer'd Beard August 26, 2012 at 07:54 am

Well I carry a pistol because A) I’m doing other things and don’t want to muck with a rifle, as well as what the law might decide I’m doing. and B) I don’t care if the bastard dies or not, I just want him to change his plans to not include me anymore!

BTW Love that he had so much data that wasn’t quite as critical to his talk, and he talked about wounds objectively, some may be good guys, lots are bad guys.

This is why antis delete comments, because a guy like this can DESTROY their arguments in seconds.

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Al T. August 26, 2012 at 08:14 am

FWIW, Docgkr watched the video and gave it his approval.

Jim P.,

1) – the term is “back face deformation”. Reading about gunshot survivors back when Rich Davis (Secondchance) was publishing accounts, most officers were not deterred from firing back unless (again IIRC) a fairly heavy cartridge was used, rifle, shotgun. In Davis’s promo videos, he would shoot himself with a .44 Magnum and engage a target with the other five shots.

2) – definitely lumped them all in. It’s a very marginal difference with handgun calibers as they all suck at stopping people.

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theblackknight August 26, 2012 at 10:58 am

The comment about fighting your way back to a rifle is derpy. If you are in your own house, sure,grab a long gun. Where the fuck else is the applicable to civilians in the US? Who walks around with a rifle? Shits not practical. That quote joined the bumper sticker list along with “i dial .357” and “if gun are outlawed,only outlaws will have them” a long time ago. When gun owners use them, they make the rest of us look like Fudds.

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JonMac August 26, 2012 at 01:02 pm

Couldn’t agree more. The quote is on a noticeboard at work, and makes me roll my eyes every time.

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ENDO-Mike August 26, 2012 at 02:13 pm

haha the point still stands that rifles kill better than handguns. I really couldn’t give less of a shit what non gun owners think, because I’m assuming they get all the info they care about from the media anyway.

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theblackknight August 26, 2012 at 03:41 pm

We all know rifle wins in ternimal ballistics. velocity is king. You don’t need to derp to make that point. I’m not sure you realize this, but in a small way, ENDO is the media. You have a good following. people link here a lot.

Phil from All that Remains talks about this very issue and how bumper sticker quoting rednecks don’t help our image any.

http://www.altpress.com/contributors/entry/phil_labonte_of_all_that_remains_on_the_second_amendment_and_our_right_to_b

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Weer'd Beard August 26, 2012 at 07:04 pm

The point is awesome! Hardly Derpy!

I carry a handgun because I don’t plan on being in a gun fight, and plan on doing other things.

In the event of my EXPECTING violence (such as civil unrest due to natural disaster, terrorist or military attack, or riots) my handgun becomes my backup and I will NOT want to stray far from my rifle.

I’ll further trump that my go-to rifle is in .308. I know 5.56×45 is a great round and works in the field, but I’d like a little bit more.

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theblackknight August 27, 2012 at 04:31 pm

Jesus Reloading Christ.

Obvious points are obvious? The quote at task has zero application to 99% of the lives of the average civilian who carry’s a handgun.

Now you can realize what I’m saying is true, or continue to be a retard and do something gay like link to a youtube vid showing a guy defend himself with a AR like that’s somehow representative of the majority of shootings.

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theblackknight August 27, 2012 at 05:51 pm

From the FBI article below.

“Experienced officers implicitly recognize that fact, and when potential violence is
reasonably anticipated, their preparations are characterized by obtaining as many shoulder weapons as
possible. Since most shootings are not anticipated, the officer involved cannot be prepared in advance
with heavier armament.”

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Rob August 26, 2012 at 12:48 pm

You may not stop someone dead with a handgun but don’t underestimate the power of being shot and its ability to make you reconsider what you’re doing. A handgun is still a tremendous self defense tool if for no other reason than its psychological capabilities.

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Martin August 26, 2012 at 05:15 pm

I was into the video, till I took the SBR to the knee. Sheesh, this is very factual, almost too much info. Going to show this to my NRA instructor, might be able to incorporate it into his class.

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Nemo August 26, 2012 at 06:24 pm

Very informative video. Thanks for posting it.

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overkill556x45 August 26, 2012 at 06:26 pm

Everyone knows that if you’re hit with a .45 you die immediately from your entire skeleton exploding. And if you’re shot with a 9mm, you’ll actually get healthier because the cartridge is so wimpy. This “trauma surgeon” needs to get his facts straight.

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cc19 August 26, 2012 at 10:28 pm

Same with the .30 carbine and 5.7×28; use only if you are trying to tickle your targets to death! You’re better off racking a pump twelve gauge so you can stop the bad guy via heart attack.

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Tom August 26, 2012 at 09:29 pm
M August 27, 2012 at 12:47 am

Thats pretty good. I wonder if the FBI used that to pick the 10mm…

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bbmg August 27, 2012 at 04:57 am

Unfortunately in spite of all the studies that have been carried out, there are still a lot of myths surrounding wound ballistics.

This FBI report is particularly well written: http://www.firearmstactical.com/pdf/fbi-hwfe.pdf

These are the conclusions drawn:

“Kinetic energy does not wound. Temporary cavity does not wound. The much discussed “shock” of bullet impact is a fable and “knock down” power is a myth. The critical element is penetration. The bullet must pass through the large, blood bearing organs and be of sufficient diameter to promote rapid bleeding. Penetration less than 12 inches is too little, and, in the words of two of the participants in the 1987 Wound Ballistics Workshop, “too little penetration will get you killed.” Given desirable and reliable penetration, the only way to increase bullet effectiveness is to increase the severity of the wound by increasing the size of hole made by the bullet. Any bullet which will not penetrate through vital organs from less than optimal angles is not acceptable. Of those that will penetrate, the edge is always with the bigger bullet.”

Makes you wonder if it’s worth using hollowpoints that sacrifice penetration depth for a larger permanent cavity are worthwhile in a relatively low velocity handgun round.

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Al T. August 27, 2012 at 08:54 am

“Makes you wonder if it’s worth using hollowpoints”

Looking at several different media tests, I think the .380 and lesser cartridges do indeed cross that threshold.

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bbmg August 27, 2012 at 02:57 pm

While they might penetrate more than 12 inches of ballistic gelatin, this doesn’t take into account the bullet encountering armor, clothing or bone, and therefore the margin of error might not be sufficient.

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hnl.flyboy August 27, 2012 at 05:11 am

So Mike, does this mean that by attaching your stock to my Glock, it magically obtains all the killing power of a Barret .50 as it’s now a (short-barreled) rifle? XD

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lolinski August 27, 2012 at 07:43 am

Couldnt you in theory get something like the OA-93(or whatever they are called now) since it doesnt have the buffer tube and then use a 20 or 15 round magazine(maybe shorten the barrel down to 10 cm?) it would be a bit heavy for conceal carry but it would/could be effective if you trained with it and wore a shoulder holster.

At least you would avoid the whole “not flinching while getting shot by handgun” part if you have to shoot someone.

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45er August 27, 2012 at 09:02 pm

8:42, reason why you need to know what you’re doing when you’re carrying a carbine on your chest. Ouch.

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Saxon August 27, 2012 at 11:23 pm

I wonder if the guy at 8:42 was a BATFE? they seem to have a knack for shooting themselves. Hey Blacknight, whats wrong with the quotes? The one about fighting your way to a rifle COULD apply in an extreme active shooter situation. and the slogan “when guns are outlawed, only outlaws will have guns” is a truism. Why is most of the world under daily combat and seige? Not enough guns in good hands, too many guns in bad hands. The only reason the bumper stickers exist in the first place is because of liberals and statists who lack common sense and hold no respect for the Constitution. Like it or not, bumper stickers and silly slogans are a line of defense. Would you rather fight a political battle or an actual battle?

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Saxon August 27, 2012 at 11:39 pm

And bullet velocity is not a guarantee of damage. During the Second World War several Japanese soldiers were shot with 30.06 rounds and didnt go down (because they passed right through). Bullet weight and tumble/fragmenation are probably the more deadly factors. Its why the original M-16 rounds in the early stages of Vietnam were awesome.

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Mike M February 23, 2014 at 12:12 pm

Several years ago, in reading a lot of gun blogs and researching, I came across what was I believe a forum post (or series of posts) by a man who was either an ER doctor or did autopsies for the city morgue, discussing his own observations over a long career of gunshot wounds, stopping power, caliber, etc. If my memory is correct, he worked in or around Atlanta, or otherwise in/near a high crime city. His discussion was many pages, and it took me several days of afternoons to read it all. I can’t find it now though. Does anyone else remember that or know where it’s likely to be found? Possibly The High Road, or similar popular forum site, but I’ve exhausted my Google Fu skills and have come up blank.

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ENDO-Mike February 23, 2014 at 12:14 pm

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