How serious would a shotgun wound be when not fired in close range?

Apr 18, 2016 03:15

Setting: Present-day, a healthy man in his mid-thirties is running and hit from behind by ammo from a shotgun. The wound is in the left side area ( Read more... )

~medicine: injuries: gunshot wounds

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e_moon60 April 19 2016, 15:14:14 UTC
Part 2/2

What is the distance at which a shotgun blast won't be serious? Lots of variables. Ammunition: shot or slug, and what weight of shot? What/how much propellant (which determines muzzle velocity)? Where is the victim hit? How much of the scattered shot (if it's shot and not slug) hits the victim? Age, size, physical condition of the victim? (Although infection is always a concern, both fat and muscle--though differently--can "catch" low-velocity shot if thick enough.) Healthy victims survive better than ones already sick or debilitated. Timing and quality of medical care matter a lot.

For your specific question about someone running away and hit in the left side of the back: lots of things on the left side of the back could be damaged with dire results. The shoulder area is somewhat protected by the shoulder blade, so we'll ignore for the moment what's behind it. The spine is always at risk, top to bottom. Below the shoulder blade and the pelvis are the left-side abdominal contents--soft tissue easily damaged. There are lower ribs (which if broken leave sharp edges to cause further injury), the left kidney, part of the left lung, the stomach, the spleen, some intestines (small intestine and the descending colon, IIRC and without looking it up) all exposed between the shoulder blade much higher up and the pelvic crest. A low enough shot in the back could fracture the pelvic crest on that side and bands of tendon that anchor the lower spine and the muscles of the upper back. Small projectiles, like shot, are apt to bounce around from bone to bone inside the body, making holes in other things that get in the way. They lose velocity pretty soon, but by then they may have done a lot of damage. Penetrating wounds to the digestive tract (stomach, intestines, rectum) cause serious, often life-threatening infections...all those E.coli and other bacteria in the gut get loose in the rest of the body.

Where to look for more specifics: textbooks or handbooks for EMS personnel and trauma physicians, anatomy charts (some are online) that show what's inside every part of the skin. Talk to some EMTs, paramedics, trauma surgeons and forensic pathologists...and also to military and law enforcement (who are the ones to know exactly how far shooter was from victim--the trauma surgeon knows the wounds, but knows the history only by hearsay.

Hope this helps.

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tabaqui April 19 2016, 16:16:25 UTC
Not the OP, but your comments rock. Awesome. Thank you!

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insaneladybug April 19 2016, 21:43:22 UTC
Thank you so much! That is very informative. It sounds like the wound probably could be as serious as portrayed in the episode. I'll have to think some more about how to handle it in detail if I want to get more in-depth about it than I have in the past three years.

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e_moon60 April 20 2016, 00:03:45 UTC
I've never watched the show you referenced, so can't comment directly on that. If you're going to be writing (fiction or nonfiction) that involves serious bodily harm, some background is very helpful...but anyone can begin collecting an expert panel for medical, firearms, etc. advice for a given piece of work. Ideally you talk to an active or recently retired EMT/Paramedic (civilian or military) and a good ER nurse and doctor. Tell them you don't want to make stupid mistakes, and ask if they'll vet your mechanism of injury (they won't have time for a whole book.) Movies and TV often get it wrong for reasons of time, money (it costs more to do it right), and dramatic impact. They're not a teaching tool. They aren't supposed to be. Even as a kid I knew that Roy Rogers didn't have the equivalent of a roll of caps in his revolver, so beyond six (or twelve if he used both) it was all Hollywood. Writers of stories/books should do better, because the audience isn't distracted by the sights and sounds of the action.

Books: If your local library doesn't have the right kind of books, a community college with an EMT certification program will, in its bookstore. You need a book on human anatomy that makes clear what's where, and what's behind what, a basic "trauma care in the field" kind of text (for first responders, EMTs, etc.) that will give you lots of details on how various injuries should be handled. When to suspect a ruptured spleen, when to suspect trauma to the heart or great vessels, etc. There used to be a good magazine for EMS personnel, with discussions of specific emergencies.

Be alert for opportunities to learn more--useful articles sometimes appear in newspapers and magazines, on news shows on TV. You may meet someone with specialized knowledge you can use.

My life changed direction with the adoption of an autistic kid (no more jumping on the ambulance at a moment's notice) so I don't know what the current titles/authors are anymore, but the basics are similar because human anatomy, physics, and the mechanics of injury don't change. This kind of stumble breaks an ankle one way; that kind of all breaks it another. Airway, Breathing, Circulation are still the foundation of life-saving response, whether on the streets, in a back yard, or in combat.

Good luck with your projects.

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