Managing Gunshot Injuries

Gunshot injuries are the injuries to any part inflicted by a bullet or shotgun. These injuries are more common in young men who live in urban areas.

Effects of Gunshot

The effect of a gunshot injury depends upon the site of the injury, type of weapon, type of bullet and the range from which the weapon was fired. In addition to the damage to the tissues, there is high risk of infection. The wounds to the head or the trunk are often life threatening.

A gunshot injury may damage muscle or cause a fracture. Such injuries are not serious. But damage of vital organs may be serious. An injury to the chest wall may cause breathing problems or pneumothorax (air enters the space between the membrane that surrounds the lungs).

If the spleen or liver is damaged, fatal bleeding may occur, which may lead to loss of consciousness and shock. A gunshot injury to intestine may cause the contents to leak into the abdominal cavity leading to infection. Injuries to brain or heart are the most dangerous and often lethal.

Investigations

Investigations to be done after a gunshot injury include chest x-ray, CT scan or MRI to find the exact site of injury.

Treatment

Anyone with a gunshot injury needs to be taken to a hospital immediately. Till the time ambulance arrives, external pressure may be applied so as to try to stop external bleeding.

Initial measures include controlling bleeding and giving oxygen and intravenous fluids. Blood transfusion may be required in case of severe blood loss. After initial measures, the extent of tissue damage is investigated using the imaging techniques.

Almost all gunshot injuries require surgery to repair the damaged organs and remove the parts of bullet, clothing and other debris in the wound. After the cleaning, once the bleeding is stopped, the wound is covered with sterile gauze to help prevent the infection. The wound is then closed.

Specific injuries may need additional treatment like chest aspiration in pneumothorax and mechanical ventilation in case of breathing difficulties. Injections are to be given to prevent tetanus and antibiotics are given so as to control infections.

Counseling may be offered to help reduce the possibility of post-traumatic stress disorder.

Prognosis

With immediate treatment, many gunshot injuries do not lead to long-term physical damage. But in case of injury to the vital organs, the injury may be fatal.