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Gunshot wound

Gunshot wound
Skull, viewed from side, with hole on parietal bone from bullet exit
Male skull showing bullet exit wound on parietal bone
SpecialtyTrauma surgery
SymptomsPain, deformity, bleeding[1][2]
ComplicationsPTSD, lead poisoning, hypovolemic shock, nerve injury,[1][2][3] wound infection, sepsis, brain damage, gangrene, disability, amputation[4]
CausesGuns
Risk factorsIllegal drug trade, ignorance of firearm safety, substance misuse, alcohol abuse, poor mental health, firearm laws, social and economic differences, some occupations, war[5][6]
PreventionFirearm safety, crime prevention[7][8]
TreatmentTrauma care[9]
Frequency1 million (interpersonal violence in 2015)[10]
Deaths251,000 (2016)[5]

A gunshot wound (GSW) is a penetrating injury caused by a projectile (e.g. a bullet) shot from a gun (typically a firearm).[11][12] Damage may include bleeding, bone fractures, organ damage, wound infection, and loss of the ability to move part of the body.[2] Damage depends on the part of the body hit, the path the bullet follows through (or into) the body, and the type and speed of the bullet.[12] In severe cases, although not uncommon, the injury is fatal. Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and debility, and lead poisoning.[1][2]

Factors that determine rates of gun violence vary by country.[5] These factors may include the illegal drug trade, easy access to firearms, substance misuse including alcohol, mental health problems, firearm laws, social attitudes, economic differences, and occupations such as being a police officer.[5][6] Where guns are more common, altercations more often end in death.[13]

Before management begins, the area must be verified as safe.[9] This is followed by stopping major bleeding, then assessing and supporting the airway, breathing, and circulation.[9] Firearm laws, particularly background checks and permit to purchase, decrease the risk of death from firearms.[7] Safer firearm storage may decrease the risk of firearm-related deaths in children.[8]

In 2015, about a million gunshot wounds occurred from interpersonal violence.[10] In 2016, firearms resulted in 251,000 deaths globally, up from 209,000 in 1990.[5] Of these deaths, 161,000 (64%) were the result of assault, 67,500 (27%) were the result of suicide, and 23,000 (9%) were accidents.[5] In the United States, guns resulted in about 40,000 deaths in 2017.[14] Firearm-related deaths are most common in males between the ages of 20 and 24 years.[5] Economic costs due to gunshot wounds have been estimated at $140 billion a year in the United States.[15]

  1. ^ a b c "Gun Shot Wounds - Trauma - Orthobullets". www.orthobullets.com. Retrieved 13 July 2019.
  2. ^ a b c d "Gunshot wounds - aftercare: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 13 July 2019.
  3. ^ Stein JS, Strauss E (January 1995). "Gunshot wounds to the upper extremity. Evaluation and management of vascular injuries". The Orthopedic Clinics of North America. 26 (1): 29–35. doi:10.1016/S0030-5898(20)31965-9. PMID 7838501.
  4. ^ Nair R, Abdool-Carrim AT, Robbs JV (2000). "Gunshot injuries of the popliteal artery - Nair - 2000 - BJS - Wiley Online Library". The British Journal of Surgery. 87 (5): 602–7. doi:10.1046/j.1365-2168.2000.01397.x. PMID 10792317. S2CID 8418598.
  5. ^ a b c d e f g Naghavi M, Marczak L, et al. (28 August 2018). "Global Mortality From Firearms, 1990-2016". JAMA. 320 (8). Global Burden of Disease 2016 Injury Collaborators.: 792–814. doi:10.1001/jama.2018.10060. PMC 6143020. PMID 30167700.
  6. ^ a b Branas CC, Han S, Wiebe DJ (2016). "Alcohol Use and Firearm Violence". Epidemiologic Reviews. 38 (1): 32–45. doi:10.1093/epirev/mxv010. PMC 4762248. PMID 26811427.
  7. ^ a b Lee LK, Fleegler EW, Farrell C, Avakame E, Srinivasan S, Hemenway D, Monuteaux MC (1 January 2017). "Firearm Laws and Firearm Homicides: A Systematic Review". JAMA Internal Medicine. 177 (1): 106–119. doi:10.1001/jamainternmed.2016.7051. PMID 27842178. S2CID 205119294.
  8. ^ a b Santaella-Tenorio J, Cerdá M, Villaveces A, Galea S (2016). "What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?". Epidemiologic Reviews. 38 (1): 140–57. doi:10.1093/epirev/mxv012. PMC 6283012. PMID 26905895.
  9. ^ a b c Breeze J, Penn-Barwell JG, Keene D, O'Reilly D, Jeyanathan J, Mahoney PF (2017). Ballistic Trauma: A Practical Guide (4 ed.). Springer. p. 75. ISBN 9783319613642.
  10. ^ a b GBD 2015 Disease and Injury Incidence and Prevalence Collaborators (8 October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  11. ^ "Gunshot wound definition and meaning | Collins English Dictionary". www.collinsdictionary.com. Retrieved 13 July 2019.
  12. ^ a b "Gunshot Injuries; Gunshot wounds (GSW) information". patient.info. Retrieved 13 July 2019.
  13. ^ Cukier W, Eagen SA (February 2018). "Gun violence". Current Opinion in Psychology. 19: 109–112. doi:10.1016/j.copsyc.2017.04.008. PMID 29279206. S2CID 20214015.
  14. ^ McLean RM, Harris P, Cullen J, Maier RV, Yasuda KE, Schwartz BJ, Benjamin GC (7 August 2019). "Firearm-Related Injury and Death in the United States: A Call to Action From the Nation's Leading Physician and Public Health Professional Organizations". Annals of Internal Medicine. 171 (8): 573–577. doi:10.7326/M19-2441. PMID 31390463.
  15. ^ Rhee PM, Moore EE, Joseph B, Tang A, Pandit V, Vercruysse G (June 2016). "Gunshot wounds: A review of ballistics, bullets, weapons, and myths". The Journal of Trauma and Acute Care Surgery. 80 (6): 853–67. doi:10.1097/TA.0000000000001037. PMID 26982703.

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