Gunshot Entry And Exit Wounds

1. Types Of Gunshot Wounds
2. Gunshot Entry And Exit Wounds Video
3. Bullet Exit Wound Chart

A radiologist who has worked multiple mass shootings, points to a critical difference between incidents involving assault rifles and ordinary handguns.As I opened the CT scan last week to read the next case, I was baffled. The history simply read “gunshot wound.” I have been a radiologist in one of the busiest trauma centers in the nation for 13 years, and have diagnosed thousands of handgun injuries to the brain, lung, liver, spleen, bowel, and other vital organs. I thought that I knew all that I needed to know about gunshot wounds, but the specific pattern of injury on my computer screen was one that I had seen only once before.In a typical handgun injury that I diagnose almost daily, a bullet leaves a laceration through an organ like the liver. To a radiologist, it appears as a linear, thin, grey bullet track through the organ. There may be bleeding and some bullet fragments.I was looking at a CT scan of one of the victims of the shooting at Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. The organ looked like an overripe melon smashed by a sledgehammer, with extensive bleeding. How could a gunshot wound have caused this much damage?The reaction in the emergency room was the same.

Feb 6, 2014 - Gunshot wound usually has entry and exit wounds. Therefore, the aim of this study was to determine the differences between entry and exit. Routine handgun injuries leave entry and exit wounds and linear tracks through the victim’s body that are roughly the size of the bullet. She has seen multiple gunshot wounds in her career. Gunshot wounds through clothing can be telling, however, in that they can help determine the physical position the victim was in when he or she was shot. By lining up the holes in the clothing with the entrance and exit wounds, it can be determined whether the victim was sitting, standing, slouched, or in another position.

One of the trauma surgeons opened a young victim in the operating room, and found only shreds of the organ that had been hit by a bullet from an AR-15, a semi-automatic rifle which delivers a devastatingly lethal, high-velocity bullet to the victim. There was nothing left to repair, and utterly, devastatingly, nothing that could be done to fix the problem. The injury was fatal.A year ago, when a gunman opened fire at the Fort Lauderdale airport with a 9mm semiautomatic handgun, hitting 11 people in 90 seconds, I was also on call. It was not until I had diagnosed the third of the six victims who were transported to the trauma center that I realized something out-of-the-ordinary must have happened. The gunshot wounds were the same low velocity handgun injuries as those I diagnose every day; only their rapid succession set them apart. And all six of the victims who arrived at the hospital that day survived.Routine handgun injuries leave entry and exit wounds and linear tracks through the victim’s body that are roughly the size of the bullet. If the bullet does not directly hit something crucial like the heart or the aorta, and they do not bleed to death before being transported to our care at a trauma center, chances are, we can save the victim.

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The bullets fired by an AR-15 are different; they travel at higher velocity and are far more lethal. The damage they cause is a function of the energy they impart as they pass through the body. A typical AR-15 bullet leaves the barrel traveling almost three times faster than, and imparting more than three times the energy of, a typical 9mm bullet from a handgun. An AR-15 rifle outfitted with a magazine cartridge with 50 rounds allows many more lethal bullets to be delivered quickly without reloading.I have seen a handful of AR-15 injuries in my career. I saw one from a man shot in the back by a SWAT team years ago.

The injury along the path of the bullet from an AR-15 is vastly different from a low-velocity handgun injury. The bullet from an AR-15 passes through the body like a cigarette boat travelling at maximum speed through a tiny canal. The tissue next to the bullet is elastic—moving away from the bullet like waves of water displaced by the boat—and then returns and settles back. This process is called cavitation; it leaves the displaced tissue damaged or killed. The high-velocity bullet causes a swath of tissue damage that extends several inches from its path. It does not have to actually hit an artery to damage it and cause catastrophic bleeding.

Exit wounds can be the size of an orange.With an AR-15, the shooter does not have to be particularly accurate. The victim does not have to be unlucky. If a victim takes a direct hit to the liver from an AR-15, the damage is far graver than that of a simple handgun shot injury. Handgun injuries to the liver are generally survivable unless the bullet hits the main blood supply to the liver.

An AR-15 bullet wound to the middle of the liver would cause so much bleeding that the patient would likely never make it to a trauma center to receive our care.As a technical matter, the difference is the ammunition, not the weapon itself. But this is a powerful bit of testimony as to why banning particular tool of violence might have an outsized effect.UPDATE (2/26): has a new posting out explaining, “ Why the AR-15 is a very deadly military weapon.” He lays out quite a bit of detail on the evolution of the AR-15/M-16/M4 carbine series of rifles as well as their ballistics patterns. WAPO has an article, The real reason Congress banned assault weapons in 1994 — and why it worked.But the 1994 assault weapons ban was never intended to be a comprehensive fix for “gun violence” writ large. Its purpose, according to gun violence experts and the lawmakers who wrote the bill, was to reduce the frequency and lethality of mass shootings like the ones in Parkland, Sandy Hook and elsewhere.

And on that front, the data shows it had a significant impact.It notes that in the decade before the 1994 ban there were 19 incidents with 6 or more deaths for 155 deaths. In the decade the ban was in force 12 incidents and 89 total deaths. In the decade after 2004-2014) 34 incidents and 302 deaths.

@: I’d be curious to see that article — partly to see if they do a breakdown on the types of weapons used in those shootings.On the surface, it seems an interesting correlation. But as we all know, correlation does not necessarily mean causation. There are a multitude of other factors that could come into play.(Never mind,.)Couple of facts about the cases they cite:Stockton school shooting — shooter was a convicted felon who twice attempted suicide while in prison — he should never have been able to buy a gun.101 California Street shooting — shooter used 3 guns, two of which were specifically targeted by the Assault Weapons Ban. Shooter apparently didn’t have any history of criminality or mental illness. (Well, he was a nut, but he wasn’t a documented nut.)Long Island Rail Road shooting — shooter had a single Ruger 9mm pistol, which would have been unaffected by the AWB.The Wikipedia article on the AWB also cites the Luby’s shooting as a factor, but that one has been used to argue against weapons bans. The shooter used two handguns that would not have been affected by the AWB, and was livid because she’d been forced to leave her gun in her vehicle, meaning she had no way to confront the shooter who then killed her parents in front of her.I would also like to see some contemporary sources that talk about how the intention ascribed here was actually a factor, and not just a bit of post hoc rationalization.Interesting thought, though.

I still think a lot of the terms of the AWB were downright stupid, but — if true — this indicates that the backers weren’t complete idiots. I don’t know if I accept their reasoning, but it is interesting. @: A musket wound is just as bad due to the large size of the round and the softness of the lead allowing for massive expansion. Expansion of the round allows for far more efficient transfer of energy into surrounding tissue.

FPS is still over 1200 even with black powder.@: Automatic rifles have been heavily regulated since 1986 and prior.@: That can happen with a.22 long rifle rimfire round. In theory a pellet gun could do the same thing.Can we please stay somewhat grounded in reality?

A bullet isn’t magically more damaging/powerful just because it was fired through an ar-15. Generally rounds are less powerful when fired through an ar-15 vs a bolt action simply because ar-15s tend to have 16 inch barrels while bolt actions are 20+ inches. Longer barrel = higher fps and better accuracy. Also bolt actions allow for more chamber pressure to build (usually) so that further boosts the fps of the round. In contrast the ar-15 diverts some of the gas that is propelling the bullet to work the action. The semi-auto aspect lowers the velocity of the bullet being fired.Frankly the article is a mess written by someone that has little knowledge of guns. For example.(quote)With an AR-15, the shooter does not have to be particularly accurate.(/quote) That describes shotguns not ar-15s.

If you’re applying that to ar-15s then it’s applicable to almost every gun in existence. Excluding the small.22s and such. From the article: “An AR-15 rifle outfitted with a magazine cartridge with 50 rounds allows many more lethal bullets to be delivered quickly without reloading.”There is no such thing as a “magazine cartridge”. A magazine is the metal or plastic box that holds bullets and loads them into certain firearms via a spring.A typical AR-15 magazine holds 20 or 30 rounds. 50 round magazines are extremely rare curios and almost never used by anyone.The above quoted sentence proves the author knows nothing about firearms or AR-15’s. Given that, why should we believe anything he has written on the subject? @: Bob, you should get used to the idea that the left is not going to always be the non-violent milquetoasts they’ve been the last few decades and proceed accordingly.I got used to that quite thoroughly over the last year or so, thank you.

Perhaps you’re familiar with ANTIFA, James Hodgkinson, Floyd Lee Corkins, and Rene Boucher, among others?What YOU need to consider is whether or not you want your side to engage in a violent showdown with the right. Especially when you consider factors like which side has more guns, and which side tends to practice more with those guns.You prove your own dishonesty every day, chump. IF the right wing was filled with as many crazed, dangerous, violent hate-mongers, you’d be too frightened to trash-talk them. Or you’d be dead.You not only know that you’re lying about them, you’re depending on your insults being lies. You’re literally betting your life on it. The author was getting to the point of damage of a high velocity round vs a low velocity round.

He is not a firearms expert and does not need to be. Lets be fair and address the actual article and it’s intent. He is speaking to the wound. The plasticity of human tissue, in high velocity impacts, allows it to be pulled along with the bullet along it’s path and then it snaps back like a rubber band and this shreds the tissue leaving 10 times the damage of a slow round.

To observe this simply look at the wound track of rounds fired at ballistic gels. They are all over you tube. Personally I would prefer my rounds made out of HEIR, but some think that is a little overkill. @:The author is not making the claim that a 5.56 round does more damage fired from an AR than from any other weapon chambered in that round, but that a 5.56 does more damage than a 9mm (specifically from a handgun) due to greater cavitation, and therefore the bullet track does not need to be as “accurate” because the zone of damage is wider. She certainly does not seem to be a gun expert, but she is an expert on how bullets effect tissue (at least on X-ray images), which is what her commentary is based on. @:That can happen with a.22 long rifle rimfire round. In theory a pellet gun could do the same thing.Josh wasn’t shot with a.22.

Types Of Gunshot Wounds

He was shot along with about 70 other people with an AR-15.Why did the killer pick that gun instead of a.22? You know why, and it ain’t for “cosmetic” reasons. These killers want to kill as many people in as short a time as possible, and for thatyou get the Jargon 500 with the extra jargon.(.Or as we laymen call it: an assault rifle.)@:The above quoted sentence proves the author knows nothing about firearms or AR-15’s.So what? I’m so sick of the “I’m a gun nut so only I get to have an opinion on guns” crap. Yeah, there’s a lot of ignorance on guns. It’s almost as if a lot of that knowledge is vestigial in modern life.@:What YOU need to consider is whether or not you want your side to engage in a violent showdown with the right.Oh, Bob, I’ve considered what will happen if the American left gets into a hot war with the American right: The left would get smashed.But there won’t be any hot war between the American left and the American right.

It will a cold war between the mainstream and the extremists. If you think you’ll win, just remember: You have the guns, but we have the numbers.IF the right wing was filled with as many crazed, dangerous, violent hate-mongers, you’d be too frightened to trash-talk them.I assure you, Bob, I’m not frightened to trash-talk anyone.Besides, you’re the one pushing the idea that these spree killers have a political agenda. This is their political agenda: Kill, kill, kill, kill. The alignment with your political agenda –no restrictions on guns!– should disturb you, but it doesn’t.

@: It’s meaningless as even pistol ammo does more damage when fired through a longer barrel (hence their usage in Submachine guns). I wouldn’t call her an expert on bullets effecting tissue. Her experience with rounds are severely limited by the nature of her job. She made some blatantly false statements during her commentary and used incorrect terminology. Hell I could argue that I’m more of an expert as I was raised in a family that hunts with a variety of weapons. I have seen up close the wounds from bows, crossbows, black powder rifles, shotguns (pump and semi auto), and rifles (bolt action and semi-auto).

I’d rather get shot by a.223 fmj any day over a.308 SP or 30-06 SP. We’ve also shot ballistic gel to test various rounds including at one point different broadheads for the bow.@: No she is making an argument that only AR-15s fire a round that is inherently more damaging to soft tissue. The fact is that this applies to almost all rifles in general (there are always some quirky rounds/guns which are the exception). The whole article is meaningless without the scaremongering of the ar-15 as it’s commonly known that the longer the barrel (up to a point) the more fps and thus damage you get (moar JOULES BRAW).

@: Your “expert” apparently just discovered that a longer barrel results in a higher FPS of the bullet which can be then calculated in JoulesThat is litterly the entire article summed up.The ammo itself matters tremendously as FMJ.223 will generally create a much smaller cavity then say a 5.56 SP hunting round. Same goes for pistols. A 9mmx18 fmj will punch a nice clean hole while a self defense round will expand and cause massive cavitation in comparison.OF course your expert doesn’t know this because they haven’t actually done scientific tests to actually measure the difference.

Instead your “expert” has nothing more then what they feel/think is happening. @: Actually, I was thinking that one of the key doctrines of modern progressivism is comparative victimology — the moral side is whichever can claim the greatest level of victimhood. That’s the key principle behind “intersectional feminism.”And being the side that has a superior record in putting the other side in the hospital makes it kind of hard to claim “victimhood.”Let me throw another name out there: former ethics professor Eric Clanton. Because nothing says “anti-fascist” than dressing up in black, wearing a face mask, and going to a political rally to sucker-bash some guy on the other side with a bike lock, splitting his head open and sending him to the hospital. @: Your point here is summed up in the basic tradeoff for any gun, from pistols to big ol’ howitzers and naval guns.A longer barrel equals more accuracy, more range, and more firepower — because the bullet keeps accelerating as long as it’s in the barrel. The tradeoff is this makes the gun bigger, heavier, and harder to conceal. (Also, recoil gets really nasty.)Most criminals aren’t that interested in range and accuracy, or even power.

They want light and easily concealable. That’s why the vast majority of murders are committed with handguns, not Barrett.50-caliber sniper rifles that can reach out and kill people over a mile away. Not M2 machine guns that weigh 80 pounds and require two people to operate, but can spit out over 450 rounds a minute. @: I think we agree that a bullet that can deliver higher energy to tissue (irrespective if that energy delivery is due to higher initial kinetic energy from a round traveling faster or because it is able to dump more energy rapidly because it is a self defense round, or both) does more damage to that tissue.

Maximizing damage is why I have hollow points for my handgun and one of many reasons to select an AR chambered in 5.56 for home defense.Sure, the author seems unfamiliar with weapons, but the point is that a 5.56 round fired from an AR alters tissue appearance on CT more than a 9mm round fired from a handgun. That’s the basic fact at the root of the article. I can certainly believe that this is true, and it sounds like you can too. Assuming we agree on this, we need to examine the argument built on that fact. Assumptions include: the visual patterns seen on CT reported anecdotally in the study are representative of what one would see generally if there were more data points, altered tissue appearance on CT correlates with tissue damage, and degree of tissue damage correlates with injury severity.

If you accept those assumptions then I think you have to conclude that 5.56 bullets from an AR have higher lethality than 9mm bullets from a handgun. Yes, different combinations of bullet design, bullet weight, barrel length, etc produce different results in different combinations so making sweeping generalizations like “9mm bullets don’t hurt people as badly” are not rigorously correct, and even niave, but if the point is “some weapons generally have higher lethality (and here is an example)” I think we can agree that this is true. At least I assume you would rather shoot someone meaning harm to you or yours with a 5.56 from and AR than a 9mm from a handgun (especially if it wasn’t a hollow point round). I know I would. There is a reason, after all, that 9mm handguns are not the first choice of weapon when clearing a building. That being the case, it doesn’t matter if the increase in lethality is because of higher muzzle velocity, higher rate of fire, better accuracy, or more efficient transfer of energy to the target.

Some weapon systems have significantly higher lethality.The next step in the discussion, and in my opinion the one worth having rather than quibbling over non-shooters’ use of terminology or unsophisticated assumptions that are wrong, is where to set a threshold beyond which the danger to innocents exceeds the benefit of that weapon system employed by non-combatants. People unsophisticated about guns might not be able to fully participate in that discussion, at least without help from experts, but that doesn’t mean they can’t demand that such a discussion occur or help set the goals for that discussion.Editied to add: actual paragraph breaks. Holy wall of text. Sorry, but as has been said, I didn’t have time to write a shorter response.

Different tools for different jobs and all that. To summarize my point from the overly long reply to Matt that I was writing when you posted: the important discussion to have is when does the danger to innocents of any weapon system exceed the benefit of that weapon system for the general public? Are you making the argument that the place to start with gun control laws is with guns that qualify generally as “light and concealable” since they are the favorite of criminals (and presumably criminals are more likely to harm people with guns)? I suspect that might generate some significant push back, but it is a discussion worth having. @: What I would use to shoot someone in a defensive situation depends on the situation itself. In my house I’d rather use a 9mm with Barnes TAC-XPD ammo over an AR-15 using fmj with a small grain load simply because the 9mm ammo will do a LOT more damage (as you say alter tissue far more). Now if body armor and vehicles are involved then the scenario changes.

Personally I’m more of a shotgun person when it comes to home defense because a shotgun in one shot can put out WAY more damage than either a handgun or rifle while having far less strict requirements in aim. Nothing says “Fck OFF!” quite as well as racking a pump shotgun. Which is an important thing to me because if I can avoid a fight in the first place then all the better. There’s also the whole over penetration problem with a handgun/rifle. Frankly speaking an ar-15 using a 5.56 upper is pretty terrible for home defense.Sub machine guns are generally the first choice for clearing buildings and those use pistol rounds with 9mm or.45 cal being the most popular.The next step in the discussion, and in my opinion the one worth having rather than quibbling over non-shooters’ use of terminology or unsophisticated assumptions that are wrong,So it’s perfectly fine to be almost completely ignorant of the subject being discussed because who needs to know details to form an opinion right?

SO I should never bother to try to educate them at all because I dunno that’s mean or something?EDIT: I tried to upvote you for the long post being well formated and spoken but something went stupid and you got a downvote instead. My apologies I’ve been having some issues with the new site and some of my plug ins.

@: I’m just suggesting a real heresy — applying a smidgen of common sense to the situation.There is a major correlation between gun control laws and murder rates — an inverse relationship. The tougher the laws, the the more murders.

The laxer the laws, the fewer murders.The obvious conclusion is that gun control laws only restrain otherwise law-abiding citizens, and give criminals the confidence that their (illegal) gun will be the only gun present — their victims will almost certainly be unarmed.How many mass shootings have taken place in gun shows, gun ranges, gun stores, police stations, fish and game clubs, hunting camps, or other places where there are a lot of guns? The only exception I can think of is Fort Hood, an Army base — but an army base where the vast majority of the troops were, by regulation, unarmed, meaning the shooter (radical Islamist and traitor Major Nidal Hasan) was the only armed person on the scene, until civilian law enforcement showed up and shot him. @:Let me throw another name out there: former ethics professor Eric Clanton. Because nothing says “anti-fascist” than dressing up in black, wearing a face mask, and going to a political rally to sucker-bash some guy on the other side with a bike lock, splitting his head open and sending him to the hospital.Bob, I know this is going to be surprising, but when Bike Locker Man smashes Based Stick Man over the head during the “Trump Made Me Stupid” demonstration, you don’t get to draw any conclusions from that other than, “Wow, those people are really f’ing stupid.”But, you know, do you, Bob.

@: good points about weapons selection. I suspect we would both enjoy traveling further down that rabbit hole to parse out different scenarios, but I’ll leave it so we don’t go too far from the main topic.Educating people (that will listen) is always worthwhile, and I would never suggest otherwise. It is clearly important to understand the topic to have an opinion that is worth anyone listening to, and when it comes to crafting the nuts and bolts of policy/laws that is critical. I do think it is reasonable for people that don’t know anything about guns/ammo to look at the news, become concerned about the level of gun viloence, and demand that the issue be addressed. That doesn’t mean that when knowledgeable people address the issue that they will or should get the answer that their uninformed knee jerk instinct says should be given, however.As Steven points out, ARs are in the spotlight because they have been prominent in recent mass shootings. I think, if weighed on the risk/benefit axis, an argument could be made that the risk for an individual AR in general circulation is substantially higher than the benefit, while the ratio for an individual handgun is closer to even, and that would also be a reason to address ARs first. You make a good argument, however, that the sheer diffence in number of each in circulation suggests it would be reasonable to take up the gun violence issue by starting with handguns because we know that that would make a bigger, if less visible, overall impact on the gun violence problem.

The public will not be satisfied until the issue of mass shootings is addressed too, though. Ultimately we need to address the problem of gun violence comprehensively, and I believe we can address both high visibility and high impact aspects at the same time.As a side note, and partially in response to @Bob’s comment, it sure would be nice if politics got out of the way of science and the CDC could study the problem so we had some hard evidence to make decisions on. That evidence would allow everyone to have more informed opinions on the issue. @:Frankly the article is a mess written by someone that has little knowledge of guns.

For example.(quote)With an AR-15, the shooter does not have to be particularly accurate.(/quote) That describes shotguns not ar-15s. If you’re applying that to ar-15s then it’s applicable to almost every gun in existence. Excluding the small.22s and such.I agree that AR-15s are less accurate than may other rifles. I gather her point was that, because of the destructive power of the 5.56 round, a shot to, say, the leg can be lethal in a way that the same shot wouldn’t be with a 9MM pistol.

With the pistol, you need a headshot or to get lucky to kill with a single round. With the AR, you simply need to connect.@:The above quoted sentence proves the author knows nothing about firearms or AR-15’s.

Given that, why should we believe anything he has written on the subject?She’s a radiologist who has studied the physical evidence from gunshot wounds via CT, MRI, or PET scans. Her testimony is about the damage done to the human body, not about how the weapons work on the firing end.

@:The above quoted sentence proves the author knows nothing about firearms or AR-15’s. Given that, why should we believe anything he has written on the subject?Whenever I hear this type of reasoning, I think how this argument would sound if we were talking about deaths caused in a hit and run car crash.“They say it was a late model pickup, but they don’t say whether it was a Ford 150 or a Toyota Tacoma, therefore the witness can’t be trusted.”“Yeah, they don’t mention whether it was a 4×4 or 4×2, either. Those are totally different and if they can’t tell, then they don’t know what they’re talking about.

We should ignore everything they say.”“And did it have the extended cab? They don’t say. So clearly, there wasn’t even a crash and we should discount everything the people who claim they saw it say happened.”.

1) That’s a really bad analogy.2) The whole point of the original article was discussing the specific differences between two classes of weapons. Since that was the topic brought up, contributions by people who can knowledgeably discuss differences are relevant.3) That’s a really, really bad analogy.4) The whole purpose of a gun is to kill and/or injure living things and damage non-living things.

There is nothing innately right or wrong in either of those things; it’s the specifics that matter.5) Remember Ethan Couch, the “affluenza” kid? His rich parents gave him everything. Then, one night, he grabbed a bunch of friends, took off in his father’s F-250, stole two cases of beer, and then crashed the truck, killing four innocent people in the other vehicles, injured four more people in the other vehicles, and left one of his buddies paralyzed. Police estimate he was doing 70 in a 40-mph zone, and three hours after the crash his blood alcohol was 0.24 (three times the legal limit for adults), and he tested positive for pot and valium.The obvious conclusion here is that we need to ban high-capacity assault vehicles like the F-250, which could carry too many people, go too fast, and was so big that it could crush other vehicles. For the record – I have no opinion about gun control whatsoever.

But I do object to the technique of silencing someone who has no background with weapons by throwing jargon out instead of addressing their point. She has seen multiple gunshot wounds in her career and can see the difference between them.

It is legitimate to discuss if the difference is caused by the type of gun or the type of ammunition and what, if anything, should be done about it.It is not legitimate to say “Ha ha! She said 50 round magazine cartridge! She needs to shut up.”. @: The point of the article is fear mongering. All she really noticed is that longer barrels result in higher fps which translates into more joules on impact (what every hunter knows). She didn’t have to go on with falsehoods about the ar-15 platform.

Anyone with no real first hand knowledge of guns would come away from that article thinking that ar-15s magically empower any bullet fired through it. That is my problem with the article.@: I have never shot anyone and I’ve been on the receiving end of gun violence (and knife/fist/bat/etc). When my neighbor was shot I didn’t run down the street trying to murder the perps. I took cover till they were leaving and then rendered assistance to the victims. If you would please refrain from stereotyping me I’d appreciate it.@:With the AR, you simply need to connect.That is incredibly factually incorrect. Dead center mass? Sure you’ve got a good chance of a kill shot but a 9mm with decent ammo isn’t that far behind in% chance.

There’s a lot of places you can connect and not have a kill shot even with a 20mm round.@:It is legitimate to discuss if the difference is caused by the type of gun or the type of ammunition and what, if anything, should be done about it.I have been addressing this issue. Unfortunately it appears you think I’m doing as quoted.The point is that the only goal of this type of argument (doesn’t even know the right terminology!) is to shut down anyone who isn’t fully immersed in gun culture.My intent is to point out that her ignorance of guns in general has resulted in an article that tries to claim that ar-15s have magical power to do more damage than normal guns.5.56×45 NATO M855 aka federal green tip7.62×39 federal 123gr sp The “ak-47” roundSame block size and distance (gun to gel).

Barrel twists were near optimal for each round. Obviously the AR shot is zoomed in more so that makes it a bit more dramatic looking.

The block is the same size and the item it’s sitting on is spaced the same so you can compensate for the zoom.Notice the energy transfer on the AK round is massive and early in penetration. The AK round slopes off gently. The AR round is near exiting the body by the time it’s energy peaks. The energy also drops off rapidly over distance.This has always been the problem with the 5.56 nato round. If you shoot skinny/malnurished targets then you basically poke neat.22 holes in them unless you hit bone. It also has a reputation for being a poor at stopping targets in general (in the military).

In hunting boars and some other animals the 5.56 is perfectly good. Reason it’s good at hunting boars is because they develop a thick “armor” of cartilage that covers some of their vitals (it’s supposed to defend against the enemy boar’s tusks). The 5.56 nato mushrooms very nicely when shot through that spot. @:I am familiar with survivor bias, but I seriously doubt that’s at work here. She has seen people die of from wounds of both weapons.

She’s seen that she can at least attempt to treat the one, and not the other. The only selection criteria is making it to the emergency room alive, which isn’t necessarily that high a bar.Beside, Sher’s not the first or only doctor to notice that AR-15s do more damage than 9mm.The killing potential of a gun is primarily based on the amount of energy imparted by the bullet when it strikes the body.

The 9mm handgun is generally regarded as an effective weapon; its bullet travels at 1,200 feet per second and delivers a kinetic energy of 400 foot pounds. By comparison, the standard AR-15 bullet travels at 3,251 feet per second and delivers 1300 foot pounds.Tissue destruction of the AR-15 is further enhanced by cavitation, which is the destruction of tissue beyond the direct pathway of the bullet; this occurs with high velocity bullets because their kinetic energies are over 2,500 foot pounds. A typical 9mm handgun wound to the liver will produce a pathway of tissue destruction in the order of 1-2 inches. In comparison, an AR-15 round to the liver will literally pulverize it, much like dropping a watermelon onto concrete results in the destruction of the watermelon.The author is editor of the Journal of Trauma, has been a trauma surgeon for more than 40 years, and is a hunter so one can presume he’s not anti-gun.

@: Once again an article trying to claim that AR-15s fire an inherently more destructive bullet because magic. I’d call him anti-AR15 for sure. There is definitely a fairly sizable contingent of hunters who dislike the AR platform because they believe it attracts the wrong kind of people.Ballistic Gel was developed by those working in the field of wound ballistics to simulate the effect of a projectile (not limited to bullets) on tissue (organs/muscle/etc). Basically to see the wound channel more clearly for study.

One of the most well known people involved was Martin Fackler.The videos that I have been linking show you the cavitation which causes the tissue destruction. I’m giving you the first hand ability to see how various rounds interact with human/animal like tissue.For more comparisonsThis is a 30-06 which is one of the most popular rounds for hunting large game in North America.

It was first used by the US Military in the early 1900s and saw service into the 1970s. The 7.62×51mm NATO round was designated to replace the 30-06 in the late 1950s but it took time.

This round was used in the m1 garand, various machine guns, and even modified gatling guns. There are 30-06 uppers out there for AR-15s along with various other rounds. That’s part of the reason why people love the AR-15 for hunting because you can hunt basically everything in North America with one gun.One of the most commonly used hunting rounds is the 30-30. It’s considered the entry level for large game in North America. Ballistically the 30-30 is very similar to the 7.62×39 at under 200 yards as both are 30 cal. The 30-30 has more powder behind it.

Also the 30-30 used in this video has an 18 inch barrel while the ar and ak rounds were fired from a 16 inch barrel (smallest barrel accepted for rifle hunting in states that allow rifle hunting).Oh and BTW the completely 3d printed metal 1911? It’s still firing away at over 600 rounds.So yeah that’s going to make things interesting as the printer’s price has dropped 66% in the last couple years. @: But I do object to the technique of silencing someone who has no background with weapons by throwing jargon out instead of addressing their point.There’s an incredibly easy way to avoid that — take the minimal effort to know what you’re talking about before you open your mouth and prove you are clueless.The point this doctor’s making is, stripped of its sensationalism, is that gunshots are bad injuries — and some guns tend to make far worse injuries than others. In other words, different guns have different effects.The AR-15’s effect she describes actually makes it a better hunting weapon — it makes it more likely to kill the animal than leave it wounded. Other advantages of the AR-15 platform are its history as a derivative of the standard military rifle (which means that veterans are already quite familiar with it), its flexibility (it can be configured for a large variety of purposes — it’s almost a Mr.

Potato Head of guns), its popularity (there are a zillion accessories out there, and replacement parts are readily available), and its reliability (after 50 years, pretty much all of the bugs have been worked out).The AR-15 is, by and far, the most common and popular style of rifle in the US today. That is not a random fact, nor is it just a quirk of statistics.

Gunshot Entry And Exit Wounds Video

That means that if you go after that particular platform, you’re going after the largest number of owners — owners who have never committed any crimes with their guns, and have no intention of ever committing any crimes with their guns.These are, by and large, law-abiding and law-respecting people. To the best of my knowledge, only one NRA member has ever been involved in a mass shooting — and that was the retired NRA instructor who stopped the Texas church shooter.Pretty much the only way these people would end up breaking gun laws would be if you changed the existing laws to criminalize things that they already do (or own) without causing any problems whatsoever.“Sorry, Joe, but we need to take that gun away from you.”“Why? I’ve never done a damned thing wrong with it in all the years I’ve owned it, and I’m sure as hell not going to now.”“Someone else did something bad with something that looks like it, so we need to go after all the guns that look like it. And we’re not taking all your guns, just this one. And that one. Oh, and that one, too. But you can keep the rest.”“And if someone else does something bad with another kind of gun, will you be back for all my guns that look like that one?”“Now that’s just crazy talk, Joe.

We’d never do something like that. You must be paranoid if you think that would ever happen.”Then, a couple of weeks later, the authorities are back for the rest of Joe’s guns, because the guy who took his AR-15s told them that Joe seemed paranoid, and nobody wants people with mental illnesses having guns. @: That’s an interesting question. These are people who are not only very law-abiding (gun owners, on average, tend to be more law-abiding than non-gun owners), but are strongly motivated to do so. If the law is changed to take away the guns that they’ve owned for some time without a single incident of mishandling them, would they peacably surrender their now-illegal firearm, or would they find some way to resist the law?I’ve seen a great deal of gun owners “jokingly” referring to taking their gun collection out in a boat on a lake, then having to sadly tell the authorities that their boat capsized and — oops!

— all their guns were lost in the lake. And I suspect that, should such a thing happen, such incidents might not be jokes.To be candid, there seems to be a bit of petty vindictiveness at play here. It’s like you’re saying to well-behaved gun owners, “so, you haven’t done anything wrong with your guns?

We’re changing the rules — give up these guns, or now you’re a lawbreaker and we’ll take all your guns!”I wish I could find that meme I saw a while ago — it featured Nancy Pelosi saying “no, we don’t want to take away all your guns. We just want to take away some of them, make you register them all, inspect your house to make sure they’re kept safe, limit the ammunition you can buy, change the rules about how you can carry your guns, limit how you can buy and sell guns, and wait for you to break one of these new rules. THEN we’ll take away all your guns!”.

Entrance woundsBullet wound trajectory through JF Kennedy's skullSource: When a hits the skin surface, it causes indentation before perforation. Following perforation, elasticity causes the skin to recoil, and the resulting round, circular defect is of a slightly smaller diameter to that of the bullet. An accurate estimation of the calibre size cannot therefore be made from measuring the radius of the wound, unlike in the movies!The mechanical passage of the bullet through the skin causes abrasion, and the circular defect is lined by a rim of abrasion – the abrasion ‘collar’. This tends to dry out like all abrasions, and may be easier to discern with the passage of time (more useful to pathologists).Lead alloy based bullets and ‘dirty’ bullets may also leave a greasy rim (‘bullet wipe’) around the entrance defect (Besant-Matthews 2000, DiMaio 1999, Dana and DiMaio 2003).Another feature of entrance wounds, of short to intermediate distance is the presence of powder markings or ‘tattooing’. Powder tattooing results from the forceful in driving of powder into the skin, whilst ‘stippling’ is the term used where the powder causes impact markings only.The abrasion collar can also be of use in approximating angle of fire – if the bullet impacts perpendicular to the skin surface, it will be round, but if the bullet hits at an angle, the abrasion collar will be uneven, and more distinct at the point of bullet entry (Spitz 1993).Higher velocity bullet wounds may exhibit less of an abrasion collar, but may have minute tears around the wound entrance.

Bullet Exit Wound Chart

If the wound is made over bone, the defect may not be circular at all – these wounds tend to be stellate in shape with ragged and torn edges caused by the overstretching of skin and tearing under tension (Dana and DiMaio 1999).In a review of contact gunshot wounds to the head, from handguns, rifles and shotguns, Faller-Marquardt and Pollak (2002) described the presence of 'stretchmark-like skin tears' of the facial skin around the mouth, forehead, submental region, around the eyes, and within the naso-labial folds.Shots in the mouth also gave rise to radial tears in the skin around the mouth. These stretch marks and tears appeared to follow the lines of tension (Langer's lines), and they postulated that they were caused by subcutaneous or intra-oral expansion of muzzle gases and/or the radial forces of the bullet causing 'ballooning' of the facial soft tissues.At the end of a bullets range it begins to lose axial stability and may tend to yaw and possible tumble end-over-end. Exit woundsBullet Hole (1988) - Matt CollishawSource:In general, exit wounds are larger than entrance wounds. They are also more irregular in outline, and their edges are everted. They exhibit no abrasion collar, and they do not have any features of secondary muzzle product projectile impact, such as soot soiling, or powder tattooing (Besant-Matthews 2000; Knight 1996).As the bullet travels through the body it looses kinetic energy, and looses stability. As it exits, it may do so at an angle, or the bullet itself may have been deformed in the body, for example after striking bone.The exit wound in such circumstances may resemble a knife wound or a laceration caused by blunt trauma.

In addition to the wound caused by the exiting bullet, secondary projectile damage may be caused by fragments of bone, particularly in headshots.Muzzle velocity is of vital importance when considering the characteristics of an exit wound – high velocity rifles rounds, for example can pass straight through the body unless they strike bone, and if the round has not been deformed, the defect can be rounded.There exists a particular type of exit wound that often causes problems with interpretation. This is the ‘shored exit wound’, and arises where the part of the body being exited by the bullet is supported by tight clothing or a structure such as a concrete floor etc (DiMaio 1999).An exit wound that is at the level of a brassier support, or a trouser belt for example, may be irregular in outline, and have abraded edges.

Contact/ close range Hard Contact woundsA contact wound is described as a ‘hard’ contact wound where the weapon has been pressed firmly against the skin surface. The action of pressing firmly causes underlying tissues to be compressed and indented, and forms a seal around the weapon’s muzzle. This seal prevents the escape of the gases of combustion and soot deposits etc from the barrel of the gun, and they are forced into the wound track (DiMaio 1999).The becomes hot following firing, and where contact is made with clothing interposed between the gun and the body, synthetic material can be melted, and cotton fibres torn. If contact is made with unclothed skin, searing or burning of the wound edges occurs.Hard contact wounds often exhibit muzzle imprints surrounding the central hole. These arise where combustion gases force the skin to balloon outwards at discharge, and the skin is forced around the end of the muzzle. The skin is abraded and bruised, and may give a fair representation of the outline of the muzzle, including identifying features such as the weapon’s site.Thali et al (2002 (b)) recreated the formation of muzzle imprints utilising their ‘skin-skull-brain model’ and high speed photography.

They found that the bruise ‘imprint’ is created by the following mechanism:. The skin bulges and presses against the muzzle in a contact shot. Intermediate range woundsAs the range of fire increases, features of intermediate range wounds are seen. There is a gradual reduction in the amount of soot soiling seen around the wound, as well as a reduction in the amount of heat searing. Soot soiling is generally seen up to about 15 cm whilst powder tattooing can be found at up to 30-45 cm. These distances can be doubled for rifles (Knight 1996).The length of the barrel also has an effect on the area of skin exhibiting soot soiling – a snub nosed revolver for example will spread soot over a larger area than from a pistol with a longer barrel. (Spitz 1993).

The use of silencers on handguns reduces the area of soot soiling and powder tattooing, and cause difficulties in determining range of fire.However, powder particles leaving the muzzle are able to impact upon the skin surface, giving rise to powder tattooing – at a distance of about 10 mm from the average handgun muzzle.Where small fragments of metal from the bullet or the barrel impact the skin surface, the term ‘fouling’ is used. Gunshot wound patternsAssessing whether a wound is self-inflicted is assisted by knowledge of epidemiology. The most common site for gunshot wound in suicide, for example, is the head (74%), usually the right temple (39%), followed by chest and abdomen.

Acting capability following gunshot woundsGunshot wounds to the head are not invariably fatal, and an individual shot in the head may still be capable of making purposeful movements/ actions.A case from Edinburgh in the 1930s, reported in the Police Journal in 1943, illustrates this well: An elderly professional man, slightly eccentric and living alone in a small private hotel, went out one winter evening and did not return. His disappearance caused no particular alarm, as his habit of walking around at night was well known. The following morning the bell to the street door rang at half past seven, and the maid answered it. On the doorstep stood the man, wearing a hat and heavy overcoat, and carrying his umbrella hooked over one arm.

To her consternation, the maid noticed blood on his face and shirt, but he brushed her mildly aside when she moved towards him. 'Don't worry,' he said. 'It's nothing. I'll just go upstairs and have a wash'. So saying he walked into the hallway, placed his umbrella in the stand, and hung up his hat and coat before going up the stairs to the bathroom.

The maid followed him up, and saw him collapse. She called an ambulance and the police, and the old man was taken to the Royal Infirmary, where he died three hours later. There was no mystery about the cause of death. Under the man's chin was a bullet wound, which tracked upwards through the mouth, through the severely damaged brain, and out through the left-hand side of the top of the skull. The exit wound was about one and a quarter inches in diameter, and suggested a.45 calibre bullet with 'tailwag'; powder stains in the mouth itself seemed to indicate that the man had placed the gun under his chin and pulled the trigger. The police went back to the hotel and, in the freshly fallen snow, traced bloodstained footprints across the road to a small public garden opposite, where on the seat of the shelter, they found a.45 revolver, which was later identified as the property of the dead man.

In front of the seat was a large pool of blood, and in the roof of the shelter was a bullet hole surrounded by fragments of bone and brain tissue; here was where the act had been committed, but the time was more difficult to fix. The man had left the hotel some time the previous evening and had apparently spent part of the night in the shelter. At six that morning it had begun to snow, and a 165-yard circle of footprints and bloodstains leading from the shelter, out onto the grass, and back to the shelter again, showed that the wound must have been inflicted at around six.

Apparently the man had shot himself at about that time, and had sat on the seat with his head hanging forward between his hands, dribbling blood onto the ground. Then he had got up, walked around in a circle, and returned to his starting point once more. After resting a while longer, he had finally risen to his feet, walked straight across the grass and across the street and rung the doorbell of his hotel.by Frank Smyth (1980). Gunshot wound imagingWhen bullets fired from handguns enter the body and fragment (particularly after striking bone), they can be seen on as scattered fragments. However, when a semi-jacketed high velocity rifle round fragments, it is seen on x-ray as a ‘snow storm’ of fragments. Fully jacketed rounds tend not to fragment, and do not have these radiological features.Imaging of gunshot wound victims may also show another surprise feature – bullet emboli, where a bullet, or fragment impacts an artery or great vessel and is carried into the bloodstream to lodge at another site distant from the wound track.

However, this is more likely to occur in distance wounds from shotguns where the pellets are embolised.CT/ MRI imaging. Gunshot wounds (general) - Thali et al 2003(a). Shotgun entrance wound - Thali et al 2003 (b). Rubber bullet - Bruschweiler et al 2003. High velocity gunshot wounds (virtual autopsy) - Levy et al 2006.

Tear-gas cartridge gunshot woundsClarot et al (2003) reported a case of head injury caused by a cartridge fired in a suicide. The weapon was an 8mm blank firing pistol loaded with a CS 8mm cartridge.The discharge of blank firing guns or tear-gas cartridges produces a gas jet capable of causing pronounced close range/ contact wounds, often more so than other gunshot wounds, where the expanding gases are able to follow the path of the penetrating projectile – unlike in the case of blank firing weapons. References. Besant-Matthews P.E.

(2000), ‘Examination and interpretation of rifled firearm injuries’, Chapter 4 in Mason J.K., Purdue B.N. ‘The Pathology of Trauma’, 3rd Ed, Arnold Publishers.

Bruschweiler W, Braun M, Dirnhofer R, Thali MJ (2003), Forensic Science International 132:130-138. Clarot F., Vaz E., Papin F., Clin B., Vicomte C., Proust B. (2003), Forensic Science International 137(1):45-51. Dana S.E., DiMaio V.J.M.

(2003), ‘Gunshot trauma’, Chapter 12 in Payne-James J.J., Busuttil A., Smock W. ‘Forensic Medicine: Clinical and Pathological Aspects’, Greenwich Medical Media. DiMaio V.J.M. (1999), ‘Gunshot Wounds: Practical Aspects of Firearms, Ballistics and Forensic Techniques’, 2nd Ed, CRC Press LLC.

Faller-Marquardt M, Pollack S (2002), Int J Legal Med 116:262-266. Karger B, Billeb E, Koops E, Brinkmann B (2002), Int J Legal Med 116:273-278.

Knight B. (1996), ‘Forensic Pathology’, 2nd Ed Arnold Publishers. Levy AD, Abbott RM, Mallak CT et al (2006), Radiology 240(2):522-528. Quatrehomme G, Iscan MM (1999), J Forensic Sci 44(3):568-576.

Spitz W.U. (1993) (Ed), ‘Spitz and Fisher’s Medicolegal investigation of death – Guidelines for the application of pathology to crime investigations’, 3rd Ed Charles C Thomas Publishers. Thali M.J., Kneubuehl B.P., Zollinger U., Dirnhofer R (2002a), Forensic Science International 125(2-3):190-194. Thali MJ, Kneubuehl BP, Dirnhofer R, Zollinger U (2002b), Forensic Science International 127:168-173.

Thali M.J., Yen K., Vock P., Ozdoba C., Kneubuehl B.P., Sonnenschein M., Dirnhofer R. (2003a), Forensic Science International 138(1-3):8-16. Thali MJ, Braun M, Wirth J, Vock P, Dirnhofer R (2003b), J Forensic Sci 48(6):1-10.