A gunshot wound ( GSW) is a penetrating injury caused by a projectile (e.g. a bullet) from a gun (typically firearm or air gun ).   Damages may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of the body and, in more severe cases, death. 
- Signs and symptoms
Trauma from a gunshot wound varies widely based on the...
The degree of tissue disruption caused by a projectile is...
Gunshot wounds are classified according to the speed of the...
- Signs and symptoms
A gunshot is a single discharge of a gun, typically a man-portable firearm, producing a visible flash, a powerful and loud shockwave and often chemical gunshot residue. The term can also refer to a ballistic wound caused by such a discharge. Multiple discharges of one or more firearms are referred to as gunfire.
A transmediastinal gunshot wound is a penetrating injury to a person's thorax in which a bullet enters the mediastinum, possibly damaging some of the major structures in this area. Hemodynamic instability has been reported in approximately fifty percent of cases with a mortality rate ranging from twenty to forty percent. Some studies have shown mar...
Complications caused by a TMGSW can range from mild to life-threatening depending on which structures are damaged. It can be rapidly lethal if a major structure is involved. Some of the possible complications caused by a TMGSW are: 1. damage to great vessels such as the vena cava
Previously every stable patient that suffered a TMGSW received extensive evaluation that included chest radiography, oesophagography, esophagoscopy, angiography, bronchoscopy, cardiac ultrasound. Grossman et al. found evidence that the trajectory of the bullet can be delineated w
The criteria to define a patient as stable or unstable could have variations from institution to institution. For example, Burack et al. used a list of 6 criteria in his paper that defined an unstable hemodynamic state: Traumatic cardiac arrest or near arrest and an EDT[clarifica
Stable patients will be evaluated with CT, ultrasound, chest x ray as the institution's protocol specifies. When this initial survey is negative, patient can be observed with conservative management. In many cases, chest tubes are required due to concomitant lesions in the pleura
Unstable patients are managed by operative exploration of the mediastinum. Moribund patients will go through an emergency department thoracotomy. This measure is taken because at their arrival in the emergency room, these patients are in such critical condition that they would no
BulletsGeneral caliber classificationCommon shotgun gaugesShotgun pellets, small to largeAssess for number of wounds to help determine if projectile may still present in bodyEntrance wound (typical features)Exit wound (typical features)Range of fireATLS/FAST/Trauma LabsCT Scan as needed depending on locationX-ray if bony injury suspectedCTA if vascular injury suspectedTrauma consult depending on location and extent of woundOrtho consult for bony injuriesNeuro/OMF/ENT as neededRemoval if intraarticular, with case reports of lead toxicityTo OR if significant injuriesAdmission/Obs for less concerning injuriesMinor injuries may be dischargedGSW Protocol allows lower extremity wounds to be discharged from ED after 9 hours without invasive imaging if they have normal ABIs
- Clinical Features
- See Also
A gunshot is the discharge of a firearm. It produces a mechanical sound effect and a chemical gunshot residue. The term can also refer to a gunshot wound caused by the bullet. Multiple discharges of a firearm or firearms are referred to as gunfire. The word can mean either the sound of a gun firing, the projectiles that were fired, or both.
Ballistic trauma Ballistic trauma or gunshot wound (GSW) is a form of physical trauma sustained from the discharge of arms or munitions.  The most common forms of ballistic trauma stem from firearms used in armed conflicts, civilian sporting, recreational pursuits and criminal activity. 
The gunshot wound to the back of the president's head was described by the Bethesda autopsy as a laceration measuring 15 by 6 millimetres (0.59 in × 0.24 in), situated to the right and slightly above the external occipital protuberance.