Tag Archives: gunshot wound

Alrighty, so I’m writing a dramatic scene where a character intends to save another character from a bullet. Say the ~hero~ character gets shot in the shoulder, but it’s a clean shot and mostly went to the side. Would the character (who is in this sort of situation a lot) passing out be reasonable, and if they were given slightly sketchy medical service within an hour (along with first aid to stop the bleeding), would this be survivable without great damage?

Okay, let’s walk through this for a second:

  • You have a character who is shooting another.
  • You have a character who decides to dive heroically into the path of the bullet.
  • They leap heroically into the path of the bullet.
  • The bullet strikes the “heroic” character.
  • As bullets are wont to do, it passes through them and into the intended victim.
  • Additionally, the bullet is now traveling more slowly, and slightly more prone to ricocheting in the intended victim. If the bullet does this, it has the potential to do far more damage than if it had been allowed to go on its way unmolested.
  • They have both been shot.
  • The intended victim’s injuries may actually be more severe now than they would have been without any intervention.
  • I sense a problem here.

I mean, it is a problem with this entire cliche to begin with. Dodging in front of the bullet only makes sense when the person trying to take the bullet is wearing body armor, and the intended victim is not. Even then it will only actually achieve something if the wannabe martyr actually takes the bullet in their armor. A through and through in the shoulder won’t do that.

If you’re still wanting more information, we do have a gunshot wound tag, and a tag reminding you that I’m not a real doctor. Technically two because I used to have a slightly stranger name for the same reminder. So far as it goes, about the furthest I’ve gotten on shoulder wounds in the past is suggesting a Google Image Search, though there have been a few discussions on gunshot wounds in the past, just not in the shoulder specifically.

-Starke

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I don’t know if you guys are the right people to ask, but I thought I’d chance it. What are places on the body that can get “non-lethally” shot? Like places where a bullet can hypothetically go through (completely) and not kill you, assuming you had medical aid nearby?

So, this is one of those things. There is no such thing as a safe gunshot wound. If you get shot, without medical attention, there’s a real probability it will kill you.

With immediate medical attention, gunshots are very survivable. Life threatening, don’t mess around with it, it can still kill you, but you’re odds of living are much better than your odds of dying.

A study conducted on Philadelphia first responders (police, and EMTs) pegs the survival rate for gunshot wounds that make it to the emergency room at around 67%. The mortality rate during transport was in the high 20% range (I don’t have the data set in front of me, so I’m working off an abstract.)

So, if you get shot, and someone can get you to the hospital, you have a pretty decent chance of living. In the past, I’ve pointed out that getting shot in the head is surprisingly survivable (the odds of dying are somewhere around 95-98%). I can’t recommend it as a career path, but people can and do survive those.

In cases where the bullet results in serious internal damage, like a collapsed lung, there is a real chance you can survive. There’s also a chance you’ll never fully recover from your injuries, depending on what got shot. And, even if you do survive, you’re going to be out of commission for a long time while you recover.

One bullet is an immediate threat to your life, but it’s not an automatic death sentence.

Getting shot ten or twenty times? Then you’re probably screwed. Again, this is survivable, but the more holes bullets make in you, the faster you’ll bleed to death. So, getting hit repeatedly is a much more dangerous situation.

-Starke

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Do you have any reference as to what a bullet wound in the shoulder would look like/ scarring and healing time and if they would need plates and screws etc?

If you need a visual reference, then Google Image Search has you covered. Just, remember to turn off safe search, and bring a strong stomach. Understandably, this isn’t pleasant viewing material.

I think this is the most detail I’ve gone into on specifics for gunshot wound forensics, even if the specific discussion had to do with 18th century pistols. Though we do have a gunshot wound tag, and there’s a mix of stuff in there that might be useful.

Also, I think I’ve identified it before, but I tend to use the Howdunit Forensics book preferentially as a resource, so if you need a closer look on how and why gunshot wounds behave the way they do, that’s probably worth looking at.

-Starke

Q&A: Honeyed Wounds

I watched The Equalizer recently. Is it really possible, in your opinion, to seal up a gunshot wound with boiling hot honey? McCall does this as a quick patch up so can keep fighting later on. Wouldn’t it just hurt more when he tries to take off the honey to treat the wound?

I’m honestly not sure. I know honey is bacteriostatic, so you can use it as an antibacterial salve on minor wounds. As for actually sealing a wound? Especially one with deep trauma. I’m skeptical. This would be (almost exactly) like trying to treat a gunshot wound with Neosporin. Yeah, it’s great for minor cuts or mild burns, but against a bullet, not so much.

If this is after field surgery to keep the wound from getting infected, it’s a lot more plausible, but not just, “boil and pour it in there.”

My recollection is that boiling honey breaks down the enzymes that make honey bacteriostatic, which is vital to preparing it for fermentation into mead. …but, the internet says I’m wrong, that you can get honey to ferment at room temperature if you cut it with enough water, and that there’s no enzyme function involved.

I suspect that, as with a lot of organic mater, your body can pretty safely absorb it during the healing process. So, getting it out of the wound is a lot less important than you might think. That said, if you do need it out of the wound, you can wash it off, which you need to do when cleaning most wounds.

-Starke

dogmatix said:

I think what they’re asking is ‘how do I shoot someone without killing them?’ Yes, there is no safe way, but you’re not really explaining WHY. Probably something to do with the possibility of hitting veins/arteries, organs, etc, I’d guess?

That’s the basic gist of it. Also, we have talked about gunshot wounds before; here, and here. We even have a tag on the subject. (It actually manages to make the tag cloud with 12 entries… I should probably switch that to alphabetic sorting for everyone’s convenience.) The short version is that bullets have a nasty habit of doing unexpected things. It’s not exactly random, but there’s way too many variables to predict in the field, meaning any bullet could turn your internal organs into goulash. Even under the best circumstances, any untreated gunshot wound can result in death.

This is before you even get into weirdness like hydrostatic shock, which might not be an actual thing. Though, I do need to expand that tag, and might need to do a more detailed post on it, because I know I’ve talked about it more than once.

-Starke

Hi! Sorry if this is a dumb question but I have a character who is shot at, her head being grazed by the bullet. In order for that to happen as realistically as possible, what would the circumstances have to be? Does the gunshot have to come from a distance? Would she lose consciousness? Would there be lots of blood? What kind of wound would she have and how would it get treated after? That’s more than one question haha. Any information would be of great help!

The circumstances would have to be that the bullet missed. It’s not really any more complicated than that. You put a round in the general vicinity of someone, and didn’t quite connect, but you still tore up some tissue on the way through.

This can just be the result of poor aim, situations where a character is just pointing a gun rather than actually aiming it. Though, someone who doesn’t know what they’re doing and is trying to aim could also result in a glancing blow. Or, if both the shooter and the victim are moving, then hitting a target accurately is a lot harder, and a glancing blow like that is certainly possible. I don’t want to say, “more likely,” because it’s not really a common outcome.

There’s a slightly rarer situation where a shot directed at the head will skate across the skull, it’s one of those “the world is a weird place sometimes” kind of fluke things, but it does happen, rarely.

Range only makes a glancing shot less likely, but it also reduces the chances of getting hit, so, not really a concern.

In general, she probably wouldn’t lose consciousness. At least not from blood loss. Having a panic attack because someone just shot her in across the head isn’t out of the question.

Honestly, I’m not certain about how much blood. Glancing wounds will result in a disproportionate amount of blood for the severity of the wound, but it shouldn’t be life threatening. So, someplace between, “more than you want to see,” and, “not enough to kill you.”

It’s also worth pointing out that this kind of injury is rare enough that my writer’s guide to forensics has nothing on the subject, so I’m kind of flying blind here.

This probably would result in a long, shallow gash and not much else, which means it would need to be treated like any minor open wound. That is to say: disinfect (with peroxide, or alcohol), staunch the bleeding with gauze (ideally with antiseptic ointment added to the bandages, once treatment gets that far), and if the bleeding persists, get someone to sew your character up.

If this happens to you? Go to the ER. This is about as non-lethal as gunshot wounds get, but that doesn’t mean you should mess around with it, also douse whatever you cram in there with either alcohol or peroxide first, you do not want to mess with an infection if you don’t have to, and impromptu bandages are as good a vector as anything.

If the bullet takes off her ear, or part of it, that would probably require reconstructive surgery. Even if it doesn’t, she’ll probably end up with a nasty scar as a result.

Sorry, the wound info is a little more speculative than I’d like, but I don’t have anything solid on hand, so I’m having to do it mostly off the top of my head… so to speak.

-Starke

You mentioned in a previous answer that getting shot in the head is “surprisingly survivable”. Could you talk a bit more about that?

I run across the statistic occasionally, but I don’t usually try to keep track of it. My recollection is that head shots are only fatal about 98% of the time. The rest of the time the bullet either deflects off the skull or doesn’t actually do lethal damage to the brain on the way through. I’d assume this includes cases where there is serious brain damage, but the victim survives anyway.

Either way, there’s a mountain of medical cases where someone gets shot in the head and survives in some condition for any number of reasons.

-Starke

what would happen if a character were shot in the thigh? would they die of blood loss or would it depend on where on the thigh the bullet went? also if the character somehow survived, would they be left with a scar or possibly a limp? eventually how long would they be limp (forever)? sorry for my english, and thank you!

If the bullet severs the femoral artery, death would occur within… I want to say two minutes, but it could be as much as five. If the bullet blows through cleanly, and the blood loss is managed, it shouldn’t result in anything more severe than scar tissue at the entrance and exit wounds. If it damages the bone and that’s not treated, or treated incorrectly, it would permanently impair movement (barring corrective surgery).

If the bullet tears up the muscle tissue, and it doesn’t heal properly, I think that would result in permanent mobility issues, but I’m not 100% certain how that would manifest.

Again, I’m not a medical professional; my familiarity with gunshot wounds is academic. So, I could be wrong here.

-Starke

EDIT: I’m going to attach this reblog to the main post because it’s actually really useful, and I did drop the ball a bit last night after tumblr ate my first draft of the entry and exit wounds answer. So, with thanks to Disasterintow.

disasterintow:

Gunshot wounds vary depending on the type of round used, special attributes to the round (hollow point, armor piercing, etc), the distance from the shooter. A normal sized male (6’ 180lb) shot at close range to the thigh with a simple 9mm round would be in a lot of pain, but risks only moderate damage to bone, and supposing the femoral isn’t stuck, the most you would to be dealing is a hopeful through-and-through. That way, as mentioned before the most to be dealt with is stopping the blood flow and stitching up entry and exit wounds (the latter of which will be significantly larger). 

Do. Not. Dig. A. Fragmented. Bullet. Out. Unless you are a skilled surgeon, though even these days, a majority of those professionals choose to leave non-life threatening shards inside. Removing the bullet damages muscle tissue, connective tissue, and tears nerves, all of which are needed to counteract the trauma of the initial wound. And you run the risk of more blood loss. 

Now, when it comes to larger caliber bullets and shotgun shells, there is a problem with distance. Up close and personal, a .45 caliber handgun round could shatter bone and leave an exit wound the size of a Granny Smith apple. broken bones (shattered ones, at that) have a very high risk of sepsis, and if not dealt with quickly, could spread to the rest of the body. 

AP rounds – Armor Piercing – go straight through flesh and have very little sign of slowing. There is risk to bones, however, as the amount of power (force) they carry with them hits full on if it meets a hard structure. The kinetic energy alone can fracture shoulder blades. 

As for buck shot and slug for shotguns, those are trickier. They do need to be a certain distance to be effective, but make no mistake: these rounds will break bones and most certainly leave holes in you. Buckshot is pelleted, but deadly in a closer range.

A safe bet would be to say the person was shot by a .40 caliber or lower handgun, or anything around or lower than a .308 rifle round, and that the meat of the thigh took the bullet. If at a decently close range, that person should survive and most likely walk with a little hitch for most of their lives. Nothing too noticeable, however. There would certainly be scarring, and if nothing happened to bone, and no nerves were injured, there should be no loss in range of motion or use. 

Hi. Do you know anything about 18th century firearms? I’m wondering how much damage pistol shot would cause to the face at close range. Would there be just a single entry wound or would the face be unrecognisable, and at what range would that kind of damage occur? Many thanks for your help.

It wouldn’t. At least not from a pistol. Handguns usually lack the ability to completely shatter the skull, they’ll still pierce the skull, but it will be a (figuratively) clean entry wound.

Gunshot wounds vary based on how far away the gun is from the victim. Bullet velocity, and caliber also affect the wound, but it’s not a huge consideration most of the time. Now, keep in mind, this is all from modern forensics. But, the basic idea of how a gun works hasn’t really changed in the last 800 years. That is to say: boom = splat.

Gunshots over two feet from the firearm will result in a small circular wound in the victim. This will usually be slightly smaller than the bullet. This is because the skin stretches to accommodate the bullet before it penetrates. It also bunches, creating something called an abrasion collar, which is an inflamed ring around the entry wound. The collar is usually black or blue as it picks up grime and oil from the bullet as it passes into the deeper tissue.

Between two inches and two feet (roughly) there will be a pattern of burning and unburned powder that gets forced into the skin. This is called stippling. It creates tiny pinpoint hemorrhages under the skin. The closer to the victim, the smaller the ring.

It’s worth pointing out, this will occur if you shoot someone with a blank at very close range, and you can kill someone with blanks because of stippling.

Shooting someone with the gun pressed against them will result in a contact wound. In these cases the expanding gasses from the gunshot will vent into the victim, resulting in a star shaped eruption under the skin. These are big messy wounds… but they still won’t cause someone’s skull to cave in, or even for their face to be completely unrecognizable.

As an aside: These are the same gasses you’re trying to reduce when suppressing a firearm. I’m not sure what kind of a contact wound you’d get off a suppressed firearm.

Now, a shotgun loaded with buckshot, at medium range, can turn someone’s face into hamburger. The 18th century equivalent would be a blunderbuss. These were loaded with whatever shrapnel came to hand, and were really nasty weapons. So, if you haven’t looked into them, that’s probably what you want, even if they weren’t one handed.

If your character hot loaded their pistol and forgot (or chose not) to load a ball, the resulting spray at close range might be enough to sear their opponent’s face. This should kill them, but it is theoretically possible for a character could survive that. Though, getting shot in the head is surprisingly survivable, in general.

Now, that’s if we’re talking about the entry wound. Exit wounds are usually larger and ragged, particularly if we’re talking about 18th century firearms (there’s some modern exceptions). If your character was executed by a gunshot to the back of the head, it’s possible, if the angle was right, for the bullet to take most of their face off on the way out. Obviously, this isn’t a survivable wound, but it is possible.

In a modern context, jacketed and high velocity rounds tend to produce exit wounds that are very similar to entry wounds. When the shooter was more than a couple feet from the victim, and using one of these rounds, it can sometimes be difficult for an ME to differentiate between a victim’s entrance and exit wound.

Incidentally, Teflon coated rounds would actually fall into the high velocity group there. These gained a reputation for armor penetration, but the actual cause is the Teflon reduces drag on the bullet, improving its flatness. Either way, if these miss bone on the way through, they’re going to leave a similar entrance and exit wound.

Soft rounds can leave really messy exit wounds. If they impact a bone straight on, they can shear apart, it can even leave multiple wounds, or they can flatten out and wedge against the bone, leaving no exit wound whatsoever. If they flatten out, continue moving and start to tumble they can leave tiny exit wounds that look like minor lacerations.

As I’ve said before: bullets are kinda random.

Oh, and a reminder, when it comes to gunshot wounds, Google Image Search hates you, but it is useful if you really, really, want to see what this stuff looks like. Just remember to bring a strong stomach.

-Starke

archieandkobi said: Apparently, the pistols back then were really weak. I’ve heard of cases where people tried to shoot themselves and failed because the balls didn’t even get through their skulls. Most seemed to suffer concussion.

That would actually depend on how much powder the loaded. One of the quirks with pre-19th century firearms was, you were responsible for the amount of powder you loaded into the weapon for each round. This was partially dealt with by using premeasured paper cartridges that you would tear open and dump down the barrel. But, those weren’t universal, much like modern speedloaders aren’t something everyone uses. If you don’t put enough powder down the barrel, it’s not going to clear it with enough force.

I’m guessing the cases you’re looking at were the result of under loading a pistol, but, I am guessing there.

-Starke

I have a character who gets shot (the shooter is about 14 feet away) while fighting another character (the shooter was a bystander), and as I was having it go, the bullet strikes her middle-to-lower-left abdomen and passes through her and strikes her opponent (who is 4-5 feet away from her) but doesn’t pass through and embeds. What actions would have to be taken to save their lives, how severe the damage would be, and how long the recovery would be? Plot twist, it’s the mid 1800s, Russia.

Yeah, that’s pretty much the exact opposite of a plot twist.

Anyway, I know we’ve talked about some of this before, so I’ll keep it brief.

Distance from the shooter doesn’t matter much for the wound unless it’s at point blank range, or beyond the weapon’s effective range.

Treatment is always pretty simple, at least in concept. You take some silk and sew shut anything that looks like it might be leaking. Of course, finding everything that’s leaking can be an issue, particularly when there’s blood everywhere, and you’re having to tear open tissue to find the tissue that was already torn apart.

Off hand, I can’t remember if lower left is a kidney or the liver and a kidney, either way, this is a wound that will kill your character if left untreated. There’s also the possibility that the bullet would perforate the intestines, at which point she better hope her surgeon finds it, or she will die from it. (Also, remember, A&P is not a part of my field, so I could be hilariously wrong here.)

Depending on where the bullet embeds this could be irrelevant or a death sentence. If he gets shot in the gut as well, I’d say that’s unlikely, but bullets don’t really seem to enjoy obeying physics when they think it’s not looking. Again, getting shot in the torso, pretty much anywhere, is not something your character will walk away from. And there are quite a few organs that will flat out kill you if you damage them with a bullet. Also, the bullet does need to come out. Unless it’s managed to find a home somewhere that can’t be removed, which is somewhat unlikely with a gut shot.

The part I know we talked about before is infection. Bullets are effectively sterilized by the firearm. So, blood loss is a risk, but infection from the bullet isn’t. But, if we’re talking 1860s, there’s no disinfectants. Alchohol’s primary use in surgery was as an anesthetic, not an antiseptic. The surgeons weren’t using dirty tools, but the practice of sterilizing equipment just didn’t exist, and there wasn’t a clear understanding of how to treat or prevent bacterial infections. Short version is, unless your characters are extremely lucky, they’ll probably die.

Also, I don’t know if you know this, but mid-nineteenth century Russia was, let’s call it, “very energenic,” politically and socially. The country was going through massive changes in an attempt to modernize and shake off the perception of being the backwoods of Europe.

Russia was still in the process of abolishing serfdom, this started in the mid-eighteenth century, and ended in 1868.

There were efforts to transition to more democratic monarchy, with the creation of local governing Dumas. The national Duma wasn’t founded until the 1880s (if I’m remembering correctly.) Internally there was a lot of friction between traditional cultural identity and imported ideology from Western Europe.

I want to say there was tension between the protestant denominations and the Eastern Orthodox Church, but I can’t remember the details, so that might have been minor or a non-issue.

If you want a better look at all of this, Fathers and Sons by Turgenev is a good jumping off point for the cultural tensions. Also, although his work tends to be dense as spent bricks, almost anything from Dostoyevsky will be helpful, though (and you may hate me for this) Crime and Punishment is probably the place to start for the timeframe you’re talking about. The Brothers Karamazov might be useful as well. Just remember, both authors had their own agendas.

-Starke