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Exit wounds can be the size of an orange. It does not have to actually hit an artery to damage it and cause catastrophic bleeding. The high-velocity bullet causes a swath of tissue damage that extends several inches from its path. This process is called cavitation it leaves the displaced tissue damaged or killed. 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. The bullet from an AR-15 passes through the body like a cigarette boat traveling at maximum speed through a tiny canal. The injury along the path of the bullet from an AR-15 is vastly different from a low-velocity handgun injury. Years ago I saw one from a man shot in the back by a SWAT team. I have seen a handful of AR-15 injuries in my career. An AR-15 rifle outfitted with a magazine with 50 rounds allows many more lethal bullets to be delivered quickly without reloading. 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. The damage they cause is a function of the energy they impart as they pass through the body.
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The bullets fired by an AR-15 are different: They travel at a higher velocity and are far more lethal than routine bullets fired from a handgun. If the bullet does not directly hit something crucial like the heart or the aorta, and the victim does not bleed to death before being transported to our care at the trauma center, chances are that we can save him. Routine handgun injuries leave entry and exit wounds and linear tracks through the victim’s body that are roughly the size of the bullet. Trump’s Hollow Gesture on Guns Elaine Godfrey And all six of the victims who arrived at the hospital that day survived. The gunshot wounds were the same low-velocity handgun injuries that I diagnose every day only their rapid succession set them apart. 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 injury was fatal.Ī year ago, when a gunman opened fire at the Fort Lauderdale airport with a 9 mm semiautomatic handgun, hitting 11 people in 90 seconds, I was also on call. Nothing was left to repair-and utterly, devastatingly, nothing could be done to fix the problem. 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 semiautomatic rifle that delivers a devastatingly lethal, high-velocity bullet to the victim.
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The reaction in the emergency room was the same. How could a gunshot wound have caused this much damage? The organ looked like an overripe melon smashed by a sledgehammer, and was bleeding extensively. I was looking at a CT scan of one of the mass-shooting victims from Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. There may be bleeding and some bullet fragments. To a radiologist, it appears as a linear, thin, gray bullet track through the organ. In a typical handgun injury, which I diagnose almost daily, a bullet leaves a laceration through an organ such as the liver. 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. The history simply read “gunshot wound.” I have been a radiologist in one of the busiest trauma centers in the United States for 13 years, and have diagnosed thousands of handgun injuries to the brain, lung, liver, spleen, bowel, and other vital organs. As I opened the CT scan last week to read the next case, I was baffled.