Medical question

Damn what a question. What kind of damage it causes depends on not only the round, (You mentioned a .40 cal) and where exactly in the shoulder the round hits.

If it hits on the outside of the arm you might see a "flesh wound". This would include a large amount of muscle damage and the possibility of bone involvment. Splinting for the first couple of days at least would be recomended even if there is no bone involvment to limit additional damage to the soft tissues.

If the hit is in the shoulder itself, well,,,,,,
The average human male has a sweet spot of roughly two square inches where the only damage will be soft tissue. (Most likely including nerve damage from the Brachial Plexus though.) Outside of that sweet spot you will be involving the bones of the shoulder girdle, (Humerus, Clavicle and Scapula.) You also are running the risk of damage to the ribs.

Along with this kind of damage you are also dealing with the potential nerve damage to the arm itself as well as vascular, (blood vessel ) damage. Remember the Brachial Artery as well as several veins run through the shoulder.

Any bone damage would most likely involve splintering which will require surgery to repair.

Any muscular damage involved is most likely going to be rather extensive from the type of round you mentioned as well as the range. (Figure this type of round and range the damage is going to be at a minimum four to six times the diameter of the round.)

The human body does not like to be shot. About the only places you can shoot a person with modern rounds without causing major damage is the outside of the arm and the outsides of the thighs. (In some cases of people I know a shot into the head will not cause more than cosmetic damage.)

Cat
 
SeaCat said:
In some cases of people I know a shot into the head will not cause more than cosmetic damage.
I know a lot of people like that. Shoot 'em right through the head and nothing important will get damaged. S' not like they use what's in there anyway :rolleyes:
 
carsonshepherd said:
Thanks, SeaCat and Debbie. Very informative and just the info I need. :)

I'm glad that I could help in a small way.

Cat
 
You should have an entry and exit wound. The exit wound will be larger than the entry wound. I've had a patient with a small entry wound and a gaping hole in his back where the round exited. If the round richocheted off the bone it could exit anywhere. I've seen rounds hit bones and exit feet away from where they entered.
If bone was hit, surgery is going to be required due to the splintering. A shoulder cast will be need to immobilize the arm.
As Debs said, connective tissue will need to be repaired along with the bone. Pins maybe needed depending on the type of fracture. You'll also have to watch for nerve damage. The best way to check is for feeling in the peripheral areas such as a hand in this case.
The dressing will have to be changed at least once a day for a week. More if the dressing gets dirty or wet. The gauze and antibiotic cream will be the treatment of choice. An oral antibiotic will also be ordered to counter any internal infection which may occur. Usually a broad spectrum antibiotic would be prescribed.
For pain meds you have a wide choice. Demerol is best for bone pain. Oxycontin is also commonly prescribed for serious pain and is morphine based. We always use Demerol for bone injuries and Morphine for other injuries with good results. Most are sent home with at least Vicodin 7.5. If that doesn't ease the pain then we go to something like Oxycontin. The problem with oxycontin is it's over prescribed. The dealers have a price on each tab. Many Doc's have been busted for overprescribing Oxycontin to people who don't need it and are selling it on the street. Due to this, prescriptions for oxycontin are down and the government is watching everyone who gets a prescription.
Hope this helps.

LDW
 
Well regardless of the type of injury it always has to be borne in the mind that the person dealing with the injury has to deal with the thing so he has got to make the necessary adjustments that would allow him to be adapted with his current state. There maybe a bandage across the shoulder then he has to learn the ways of getting with it, as there are hardly any other options.
 
Back
Top