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Gun Shot / Blast Injury

Knee GSW image

High Velocity GSW image

 3 Phases of Blast (bomb) injury
  • Primary phase: high-pressure shock wave followed by blast wind.
  • Secondary phase: Surrounding objects are turned into projectiles causeing injury. Biologic projectiles (bone fragments from the bomber or surronding people) but victums at increased risk for disease transmission. Consider Hep B vaccination, anti-retroviral therapy. (Wong JML, J Trauma 2006;60:402).
  • Tertiary phase: Injuries caused as victums are thrown against solid ojects.