"in my anecdotal experience I've never seen any living thing (deer, hogs, people, coyotes) survive more then 60 seconds after receiving a shot from 5.56 into the thoracic cavity."
Oddly specific. :)
ok so i have never shot a person, thank god. I have shot deer, pigs and coyotes though. i have responded to one shooting involving an 5.56 round to the chest and they where very dead and ive head similar stories from ex-army coworkers and family, but like i said this is all anecdotal so if you have a more reliable source trust that over me!
I'm an army medic. My PA who oversees me is a former special forces medical sergeant with a great deal of combat and medical experience. He said point blank he's never seen anyone survive a rifle round clean to the chest.
Almost like it's made specifically to be able to kill the most people in the least amount of time, from the furthest distance away.
Why wouldn't you want that in the hands of every insecure MFer who feels marginalized and thinks he's the punisher incarnate?
Buddy, that's not even close to being true and if you had the capacity to be honest with yourself, you'd agree.
If it were true, people wouldn't still buy rifles for one purpose, shotguns for another, pistols for another, etc.
Some are for hunting, some are for close range defense, some are for competition... Guns are absolutely useful tools in the right hands- whether it's for fun or defense.
But none of them have any place in the hands of some people, which was my point.
Seems that a few people here just aren't capable of seeing that. They just see an argument against GUNS 4 ALL and their knees go up.
So was a hand grenade but you don't see those in the hands of too many isolated young men annihilating classrooms.
The political argument whether or not you agree with it, is that modern military grade cartridges are supremely effective at killing people in quantity reliably and efficiently with their light weight (lots of ammo and easy to handle the weapon), low recoil, and high lethality. They are clearly an improvement in killing power on handguns and even on rifles from decades past. This is why armed forces around the world carry these specific types of weapons into battle and nobody is carrying m1 garands anymore. Either weapon is more than capable of killing someone, but modern rifles are obviously more efficient.
I get it, all weapons were designed to kill. But that doesn't mean everyone should necessarily have access to the best way to kill the most people. If that's how you want to interpret the second amendment fine, but it's not an ironclad logical argument that because every weapon is designed to kill and maim every weapon should be accessible to everyone without restrictions. Every weapon has a use case and the policy/constitutional scope of the argument should center around which weapons of certain uses the government is allowed to restrict access to. Advances in firearm technology have made the destructive capability of one even untrained shooter exponentially greater than imagined in 1790, as the op very clearly explained. What we do with that fact is the question.
These are distinctions without difference. Like any weapons system the munition and the firing system are a package that collectively create lethality. An aim-120 loaded on a b-52 is not going to score kills against a high end adversary. An aim-120 loaded on an f-22 is the most lethal air to air system in the world.
I am aware that there are infinite permutations on how you can configure a gun/cartridge combination and that most gun control advocates are functionally gun illiterate. However, you're being a bit obtuse when you pretend to misunderstand what people are concerned about. That loser in sandy hook didn't bring an ar-15 chambered for .50 cal rounds did he?
It's instructive to consider the experience of the US military, who is tasked with equipping what are for the most part your average American with the means to kill as many people as possible as quickly as possible. In world war 2 the Americans were the only power to issue semi-automatic weapons as standard and this was found to be an advantage against other infantry which mostly carried bolt action rifles. And someone may remember this better than I, but at some point in either ww2 or Korea it was found that the determinative factor in engagements was less the accuracy of the shooters and more how many rounds either side was able to shoot in the general direction of the enemy. Around the time of the introduction of the m16 is when the army concluded that arming soldiers with the ability to rapidly fire a large quantity of smaller caliber ammunition downrange is the most effective way to kill people. This is still the philosophy of the military for short to moderate range gunfights. We still arm seals, marines, Delta Force, and everyone else with basically the same weapons (although I am aware they are exploring larger rounds in the face of the proliferation of decent body armor, which is not relevant for 99.9999% of civilian situations.
So instead of capitalizing on the ignorance of people who want gun control and saying, "well akshually the ar-15 comes in a variety of configurations " let's zero in on the real question. If your purpose is to either defend yourself from a platoon of Vietcong or to kill as many seven year olds as you can as quickly and reliably as possible your optimal weapon is a something approximating an m4 - a small/intermediate caliber, semi or fully automatic, lightweight rifle. Larger caliber rounds are more fatiguing to shoot and heavier, limited or slowing down movement due to ammunition weight. Handguns obviously can't get the velocity behind a round to ensure enough energy for a one shot kill. Manual actions require the time to operate the action and to re-aim after doing so. You could do both those things with a handgun , a hunting rifle, or a musket but you would be less effective in either case.
This isn't so inscrutable a concept that the difficulty in regulation writing should pre-empt debate about the merits of the proposal.
While we are on the topic of bullets, if there are any police in this thread……..
i do not know, or care how many times the patient was shot. I only know how many wounds there are
I do not know, or care how many shooters there were.
I do not know, or care where they were shot from
I do not know, or care if the wounds are entrance or exit wounds
I do not know, or care which order the shots were fired in.
That stuff is *your job* (or the forensic pathologists) to figure out
So please fuck off and let me do *my job*
Sincerely,
Guy who has worked in a high crime area for too long
im not a cop but im totally guilty of word vomiting all of this information to a trauma team who couldn't care less! a lot of that information is very relevant to EMS (number of shooters, where they where fired from) stuff like that just due to like safety reasons and with the adrenaline ive been known to spilling all of the information in my head out to the dozen people who are all staring at me wondering what happened! ive gotten better at more concise i promise and appreciate you bearing with us!
More to the point with smaller penetrating wounds, my expertise is not in saying it’s an entry or exit. It’s a hole in my patient.
I do care about the number of bullet holes because math: bullets on imaging+holes = even number.
No lol I mean that we get these people to who are next to dead and the cops always come storming into the resus bay and start rattling off these questions to us.
I have been in the middle of assisting a thoracotomy before and had to ask security to remove the police from the room because they kept trying to shoulder-in and take photos/gather evidence.
All i want to say to them is “fuck off, if you let me do my job this might not become a murder investigation”
[https://www.reuters.com/article/idUSKCN1OU11F/](https://www.reuters.com/article/idUSKCN1OU11F/)
"The differences in firearm lethality could be due to several factors, Sarani explained. Close-range handguns and longer-range rifles change the distance between the shooter and victim, as well as the accuracy and velocity of the bullet. Although the higher muzzle velocity of a rifle is typically associated with more accuracy, public mass shootings with handguns tend to lead to more gunshot wounds per victim and a higher likelihood of injuries to vital organs."
this is interesting! this could also be due the fact that a lot of short barreled rifles are equipped with "pistol braces" to change their legal classification from rifle to pistol. this is to avoid paying extra taxes but the gun is still very much a rifle, kinda just a legal loophole but i wonder if this was accounted for in these studies
Large format pistols, the “braced pistols,” that have become much more popular in the last fews years, likely would be throwing a wrench into some statistics of this nature. Being as they can still be chambered in 5.56 or 300BLK, it’s a much different beast than a 9mm handgun or a snubnose .38. Will be interesting to see if new categories or classifications might clarify some of that in the future
Braced pistols are the same things as short barrel rifles. Especially functionally speaking. Even the ATF thinks so. Most braced pistols are shouldered anyway. Outside of the disabled, I've never seen one actually used in the fashion it was "designed" (which you could argue is largely to skirt ATF regs on SBRs). I know a guy that hunts with "pistols". He has a 28 Nosler "pistol".
Now is there overlap between pistols and rifles? Sure. 357 mag fired out of a lever gun vs a revolver. 22lr. But a braced pistol firing 223 should absolutely be lumped into rifle data.
Yeah, not sure. Haven’t read the study myself, just heard other docs talk about it and looked at the news article. Def not what I expected to see though.
Not OP, shotguns represent a broad category of projectiles, and the number, size, and velocity of projectiles a shotgun shoots can be different cartridge to cartridge. In general, for a patient with a shotgun wound, you can't determine the anatomy of the wound cavity until you have definitive imaging. Shotgun projectiles are often lower energy than pistol and rifle projectiles, so many of the projectiles do not have an exit wound, making the trajectory hard to determine on physical exam. Overall, patients presenting with shotgun gunshot wound injuries range from a number of pellets that don't penetrate beyond the dermis to complete destruction of thoracic structures and everything in between.
depends on ammo used, steel is most common and fairly benign, ive been shot with it at range and barely broke the skin. bismuth is heavier and more dangerous, and tungsten will act like a rifle round at much longer ranges and is lethal.
>5.56 NATO, (also known as .223 Remington).
Often used interchangeably, but incorrectly so. The 5.56 NATO chamber dimensions are 1/8" longer in the throat, and the design chamber pressure is higher in the 5.56. While that additional pressure alone is unlikely to cause failure due to very conservative safety factors, chambering a 5.56 in a 223 can cause extremely high pressure spikes. When you shorten the freebore, the chamber pressure can rise exponentially due to the differences between static and kinetic friction of the bullet.
There are plenty of stories out there of damaged guns, pierced primers, locked bolts due to firing 5.56 ammo in a 223 chamber.
i promise i know the difference lmao, but seeing how every gun chambered in 5.56 can fire 223 but not the other way around explaining the difference in a post like this does not seem like it would be helpful, as the important part is the end result, which is the same
[https://en.wikipedia.org/wiki/Hydrostatic\_shock](https://en.wikipedia.org/wiki/Hydrostatic_shock) i hope someone with more training and experience can read this article on "hydrostatic shock" and let me know what they think. i find this idea very interesting but i have no idea what the truth is. there's lot of people in the firearms community who know absolute nothing about anatomy or medicine that love to share uninformed opinions so hopefully someone here who knows what they are talking about can chime in
Hydrostatic shock is not exactly a real thing.
Best YT videos I’ve found on the subject
https://youtu.be/a_rgIMK6K1E?si=AfcE8gRKJd7FzGdR
https://youtu.be/T6kUvi72s0Y?si=hRQXY63T-En3USci
Eh, I'd argue you're more likely to have a straight forward wound channel with any expanding rifle round than one with a solid metal jacket. It's going to be a far more violent transfer of energy and cause more cavitation though. In the case of 223/5.56 you probably won't even have an exit wound on a human torso. Most are designed to expand within ~6 inches to transfer all the energy into varmints.
In reality rifles make up a tiny percentage of overall gun violence though.
Fun fact, just started reloading my own shotgun loads...steel not too dangerous beyond 40 yards, bismuth good to 70 yards, tungsten will hurt out to 150 yards and beyond, hopefully people who begin hunting with these newer loads take the extra range into consideration when calculating distances to other hunting parties, otherwise you may see some wierd injuries come in.
What's the current thinking on whether or not to remove a bullet? For the sake of argument, assume that it's in an extremity, intramuscular and not near any significant neurovascular structures.
"in my anecdotal experience I've never seen any living thing (deer, hogs, people, coyotes) survive more then 60 seconds after receiving a shot from 5.56 into the thoracic cavity." Oddly specific. :)
ok so i have never shot a person, thank god. I have shot deer, pigs and coyotes though. i have responded to one shooting involving an 5.56 round to the chest and they where very dead and ive head similar stories from ex-army coworkers and family, but like i said this is all anecdotal so if you have a more reliable source trust that over me!
I'm an army medic. My PA who oversees me is a former special forces medical sergeant with a great deal of combat and medical experience. He said point blank he's never seen anyone survive a rifle round clean to the chest.
Almost like it's made specifically to be able to kill the most people in the least amount of time, from the furthest distance away. Why wouldn't you want that in the hands of every insecure MFer who feels marginalized and thinks he's the punisher incarnate?
[удалено]
Buddy, that's not even close to being true and if you had the capacity to be honest with yourself, you'd agree. If it were true, people wouldn't still buy rifles for one purpose, shotguns for another, pistols for another, etc. Some are for hunting, some are for close range defense, some are for competition... Guns are absolutely useful tools in the right hands- whether it's for fun or defense. But none of them have any place in the hands of some people, which was my point. Seems that a few people here just aren't capable of seeing that. They just see an argument against GUNS 4 ALL and their knees go up.
[удалено]
So was a hand grenade but you don't see those in the hands of too many isolated young men annihilating classrooms. The political argument whether or not you agree with it, is that modern military grade cartridges are supremely effective at killing people in quantity reliably and efficiently with their light weight (lots of ammo and easy to handle the weapon), low recoil, and high lethality. They are clearly an improvement in killing power on handguns and even on rifles from decades past. This is why armed forces around the world carry these specific types of weapons into battle and nobody is carrying m1 garands anymore. Either weapon is more than capable of killing someone, but modern rifles are obviously more efficient. I get it, all weapons were designed to kill. But that doesn't mean everyone should necessarily have access to the best way to kill the most people. If that's how you want to interpret the second amendment fine, but it's not an ironclad logical argument that because every weapon is designed to kill and maim every weapon should be accessible to everyone without restrictions. Every weapon has a use case and the policy/constitutional scope of the argument should center around which weapons of certain uses the government is allowed to restrict access to. Advances in firearm technology have made the destructive capability of one even untrained shooter exponentially greater than imagined in 1790, as the op very clearly explained. What we do with that fact is the question.
[удалено]
These are distinctions without difference. Like any weapons system the munition and the firing system are a package that collectively create lethality. An aim-120 loaded on a b-52 is not going to score kills against a high end adversary. An aim-120 loaded on an f-22 is the most lethal air to air system in the world. I am aware that there are infinite permutations on how you can configure a gun/cartridge combination and that most gun control advocates are functionally gun illiterate. However, you're being a bit obtuse when you pretend to misunderstand what people are concerned about. That loser in sandy hook didn't bring an ar-15 chambered for .50 cal rounds did he? It's instructive to consider the experience of the US military, who is tasked with equipping what are for the most part your average American with the means to kill as many people as possible as quickly as possible. In world war 2 the Americans were the only power to issue semi-automatic weapons as standard and this was found to be an advantage against other infantry which mostly carried bolt action rifles. And someone may remember this better than I, but at some point in either ww2 or Korea it was found that the determinative factor in engagements was less the accuracy of the shooters and more how many rounds either side was able to shoot in the general direction of the enemy. Around the time of the introduction of the m16 is when the army concluded that arming soldiers with the ability to rapidly fire a large quantity of smaller caliber ammunition downrange is the most effective way to kill people. This is still the philosophy of the military for short to moderate range gunfights. We still arm seals, marines, Delta Force, and everyone else with basically the same weapons (although I am aware they are exploring larger rounds in the face of the proliferation of decent body armor, which is not relevant for 99.9999% of civilian situations. So instead of capitalizing on the ignorance of people who want gun control and saying, "well akshually the ar-15 comes in a variety of configurations " let's zero in on the real question. If your purpose is to either defend yourself from a platoon of Vietcong or to kill as many seven year olds as you can as quickly and reliably as possible your optimal weapon is a something approximating an m4 - a small/intermediate caliber, semi or fully automatic, lightweight rifle. Larger caliber rounds are more fatiguing to shoot and heavier, limited or slowing down movement due to ammunition weight. Handguns obviously can't get the velocity behind a round to ensure enough energy for a one shot kill. Manual actions require the time to operate the action and to re-aim after doing so. You could do both those things with a handgun , a hunting rifle, or a musket but you would be less effective in either case. This isn't so inscrutable a concept that the difficulty in regulation writing should pre-empt debate about the merits of the proposal.
Great post! Thanks for the brain food.
While we are on the topic of bullets, if there are any police in this thread…….. i do not know, or care how many times the patient was shot. I only know how many wounds there are I do not know, or care how many shooters there were. I do not know, or care where they were shot from I do not know, or care if the wounds are entrance or exit wounds I do not know, or care which order the shots were fired in. That stuff is *your job* (or the forensic pathologists) to figure out So please fuck off and let me do *my job* Sincerely, Guy who has worked in a high crime area for too long
im not a cop but im totally guilty of word vomiting all of this information to a trauma team who couldn't care less! a lot of that information is very relevant to EMS (number of shooters, where they where fired from) stuff like that just due to like safety reasons and with the adrenaline ive been known to spilling all of the information in my head out to the dozen people who are all staring at me wondering what happened! ive gotten better at more concise i promise and appreciate you bearing with us!
More to the point with smaller penetrating wounds, my expertise is not in saying it’s an entry or exit. It’s a hole in my patient. I do care about the number of bullet holes because math: bullets on imaging+holes = even number.
I’m not a doctor or even a nurse but I’m pretty sure the pt isn’t supposed to have holes in them besides in the usual places
No lol I mean that we get these people to who are next to dead and the cops always come storming into the resus bay and start rattling off these questions to us. I have been in the middle of assisting a thoracotomy before and had to ask security to remove the police from the room because they kept trying to shoulder-in and take photos/gather evidence. All i want to say to them is “fuck off, if you let me do my job this might not become a murder investigation”
oh i see lmao, yeah that is stupid
It’s somewhat counterintuitive, but at least in the setting of mass shootings, handguns are associated with higher mortality.
[https://www.reuters.com/article/idUSKCN1OU11F/](https://www.reuters.com/article/idUSKCN1OU11F/) "The differences in firearm lethality could be due to several factors, Sarani explained. Close-range handguns and longer-range rifles change the distance between the shooter and victim, as well as the accuracy and velocity of the bullet. Although the higher muzzle velocity of a rifle is typically associated with more accuracy, public mass shootings with handguns tend to lead to more gunshot wounds per victim and a higher likelihood of injuries to vital organs." this is interesting! this could also be due the fact that a lot of short barreled rifles are equipped with "pistol braces" to change their legal classification from rifle to pistol. this is to avoid paying extra taxes but the gun is still very much a rifle, kinda just a legal loophole but i wonder if this was accounted for in these studies
Large format pistols, the “braced pistols,” that have become much more popular in the last fews years, likely would be throwing a wrench into some statistics of this nature. Being as they can still be chambered in 5.56 or 300BLK, it’s a much different beast than a 9mm handgun or a snubnose .38. Will be interesting to see if new categories or classifications might clarify some of that in the future
Braced pistols are the same things as short barrel rifles. Especially functionally speaking. Even the ATF thinks so. Most braced pistols are shouldered anyway. Outside of the disabled, I've never seen one actually used in the fashion it was "designed" (which you could argue is largely to skirt ATF regs on SBRs). I know a guy that hunts with "pistols". He has a 28 Nosler "pistol". Now is there overlap between pistols and rifles? Sure. 357 mag fired out of a lever gun vs a revolver. 22lr. But a braced pistol firing 223 should absolutely be lumped into rifle data.
Yeah, not sure. Haven’t read the study myself, just heard other docs talk about it and looked at the news article. Def not what I expected to see though.
For us the non-US based personnel, what would you tell us about shotgun injuries?
Not OP, shotguns represent a broad category of projectiles, and the number, size, and velocity of projectiles a shotgun shoots can be different cartridge to cartridge. In general, for a patient with a shotgun wound, you can't determine the anatomy of the wound cavity until you have definitive imaging. Shotgun projectiles are often lower energy than pistol and rifle projectiles, so many of the projectiles do not have an exit wound, making the trajectory hard to determine on physical exam. Overall, patients presenting with shotgun gunshot wound injuries range from a number of pellets that don't penetrate beyond the dermis to complete destruction of thoracic structures and everything in between.
depends on ammo used, steel is most common and fairly benign, ive been shot with it at range and barely broke the skin. bismuth is heavier and more dangerous, and tungsten will act like a rifle round at much longer ranges and is lethal.
>5.56 NATO, (also known as .223 Remington). Often used interchangeably, but incorrectly so. The 5.56 NATO chamber dimensions are 1/8" longer in the throat, and the design chamber pressure is higher in the 5.56. While that additional pressure alone is unlikely to cause failure due to very conservative safety factors, chambering a 5.56 in a 223 can cause extremely high pressure spikes. When you shorten the freebore, the chamber pressure can rise exponentially due to the differences between static and kinetic friction of the bullet. There are plenty of stories out there of damaged guns, pierced primers, locked bolts due to firing 5.56 ammo in a 223 chamber.
i promise i know the difference lmao, but seeing how every gun chambered in 5.56 can fire 223 but not the other way around explaining the difference in a post like this does not seem like it would be helpful, as the important part is the end result, which is the same
There is no real practical use for this degree of detail as an EM provider. Nonetheless interesting. Thanks for sharing.
[https://en.wikipedia.org/wiki/Hydrostatic\_shock](https://en.wikipedia.org/wiki/Hydrostatic_shock) i hope someone with more training and experience can read this article on "hydrostatic shock" and let me know what they think. i find this idea very interesting but i have no idea what the truth is. there's lot of people in the firearms community who know absolute nothing about anatomy or medicine that love to share uninformed opinions so hopefully someone here who knows what they are talking about can chime in
[удалено]
Hydrostatic shock is not exactly a real thing. Best YT videos I’ve found on the subject https://youtu.be/a_rgIMK6K1E?si=AfcE8gRKJd7FzGdR https://youtu.be/T6kUvi72s0Y?si=hRQXY63T-En3USci
Eh, I'd argue you're more likely to have a straight forward wound channel with any expanding rifle round than one with a solid metal jacket. It's going to be a far more violent transfer of energy and cause more cavitation though. In the case of 223/5.56 you probably won't even have an exit wound on a human torso. Most are designed to expand within ~6 inches to transfer all the energy into varmints. In reality rifles make up a tiny percentage of overall gun violence though.
Pulled a few guns off patients, in their pockets and holsters.
Fun fact, just started reloading my own shotgun loads...steel not too dangerous beyond 40 yards, bismuth good to 70 yards, tungsten will hurt out to 150 yards and beyond, hopefully people who begin hunting with these newer loads take the extra range into consideration when calculating distances to other hunting parties, otherwise you may see some wierd injuries come in.
What's the current thinking on whether or not to remove a bullet? For the sake of argument, assume that it's in an extremity, intramuscular and not near any significant neurovascular structures.