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Old March 18, 2012, 01:33 AM   #1
TheRoadWarrior
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War Surgery Experiences

Bad part of my job is that all I deal with is trauma and war surgery. I see exactly what weapons are capable of every day. I can say this: no matter the caliber or weapon system, there is NEVER a guaranteed kill shot.

I've seen a guy get shot in the face with an SVD by an insurgent sniper. The bullet struck his zygomatic process at a glance so the bullet tunneled under the soft tissue to the base of his skull and exited. He said he felt like he got stung by something but felt blood dripping from his face and got his medic. Dude walked in to our hospital. That sniper was probably wondering if he hit him at all.

I saw a guy try to kill himself with a .45 to his chest...which I have no clue why the chest, maybe he wanted to make sure he was an open casket funeral, I don't know, but it missed EVERYTHING vital and he lived.

I saw a guy take a 9mm to his temple and blow out most of his cerebrum and he lived for hours breathing on his own until his family said their goodbyes.

But, I have seen a single small piece of shrapnel from a ricochet hit in the back and severe the aorta. I have seen a 9mm hit the femoral high in the pelvis and bleed out by the time they arrived, and I have seen a 9mm strike an arm and blow out all the major nerves and vessels resulting in an above the elbow amputation.

I have seen 9mm enter the lower abdomen and blow out a kidney and the patient's retro-peritoneal cavity completely fill with blood and the patient die by the time they arrived to the hospital. I have seen a man shot through the shoulder with a .50BMG and walk away with only soft tissue injury.

I have also seen a guy shot center mass in the chest with a 9mm and continue with what he was doing for a few minutes until he collapsed and died. I have also seen insurgents (by the time they reach me they are no longer called insurgents but "detainees" which I have no clue why...I mean you witnessed them shooting at you and all of a sudden they are not insurgents when you shoot them back lol) that have been shot multiple times by 5.56 to the abdomen and chest and they were witnessed to continue fighting until they lost enough blood to pass out or surrendered.

So my point is, a bullet hurts no matter the caliber, and when people get caught up on calibers and forget that even a .22 to the chest center mass can kill, then you might be developing a false sense of confidence that your caliber big iron will absolutely drop someone when you pull the trigger. While slower, large kinetic energy bullets will definitely make bigger holes and damage, the faster and higher penetrating rounds can pierce body parts that otherwise may not be able to by large caliber at a longer distances.

Training is the best weapon, train as you fight but never expect that your shots are going to kill someone automatically. A shot to the chest may only cause a pneumothorax/hemopneumothorax and the person can take hours to die, they may even still be a threat until their lung starts to collapse and they start having breathing difficulty. This can be the case no matter what the caliber as long as the heart and great vessels have not been effected. Everyone has seen 3 Kings I'm sure...that one part of it was actually pretty realistic where Mark Wahlberg gets shot in the chest..although there is no way he could just keep walking around for hours without seeking medical help lol. The pain alone would make you want to stop what your doing I'm sure; I have never been shot in the chest, but I probably would not want to keep walking around the desert looking for gold and stuff with a giant bullet hole in me, plus the fact that even if the bullet passed through the intercostal space, there is muscle in between, nerves and vessels, so it will probably shatter both ribs in proximity and that alone would put you in excruciating pain with every breath. But that is Hollywood of course.

So from a trauma surgery perspective, aim center mass and make sure you neutralize the threat because people don't just instantly die like in the movies!
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Old March 18, 2012, 09:41 AM   #2
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Thank yuo for your posting AND

THANK YOU for steeping in harm's way.

May you and your unit return intact (as deployed) and with fading memories.
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Old March 18, 2012, 10:03 AM   #3
TheRoadWarrior
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"THANK YOU for steeping in harm's way.

May you and your unit return intact (as deployed) and with fading memories."

Thanks, I appreciate that! My only job is to get as many soldiers back safely to their loved ones as possible!
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Old March 18, 2012, 03:26 PM   #4
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As an old Combat Infantryman,

I REALLY REALLY LIKE MEDICS.
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Old March 18, 2012, 03:51 PM   #5
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Very interesting post, TRW!
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Old March 18, 2012, 04:50 PM   #6
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I would not like to have that job, but would like to thank you for your part in helping out our troops. And holy poo! Walk into a hospital after a headshot from an svd that must have been insane. If I was the guy on the sending end I would have said "what a badass" and quit my insurgency.(I think thats a word...)
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Old March 18, 2012, 10:33 PM   #7
TheRoadWarrior
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Thanks for the support everyone!

I'm getting out of the service shortly and I will return to being a nurse in the civilian world. I hope to specialize one day in forensic nursing (like CSI stuff). I often catch myself figuring out the patient's distance from the weapon and the angle they were shot from, the caliber used and even the type of ammunition used (HP, AP, FMJ etc.) all of which lead me to believe that I would really enjoy that field.
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Old March 19, 2012, 10:57 AM   #8
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This has been a very interesting read. Thanks for laying this out factually with solid examples and thanks for your service.
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Old March 19, 2012, 01:56 PM   #9
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Real life aint like the movies for sure. When I was in Vietnam
on patrol, my unit took some rifle fire. I was lying behind a log
when a sniper round nicked the brim of my helmet and struck
me in the right foot. It exited the bottom of my boot. We
couldn't get a Medevac for 12 hours or so. In that short time
the wound got infected. I had surgery the next day to try and
repair the broken bones and damaged tendons. Needless to
say that episode ended my Army career. To this day it still
causes me considerable pain. God bless the medics. They
were there when I needed them the most.
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Old March 19, 2012, 09:37 PM   #10
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RW is correct.
A few cases have been hit with a 20mm shell and survived. There is one well documented case of an individual hit with a single pellet of birdshot at almost 100 yds who died of an aortic puncture. In civilian ERs I have seen DOAs from non-contact birdshot wounds to the chest and survival after a .45 round directly to the brain (as a matter of fact in that case the hospital magazine [Philly inner city] later had a cover photo of the x-ray showing a .45 slug directly in the middle of the brain).
None of this means that birdshot can be expected to be effective in SD scenarios, nor that a .45 to the head is inconsequential.
In the multi-year NYPD SOF studies of police-perp shootings the NYPD concluded that the only factor that was related to stopping the fight was not caliber, but shot placement.
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Old March 19, 2012, 10:49 PM   #11
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TRW: God bless u in a special way for your service. I hope and pray you and all your crew are soon home, well and fully recovered!
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Old March 20, 2012, 05:22 AM   #12
TheRoadWarrior
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Doc TH,

Thanks for your support, and your experiences just reminded me that "less than lethal" means of self defense are not always true.

If a person takes a rubber bullet or bean bag shotgun shell to the right place it can kill them, or paralyze them for life. A bean bag mid sternum can cause sudden death just like the kids that get hit with a baseball. A shot to the head or neck can severe the spine, cause massive internal head bleeding and sheering of the brain or any vessel within, if it hits the neck can crush the trachea. A child accidentally hit with this would be really in trouble almost anywhere they got hit.

A tazer gun can put you into a fatal cardiac rythym. Rare but possible.

To all veterans I salute you!
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Old March 20, 2012, 03:55 PM   #13
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Medical people are the best. My wife is one, she puts up with, well me O

A young boy was shot in the chest with a bb gun, he went into the house lifted his shirt showing his mom then he died. Was in Nebraska.
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Old March 20, 2012, 04:26 PM   #14
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Thanks for your service. Yes, most of this endless ammunition wars argument, while helping to create some basic information, is practically useless once life adds in the millions of variables. something as simple as altering the angle of impact by a few degrees, the point of impact by a half-inch, or even changing the ammunition used and hence depth of penetration or wound channel trauma can mean the difference between walking away and being carried in a bag.

Regarding the BB gun, a punk with a BB gun shot a boy local to this area as he rode past on his bike. the BB hit the kids jugular, and was flushed into his heart. Of course, they just left the thing there and bandaged the hole in his neck, and at this point, it's safe to assume that the BB has dissolved. Copper, brass, or even zinc plated iron shot should have corroded away after 15 years.
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Old March 20, 2012, 05:15 PM   #15
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Thank you for your brave service and God bless our troops!

Also I really appreciated the post!
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Old March 20, 2012, 05:54 PM   #16
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Interesting post. While we may say the shot placement is king, this post could also make a strong case that two or more holes are better than one.
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Old March 20, 2012, 06:24 PM   #17
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I really like Medics too. Married one, as a matter of fact. She's now a practicing RN and what I like best about her is her absolutely warped sense of humor. Soldiers, Cops, and Nurses have a lot in common.

Thank you for your service and come home safe.
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Old March 20, 2012, 06:52 PM   #18
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Thanks Doc.
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Old March 20, 2012, 08:13 PM   #19
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RW, you are welcome. You brought some interesting perspectives to the forum. On the web, many debates degenerate into caliber wars; it is rare that the debaters have had much personal experience with specific firearms injuries and their ultimate effects. You may want to pick up a textbook in forensic pathology to see if you are really interested in that kind of work. I do NOT recommend this to the general public, but you've already been there.
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Old March 21, 2012, 02:48 AM   #20
TheRoadWarrior
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A question about a possible situation you might find yourself in when you defend yourself: This is related to my topic because remember, not all people die when you pull the trigger.

Your life is in danger and you choose to pull the trigger. Now the threat is neutralized....but now lying on the ground bleeding all over and still alive. You are looking this person in the face and they may be talking to you begging for help or mercy, but they are no longer a threat to you. What would you do? Would you holster your weapon and give them aid, put pressure on the wound or wrap a tourniquet on them? Would you double tap them and kill a non-combatant? Would you keep your muzzle on them and call the police and let them save their life?

If I just shot someone in my home and they are not dead, I tend to fall back on my rules of engagement training and treat that person now as a non-combatant and a patient. We get taught that when you shoot the enemy and they are still alive, you do not double tap them or mercy kill, you disarm them and render aid. This is a safety issue in your own home or out in public with your CCW because if the person was armed and you shot them, they may still be a threat to you. So if they had a gun and you shot them first and they are alive, do you shoot them again if they are still holding the gun? Do you yell at them to drop the weapon or tell them to safely slide the weapon away from them? If they have just a bat or a knife would that change the situation?

But what about civilians, is there some sort of good Samaritan law about SD? Can you get sued or criminally held accountable if you shot someone and didn't provide them with aid after they were no longer a threat? Lawyers can be very clever in painting a picture in courtrooms that you were maliciously watching a person bleed to death and not offering any aid I'm sure.
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Old March 21, 2012, 06:50 AM   #21
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Not sure I'd render aid in that situation. If they were a threat to your life before you shot them, nothing really changes after you shoot them. You may even open yourself up to another attack at close range.

Stay back. Call police and ambulance. Let those paid to handle it do so.....
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Old March 21, 2012, 07:01 AM   #22
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Not only should you render aid, but you should also apologize for having to shoot them. After all, it wasn't something you wanted to do. It was unavoidable, wasn't it?

Otherwise, you might as well shoot them again.
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Old March 21, 2012, 07:48 AM   #23
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Quote:
Interesting post. While we may say the shot placement is king, this post could also make a strong case that two or more holes are better than one.
More holes certainly may be better, but shot placement is nothing without trajectory and penetration. For example, even if you have good placement and trajectory, it means nothing without penetration.
http://www.youtube.com/watch?v=yqV_rmiSCZc

Also note Roadwarriors .45 to the chest attempted suicide where the guy had placement and penetration, but the trajectory was such that the bullet missed everything vital.

All three must work in unison to get the results successful results needed.
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Old March 21, 2012, 08:15 AM   #24
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Quote:
Stay back. Call police and ambulance. Let those paid to handle it do so.....
Um..... in most of the country (area-wise), EMS is not paid ..... we volunteer for that crap, because there is not any money to pay someone, and somebody has to do it....... we can't just leave people to bleed out on the streets.

If it were me, I would call 911, and if I was pretty sure the threat was ended (disarmed and incapacitated), I'd render aid..... try to figure out an improvised occlusive dressing for a sucking chest wound.....


Quote:
Not only should you render aid, but you should also apologize for having to shoot them.
. Probably would .... I apologize to folks when I poke them with needles or lancets.....
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Old March 21, 2012, 09:55 AM   #25
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I was serious. Don't act like the bad guy. Hard rule to follow, though.
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