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Straight, No Chaser: Your Questions About Gunshot and Stab Wounds

By Jeffrey Sterling, MD December 7, 2019

 Your Top Five Questions:
 1. Why don’t the bullets always get taken out? 
Removal of bullet may cause more damage than leaving them in.  It’s sometimes not worth the effort.
2. What’s with the tubes that go in the chest?
Chest tubes are used to treat a pneumothorax (a collapsed lung).  The problem is there’s air in the space between the lung and the chest wall.  This can interfere with normal breathing and may be life threatening.  The tubes go through the chest wall to release the air from that space, thus allowing re-expansion of the lungs.
3. Why would doctors ever need to slit someone’s throat to save their lives?
That describes either a cricothyrotomy or a tracheostomy, and it’s not ‘slitting’ the throat as much as it’s creating an opening in the airway to permit airflow.  This is usually necessary because of some airway obstruction at the upper throat (foreign body in the throat, etc.) with an inability to clear it.  This procedure is only done to save a life.
4. Why would you die from a wound to the thigh?
Fractures of certain bones and laceration of certain blood vessels are potentially associated with enough blood loss that you could bleed to death.  Infection and blood clots are additional considerations that could be life-threatening.
5. What about gunshot or stab wounds to someone pregnant?
Penetrating trauma to the abdomen is typically less fatal to the mother than to a fetus because the fetus is literally acting as a shield.  In the event any wound has placed the mother’s life at risk or the mother has died from the wound, under certain extreme circumstances, an emergency C-section may be performed to save the baby.

0 thoughts on “Straight, No Chaser: Your Questions About Gunshot and Stab Wounds

  1. Thank you very much for doing this blog Dr. Sterling. It is very informative, and often provides life saving information. #4 Especially resonates with me because I live in Ashburn, VA right down the street from where the Washington Redskins practice. Shawn Taylor one of the Redskins players died from blood loss because the bullet damaged his femoral artery. It was a very sad time in this community when that happened. Especially because so many of the players live in the community and are such a big part of the community. My little niece lived with me at the time and she made me bring her to Redskins park for the memorial service that was held for him. That is something that I will never forget. That is the closest that I have ever come to a victim of gun violence. I guess I should count myself lucky because, unfortunately, gun violence touches the African American community way too often.

      1. Yeah I know. That is why he died. Too much blood loss. Is there anything that can be done to save someone’s life if there is damage to an artery? Does it always mean brain damage or death?

        1. Not all blood loss is created equal. In fact, physicians stage blood loss based on signs, symptoms and one’s vital signs. Fluid resuscitation (and in some severe instances blood replacement) is the key to survival. Prior to ER arrival, pressure to any bleeding sites really is the best you can do. Thank you for the question.

  2. Dr. Sterling, how would a small person be able to stop the bleeding on someone who is much larger than them? For instance a 4’8 woman and a man 6″11 and 300 pounds. Does the size of a person play a factor in life or death?

    1. Hi, Darla. Interesting question. You’re not attempting to place a tourniquet. You simply need to have firm pressure applied to the wound site. Conceivably a child could perform this function (assuming they weren’t completely anxiety ridden…).

    2. There is one important exception to the general rule that you want to apply some form of an occlusive dressing to a bleeding or open wound. If there is a sucking chest wound, the correct maneuver is to apply a dressing and tape it down on three ends, leave one corner to equilibrate pressure from the wound. In these specific instances, applying a complete occlusive dressing can make the wound worse.

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