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Firearm Injuries

Yusri Arif bin Sapaee
4th Year Medical Student
Kasr El-Ainy School of Medicine
Cairo University
http://budakmedik.blogspot.com

The propellant
Black powder Smokeless powder
Composition: Composition:
carbon, sulfur, potassium nitrate nitroglycerine, nitrocellulose
Fine or granular powder Cordite (nitroglycerine, gun cotton &
jelly), scales, rods or amorphous
•Sporting & Ghaffir (Schneider & •Sporting & Ghaffir (Greener) guns
Remington) guns •Service rifles, automatic pistols &
•Old revolvers recent revolvers
On ignition: 1gm  300 ml gas On ignition: 1gm  900 ml gas
Alkaline residue of: Neutral residue of:
Carbonates, bicarbonates, sulfides, Nitrates & nitrites
sulfates, thiosulfates, thiocyanates
Date of firing can be estimated by Date of firing can not be estimated by
chemical analysis of the residue chemical analysis of the residue
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Medico legal importance of
the powder
1. Diagnosis of firearm injuries
2. Differentiation between inlet & exit
3. Identification of the weapon
4. Estimation of distance of firing
5. Determination of direction of firing
6. Estimation of date of firing (black powder)
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The wads
External wad Internal wad
1. Rounded 1. Rounded
2. Thin (about 1mm thick) 2. Thick (about 1cm thick)
3. Made of cardboard 3. Made of felt
4. Functions: 4. Functions:
1. keeps shots in place 1. keeps shots in place
2. covers the shots 2. acts as a piston to the
shots
3. Separates between the
shots & the powder
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Medico legal importance of the wads
1. Diagnosis of firearm injuries due to non-rifled
weapons
2. Differentiation between inlet & exit
3. Identification of type & bore of the weapon
4. Estimation of the distance of firing
External wad Internal wad
Travels 1-3 meters Travels 3-10 meters
Penetrates the skin at 1 meter Penetrates the skin at 3 meters
Strikes the skin causing circular Strikes the skin causing circular
abrasion at 1-3 meters abrasion at 3-10 meters
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Characters of firearm injuries
1. Loss of substance in the tissues
 especially in inlet wound that depends on the size of the
missile & whether it is a bullet or shots & the striking velocity
2. Powder marks
 around the inlet wound in the skin
 clothes in near injuries
3. Presence of two wounds; inlet & exit
 unless the missile can easily be seen under the screen in the
living or by dissection in dead
 the presence of such missile in the body is apparently a proof
of firearm wound
4. Rounded perforation with beveling of the bone
 if flat bone is perforated (skull or sternum)
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Factors affecting the appearance of
the inlet
1. Type of the weapon
 Bullets produce a single hole (1 cm in diameter)
 Non rifled produce either
▫ A single central hole (2 cm in diameter)
▫ At 1 meter
▫ A central hole with dispersion
▫ At 2 meters  dispersion is 4 cm
▫ At 3 meters  dispersion is 9 cm
▫ Dispersion only
▫ At 4 meters  dispersion is 16 cm
▫ At 5 meters  dispersion is 25 cm
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Factors affecting the appearance of
the inlet (cont.)
2. Distance of firing
 Non rifled weapons
▫ Near injuries less than 1 meter  central hole without
dispersion
 Effect of gases
▫ Near injuries  explosive inlet (lacerated, irregular &
everted wound)
 Effects of powder marks
▫ Near injuries  burning, blackening & tattooing at the
inlet wound
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Factors affecting the appearance of
the inlet (cont.)
3. Direction of firing
 Perpendicular firing  circular wound
 Oblique firing  oval wound
 Tangential firing  track wound
4. Site of the wound
 Wrinkled or corrugated skin (axilla, scrotum) 
irregular laceration wound
5. Type and amount of the powder
 Dense blackening around the inlet in black powder
& grayish in smokeless powder
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Factors affecting the appearance of
the exit
1. Velocity of the bullet at the exit
2. The type of tissues hit by the bullet before the
exit
 Bone  the exit will be larger & more irregular &
may be presented by multiple exit wounds
3. Deformation or fragmentation of the bullet
4. Whether the skin is supported or not
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Inlet vs. Exit (1)
Items INLET EXIT
More  more energy Less  less energy
Loss of substances
transfer from the bullet transfer from the bullet
Smaller  the bullet is Larger  the bullet
directed by its tip usually loses its main
Except: trajectory due to
1. Near injuries resistance inside the
(explosive inlet) body
Size 2. Shots entering
together & coming
separately
3. Ricocheting bullet
4. Dumdum bullet
5. Wrinkled area
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Inlet vs. Exit (2)
Items INLET EXIT
Regular Irregular
Except:
1. Near injuries
Regularity
2. Wrinkled areas
3. Ricocheting bullet
4. Dumdum bullet
Usually inverted Always everted
Except: Except:
Edges 1. Near injuries 1. The exit is supported
2. Fatty areas
3. After putrefaction
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Inlet vs. Exit (3)
Items INLET EXIT
Usually present Absent
Except:
Powder marks 1. Far injuries
2. Covered by clothes
3. Ricocheting bullet
Soiling ring Usually present (as the Absent
(oil, grease & metal spinning bullet wipes its
particle deposit on the surface on the skin)
bullet surface)
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Inlet vs. Exit (4)
Items INLET EXIT
May be present in near Absent
Marginal abrasion &
injuries (due to
bruising
longitudinal & rotatory
“Abrasion collar”
movement of the bullet)
Present (pink color Absent
around the inlet due to
Carbon monoxide local absorption of CO by
hemoglobin &
myoglobin)
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Inlet vs. Exit (5)
Items INLET EXIT
Beveling Internal External
Embedded powder Absent
Microscopic
particles not seen by
examination
naked eye
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Estimation of distance of firing
1. Effect of hot explosive gases causing explosion
of inlet
2. Effect of flame and smoke
3. Effect of unburned powder particles
4. Dispersion of spots (non rifled)
5. The wads (non rifled)
6. Power of penetration of bullets
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