BALLISTIC TRAUMA

(GUNSHOT WOUND)

Dewi, Rahmania Kemala

Dep. Of Forensic and Legal Medicine

Medical Faculty of Airlangga University
Dr. Soetomo Surabaya District General Hospital
 LEARNING OBJECTIVE
• To independently examinate patient / victim
with suspect of Ballistic Trauma
• To do bullet or pellet extraction
• To determine bullet entry wound and exit
wound
• To write report accordingly in Visum et
Repertum
 BALLISTIC TRAUMA VICTIM EXAMINATION

1. COLLECTING & SECURING EVIDENCE

2. BALLISTIC TRAUMA DETERMINATION

3. NUMBERS OF SHOTS BEING FIRE

4. GUNSHOT ENTRY WOUNDS & EXIT WOUNDS

5. NUMBER OF ENTRY & EXIT WOUNDS

6. LOCATION OF ENTRY & EXIT WOUNDS ON THE PROPERTIES & BODY

7. FATAL WOUND DETERMINATION

8. DISTANCES ESTIMATION OF THE SHOTS

9. DIRECTION CONJECTURES OF THE SHOTS

10. SUICIDE/HOMECIDE/ACCIDENT COURSE DETERMINATION

11. PROJECTILES EXTRACTION

12. ADDITIONAL EXAMINATION : FINGER PRINT, BLOOD TYPE, TOXICOLOGY, HISTOPATHOLOGY, GSR

13. VISUM ET REPERTUM

 Ballistic Victim Examination / Pemeriksaan Korban Balistik

• Crime Scene Investigation : To Find Manner Of Death /

Pemeriksaan TKP : Menentukan Cara Kematian

1. Securing Evidence / Mengamankan Barang Bukti

2. Record The Examination Finding / Mendokumentasikan Hasil

Pemeriksaan

3. Collecting Evidence / Mengumpulkan Barang Bukti

4. Assisting The Investigator / Memberi Petunjuk pada Penyidik

 Ballistic Victim Examination / Pemeriksaan Korban Balistik

• Ballistic Trauma Examination : To Find Mechanism & Cause Of Death /

Pemeriksaan Luka Tembak : Menetukan Mekanisme & Penyebab Kematian

1. Number Of Ballistic Wounds / Jumlah Luka Tembak

2. Ballistic Entry & Exit Wounds Determination / Penentuan Luka Tembak Masuk &

Keluar

3. Type Of Entry Wounds : Contact/Close/Distant / Tipe Luka Tembak Masuk :

Kontak/Dekat/Jauh

4. Location Of The Ballistic Wounds / Lokasi Luka Tembak

5. Angle & Directions Of The Shots / Sudut & Arah Tembakan

6. Projectiles Extraction / Pengeluaran Anak Peluru

7. Firearm Type Estimation / Perkiraan Tipe Senjata Api

 FIREARM PROJECTILE EFFECT

1. Flame Effect : Burnt / Efek Nyala Api : Luka Bakar

2. Smoke Effect : Soot / Efek Asap : Jelaga

3. Ammunition Effect : Tattooage/Stippling / Efek Mesiu : Tatoase

4. Metal Effect : Fouling / Efek Metal : Fouling

5. Barrel Effect : Muzzle Imprint on Ballistic Contact Entry Wound / Efek

Moncong Laras : Cetakan Moncong pada Luka Tembak Masuk

Kontak

6. Projectile Effect : Ballistic Entry & Exit Wound / Efek Anak Peluru :

Luka Tembak Masuk & Keluar

 BALLISTIC TRAUMA CLASSIFICATION / KLASIFIKASI LUKA TEMBAK

• ENTRY BALLISTIC WOUND / LUKA TEMBAK MASUK :

1. CONTACT ENTRY BALLISTIC WOUND / LUKA TEMBAK KONTAK :

Hard Contact Entry Ballistic Wound ; Soft Contact Entry Ballistic Wound

2. CLOSE RANGE ENTRY BALLISTIC WOUND / LUKA TEMBAK JARAK

DEKAT

3. DISTANT RANGE ENTRY BALLISTIC WOUND / LUKA TEMBAK

JARAK JAUH

• EXIT BALLISTIC WOUND / LUKA TEMBAK KELUAR

 CONTACT ENTRY BALLISTIC WOUND

o Skin to muzzle barrel range : 0 cm, pressure included in hard contact

o Wound shape : circle, oval if it angled shot, star-shape/torn

if there is bone under the skin

o Wound edge : contusion ring, burnt tissues & hair, soot,

tattooage/stippling, stippling can be

embedded in subcutaneus tissues & inside

the wound, muzzle imprint

o Wound colour : pinkish-red (CO)

 CLOSE RANGE ENTRY BALLISTIC WOUND

o Skin to muzzle barrel range : < 60 cm

o Wound shape : mostly oval

o Wound edge : contusion ring,

burnt tissues & hair in range < 15 cm,

soot in range < 30 cm,

tattooage/stippling in range < 60 cm

 DISTANT RANGE ENTRY BALLISTIC WOUND

o Skin to muzzle barrel range : > 60 cm

o Wound shape : mostly oval, circle in sniper shot

o Wound edge : contusion ring

EXAMPLE : DITEMUKAN LUKA TERBUKA BERBENTUK BULAT/LONJONG WARNA

KEMERAH MUDAAN, DIAMETER LUKA NOL KOMA SEMBILAN

CENTIMETER/UKURAN LUKA SATU KOMA TUJUH SENTIMETER KALI NOL KOMA

SEMBILAN SENTIMETER, TERDAPAT LUKA BAKAR WARNA KEHITAMAN DI TEPI

LUKA, TERDAPAT KELIM LECET DI SEKELILING TEPI LUKA, TERDAPAT JELAGA

DAN TATOASE DI SEKELILING LUKA, TERDAPAT CETAKAN MONCONG

MENGELILINGI LUKA DENGAN JARAK SATU SENTIMETER DARI TEPI LUKA,

TERLETAK PADA SEPULUH SENTIMETER DI KIRI GARIS TENGAH TUBUH DAN

LIMA BELAS SENTIMETER DI BAWAH PUNCAK BAHU KIRI SERTA SERATUS TIGA

PULUH SENTIMETER DARI TUMIT KIRI

 EXIT BALLISTIC WOUND

o Wound shape : various shape & size

 STEPS IN BALLISTIC TRAUMA EXAMINATION

1. COMPLETE PICTURE & DOCUMENT OF THE ENTIRE PROPERTIES & BODY

2. COLLECT SAMPLE TO EXECUTE PARAFFIN TEST

3. COLLECT SAMPLE TO EXECUTE FIRING TEST (THE PROJECTILE)

4. CLEAN THE BODY

5. COMPLETE PICTURE & DOCUMENT OF THE ENTIRE BODY AGAIN

6. X-RAY EXAMINATION

7. BALLISTIC ENTRY & EXIT WOUNDS DETERMINATION

8. TYPE OF ENTRY WOUNDS

9. LOCATION OF BALLISTIC WOUNDS

10. ANGLE & DIRECTION OF SHOTS

11. PROJECTILES EXTRACTION

12. LOCATION OF WOUNDS HAVE TO BE PRECISELY MEASURE WITH AXIS, ORDINATE, & FROM

CALCANEUS TO DETERMINE THE DIRECTION AND ANGLE OF SHOT

 DIFFERENCE BETWEEN SUICIDAL & HOMICIDAL GUN SHOT WOUND
TRAITS SUICIDAL HOMICIDAL

Site Of Entry Wound/Lokasi Head, Heart, Mouth/Kepala, Jantung, Mulut Anywhere/Di Mana Saja
Luka Masuk

Shot Distance/Jarak Tembak Contact, Close/Kontak, Dekat Any Range/Jarak Mana Pun

Direction/Arah Upward, Forward, Backward/Ke Atas, Ke Depan, Usually Upward/Biasanya

Ke Belakang Ke Atas

Number /Jumlah One/Satu One To Many/Satu Hingga

Banyak

Hand Pressing Gun Powder Residue Present/Terdapat Residu None/Tidak Terdapat

Trigger/Tangan Yang Bubuk Mesiu
Memegang Pelatuk

Position Of Weapon/Posisi At The Scene/Di Lokasi Not At The Scene/Tidak Ada

Senjata Di Lokasi

Scene Of Crime/TKP At One House/Di Rumah Seseorang Any Place/Sembarang

Tempat

Motive/Motif Insanity, Incurable Illness, Financial Loss, Fudes, Revenge,

Unbearable Mental Pressure/Kejiwaan, Sakit Yang Robbery/Pertikaian, Balas
Tidak Dapat Disembuhkan, Kegagalan Keuangan, Dendam, Perampokan
Tekanan Mental Berat
RADIOLOGY EXAMINATION/PEMERIKSAAN RADIOLOGI :

•Locate The Projectiles/Menemukan Anak Peluru

•Determine The Amount Of Projectiles/Menentukan Jumlah Anak

Peluru

•Determine The Direction & Angle Of Shot/Menentukan Arah & Sudut

Tembakan

•Determine The Range Of Shot/Menentukan Jarak Tembakan

•Document Safe Keep/Penyimpanan Dokumen

PARAFFIN TEST/TES PARAFIN : DERMAL NITRATE TEST/TES

NITRAT KULIT : DIPHENYLAMINE TEST/TES DIPHENYLAMINE

To test whether there is residue of nitrate from the gun powder from

fired gun on the hand that pull the firearm trigger/Untuk menentukan

apakah ada sisa mesiu dari senjata yang ditembakkan pada tangan

yang menarik pelatuk  can be false +, it is consider to be obsolete

test now-a-day
DERMAL NITRATE TEST
ATAU
TES NITRAT KULIT
NEUTRON ACTIVATION ANALYSIS/ANALISIS AKTIFASI NEUTRON :

•To identified holes on properties/Identifikasi lubang di pakaian

•Determine range of shot/Menentukan jarak tembakan

•Determine the projectiles from the Pb level/Menentukan anak peluru dari

kadar Pb

•Determine whether one had fired gun from Pb, Antimoni, &

Barium/Menentukan apakah seseorang telah menembakan senjata

dengan deteksi Pb, Antimony, dan Barium pada tangan

PROJECTILE EXAMINATION/PEMERIKSAAN ANAK PELURU :

• Graphic Documentation/Dokumentasi Visual

• Weight & Diameter Documentation/Pencatatan Berat & Diameter

• Caliber Determinant/Penentuan Kaliber

• Scratch Examination/Pemeriksaan Goresan

• Firing Test/Tes Firing  Determine Range Of Shot/Penentuan Jarak

Tembakan & Firearm Identification/Identifikasi Senjata Api

HOW TO EXTRACT THE PROJECTILE/

BAGAIMANA CARA MENGAMBIL ANAK PELURU :

Preparation/ Persiapan : Gloves, Scalpel/Lancet

Extraction/ Pengambilan :

• Small incision next to skin mound/ Pengirisan kecil di sebelah

gundukan kulit (not on top of the mound)

• Push the bullet/pellet out with both thumbs or index finger/

Dorong anak peluru dengan kedua ibu jari atau jari telunjuk

• Do not use any sharp equipment in projetile direct extraction/

Jangan menggunakan peralatan tajam pada pengambilan

langsung anak peluru (Swann-Morton, 2017)

HOW TO SEND THE PROJECTILE TO FORENSIC LABORATORY/BAGAIMANA

CARA MENGIRIM ANAK PELURU KE LABFOR :

•Inscription On Projectile With Number , Date, Initial & Not To Damaged The

Marking/Inskripsi Pada Anak Peluru Dengan Nomor, Tanggal, Initial & Tidak Merusak

Goresan Yang Perlu Untuk Identifikasi

•Cotton Wrapped/Bungkus Dengan Kapas

•In To A Cardboard & Wrapped Accordingly/Masukkan Dalam Kotak Karton Dan

Bungkus Rapi

•Bundle The Box, Labelling , & Seal/Ikat Kotak, Beri Label, & Segel

•Made Bundling Report/Buat Berita Acara Pembungkusan & Serah Terima BB

CLASSIFICATION OF FIREARM :

FROM BORE/INNER SURFACE OF BARREL :

1. RIFFLED/GUNS
2. SMOOTH BORED/SHOTGUNS

1. Guns-from Velocity :
• Low Velocity : Revolver
• Medium Velocity : Pistol
• High Velocity : 3not3

2. Shotguns :
• Single Barrel
• Double Barrel
• Slide Action
• Liver Action
• Bolt Action
• Pump Action
• Semi Auto
• Auto
EXAMPLE : 9 MM AMMO
 SABOT ROUND

(Sabot, 2016)
BULLET = PROJECTILE FROM RIFFLED/GUNS & PELLET =

PROJECTILE FROM SMOOTH BORED/SHOTGUNS

(Coronado, 2017)
 THANK YOU
&
APOLOGIZED FOR THE
INCONVENIENCE