Even if the S does not HTF, in our society, if you are out and about, there is a small but real possibility you could be shot (see my last post). If S DOES HTF, the potential for death and disability, which could lead to death, increases dramatically. Shot folks continue to die with the finest, state of the art trauma care, even if they make it to a level 1 center in that critical first “golden hour”.
Gunshot wounds cause death by a number of mechanisms: first, by direct destruction of a vital organ, most obviously heart and brain (although not every brain shot kills, aka Gabbie Giffords. Location and kinetic energy transfer are key. Had Jared Loughner been loaded with 147gr JHP rather than 115gr FMJ,and shot her in the midbrain the Congresswoman would have died at the scene.). A 36gr HP 22LR behind the ear is an efficient way to kill; enough energy to penetrate the skull but insufficient to exit, so it ricochets. Think Winchester Brainamatic. A penetrating wound to the chest not only destroys lung tissue for oxygen transfer, but more acutely collapses the lung (pneumothorax) or fills the cavity with blood (hemothorax) preventing lung function or increasing pressure in the chest to the point where venous blood return to the heart is impaired. Bleeding (hemorrage) is the next quickest way to die from a bullet. A gunshot to the vena cava behind the liver or the iliac vein in the pelvis are technically difficult to stop even if you were shot in an operating room. Normal adult human blood volume is about five liters. A 1 cm hole in your portal vein draining to your liver (size of your thumb) with normal cardiac output will have you dead in less than ten minutes. Interestingly, bleeding from veins is more rapidly fatal than arteries as arteries tend to go into spasm after injury and bleed during systole (when the heart pumps ) whereas veins bleed during systole and asystole (both parts of the heart’s cycle). The final, more painful way to die from a bullet is from sepsis (infection) in the abdomen. A bullet passing through the colon or small bowel, full of bacteria, seeds a previously sterile field with multiple types of bacteria and blood and devitalized tissue, perfect culture media for bacteria in the warm incubator that is your abdominal cavity. Urine or bile spilling into the abdomen causes chemical peritonitis, or inflammation of the belly, that causes a response similar to infection.
via WRSA and Grid Down Medicine
