Gunshot wound

Gunshot wound
Male skull showing bullet exit wound on parietal bone, 1950s
Specialty	Trauma surgery
Symptoms	Pain, deformity, bleeding[1][2]
Complications	PTSD, lead poisoning, nerve injury,[1][2][3] wound infection, sepsis, brain damage, gangrene, disability, amputation[4]
Causes	Guns
Risk factors	Illegal drug trade, ignorance of firearm safety, substance misuse, alcohol abuse, poor mental health, firearm laws, social and economic differences, some occupations, war[5][6]
Prevention	Firearm safety, crime prevention[7][8]
Treatment	Trauma care[9]
Frequency	1 million (interpersonal violence in 2015)[10]
Deaths	251,000 (2016)[5]

A gunshot wound (GSW) is a penetrating injury caused by a projectile (e.g. a bullet) from a gun (typically firearm or air gun).^[11][12] Damage may include bleeding, bone fractures, organ damage, wound infection, loss of the ability to move part of the body, and in severe cases, death.^[2] Damage depends on the part of the body hit, the path the bullet follows through the body, and the type and speed of the bullet.^[12] Long-term complications can include bowel obstruction, failure to thrive, neurogenic bladder and paralysis, recurrent cardiorespiratory distress and pneumothorax, hypoxic brain injury leading to early dementia, amputations, chronic pain and pain with light touch (hyperalgesia), deep venous thrombosis with pulmonary embolus, limb swelling and debility, and lead poisoning.^[1][2]

Factors that determine rates of gun violence vary by country.^[5] These factors may include the illegal drug trade, easy access to firearms, substance misuse including alcohol, mental health problems, firearm laws, social attitudes, economic differences, and occupations such as being a police officer.^[5][6] Where guns are more common, altercations more often end in death.^[13]

Before management begins, the area must be verified as safe.^[9] This is followed by stopping major bleeding, then assessing and supporting the airway, breathing, and circulation.^[9] Firearm laws, particularly background checks and permit to purchase, decrease the risk of death from firearms.^[7] Safer firearm storage may decrease the risk of firearm-related deaths in children.^[8]

In 2015, about a million gunshot wounds occurred from interpersonal violence.^[10] In 2016, firearms resulted in 251,000 deaths globally, up from 209,000 in 1990.^[5] Of these deaths, 161,000 (64%) were the result of assault, 67,500 (27%) were the result of suicide, and 23,000 (9%) were accidents.^[5] In the United States, guns resulted in about 40,000 deaths in 2017.^[14] Firearm-related deaths are most common in males between the ages of 20 and 24 years.^[5] Economic costs due to gunshot wounds have been estimated at $140 billion a year in the United States.^[15]