Forensic Medicine &
Toxicology
Firearm Wounds
By
Dr. Amina Afzal Rao
Demonstrator KMS Medical College,
Sialkot
4/8/2015
1
Firearm Wounds
By
Dr. Arif Rasheed Malik
Associate Professor & Head
Department of Forensic Medicine & Toxicology,
SIMS, Lahore
4/8/2015
2
Weapons are fashion accessories and
easily available
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3
Firearm
“ An instrument or device with which it is possible
to propel a projectile by means of the expansive
force of the gases generated by the combustion
of an explosive substance “
FIREARM WOUNDS
“ Firearm wounding is a special form of trauma producing a breech through the body of a person by a bullet or shot charge “
Principles & Practice of Forensic Medicine by Nasib R. Awan
4/8/2015
4
History of Firearms
 Firearms came to Europe from China
 To produce an efficient firearm, there are three basic criteria to be
met.
 Weapon should be capable of causing substantial damage
 It should be reliable & convenient to use
 It should be reasonably accurate

Reverend Alexander John Forsythe, in 1807, living near Aberdeen, Scotland, held the
first patent for a percussion ignition system..
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History of Projectile weaponry





Earliest weapons: bow and
arrow, crossbow, simple catapult
to huge ballistics / trebuchet
Gunpowder developed in china
1500 yrs ago; came to Europe
and from 14th century used as
weapon
Gunpowder= Charcoal, Saltpetre
(Potassium Nitrite), Sulphur
Earliest guns were cannons, front
then breech loading
Early guns flintlock muzzle
loading with 3 parts “lock, stock
and barrel”
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Assault rifles
AK-47 Assault rifle
Developed: 1974
Mikael Kalashnikov
Caliber: 5.45mm
Magazine capacity: 30
Loaded weight: 3,600g
Killing range: 1,350m
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Ballistics
“ Knowledge of physical forces acting on the
projectile & missile “ by Nasib R. Awan
Interior Ballistics
Exterior Ballistics
Terminal / Wound Ballistics
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Ballistics
T
H
E
O
R
E
T
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C
A
L
Interior ballistics
Wound ballistics
Exterior ballistics
P
R
A
C
T
I
C
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Clear Concept
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INTERIOR BALLISTICS
 Knowledge of the forces responsible for
propulsion of projectile within the bore of the
barrel till the end of the projectile.
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 Understanding pre-requires knowledge of:-
1Missile design & cycle of fire.
2Ammunition design.
Missile design & cycle of fire
Missile design:a- Portion containing mechanical device (not important).
b- Barrel for jetting of the projectile (Important because it
has relation to WOUND BALLISTICS).
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Firearm Design
Grip
Action
Barrel
Barrel
Grip or
But Stock
Action
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Firearms
Luger 9mm
Colt 45
9 mm
Thompson
5.7 mm
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Classification of Firearms
Classified on the basis of Barrel
 Barrel
 Steel tube for jetting of the
projectile. Two ends --Breach & Muzzle end
 Bore
 Internal diameter of the
barrel. May be SMOOTH or
RIFLED
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Classification of Firearms
 Smooth Bored
 Rifled
 Choked
 Short Barrel
 Non choked
 Long Barrel
Barrel
Rifling
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Choking of Smooth bore Firearm
18.80 mm
18.40 mm
Cylindrical portion
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TYPES OF CHOKING OF BARREL OF SHOT GUN
CHOKE
FULL CHOKE
MODIFIED CHOKE
IMPROVED CYLINDER
CYLINDER
PERCENTAGE OF PELLETS AT
40 YARDS IN 30 INCH CIRCLE
65 - 75
45 - 55
35 - 45
25 - 35
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 Cycle of fire:- Three stages: i- Cartridge feeding and chambering.
 ii- Striking of fire
 iii- Extraction of fire cartridge.
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Ammunition Design
Projectile consists of:-
 Cartridge Case
 Primer
 Powder charge (Black or Smokeless)
 Plastic Wad
 Shot charge (Bullet or Lead shots)
C
A
R
T
R
I
D
G
E
B
U
L
L
E
T
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CARTRIDGE CASE
Function: expands and seals chamber against rearward
escape of gases.
Composition: usually brass (70% copper 30% zinc); also
plastic and paper in shotgun shell tubes.
Shape:
(a) straight ("always" pistol ammunition)
(b) bottleneck ("always" rifle ammunition)
(c) tapered ("obsolete").
Extractor flange: configuration at base; rimmed, semi-rimmed,
rimless ,belted, rebated.
Headstamp: manufacturers identifiction imprinted or embossed
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on cartridge case.
20
Cartridge Case
I.
II.
III.
IV.
V.
VI.
Cartridge cases (outer covering of the cartridge) are
made up of Cardboard & plastic.
Bullet cases are made of brass (70% copper and
30% zinc).
A few have a nickel coating.
Primer cases are of similar composition (Cu-Zn).
Bullet cores are most often lead and antimony,
with a very few having a ferrous alloy core.
Bullet jackets are usually brass (90% copper with
10% zinc), but some are a ferrous alloy and some
are aluminum. Some bullet coatings may also
contain nickel (Ravreby, 1982)
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FUNCTIONS OF CARTRIDGE CASE
 CONTAINS AND KEEPS THE INNER CONTENTS IN
POSITION
 PREVENTS THE BACK ESCAPE OF GASES
 PROTECTION TO THE CONTENTS
TYPES OF CARTRIDGE CASES
Rimmed, Semi rimmed, Rimless, Rebated, Belted
CSAELESS CARTRIDGE
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Primer
The major primer elements are Lead styphnate(Pb), Barium
nitrate (Ba), or a Antimony sulphide(Sb). Usually, all three are
present.
Less common elements include Aluminum (Al), Sulfur (S), Tin
(Sn), Calcium (Ca), Potassium (K), Chlorine (Cl), or Silicon (Si).
Primer elements may be easier to detect in residues because
they do not get as hot as the powder, and compounds (not just
elements) may be detectable. (Tassa et al, 1982b)
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Function:
explodes on compression igniting the propellant.
Location:
(a) centrefire. Centrally placed primer assembly
comprising primer cup (struck by firing pin), primer, anvil with flash
holes. Boxer design (USA) or Berdan design (Europe).
(b) rimfire. No primer assembly. Primer spun into rim
of cartridge case (rim struck by firing pin) and in contact with
propellant.
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Various types of Ammunition
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Powder Charge
 Modern gunpowder, or "smokeless" powder, can contain up
to 23 organic compounds (FBI study) Nitrocellulose is virtually
always present, along with other compounds containing
nitrate or nitrogen.
 One of these compounds, diphenylamine (used as a stabilizer
in the powder), can be detected using reagents containing
sulfuric acid. (Maloney et al, 1982).
 Modern gun powders are also described as "single-base"
when the basic ingredient is nitrocellulose and as "doublebase" when there is additionally 1 to 40% nitroglycerine
added. If nitroguanidine it is “Triple – base”.
 Hardy and Chera (1979) describe a method to differentiate
them using a mass spectrometer .
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BLACK GUN POWDER
POTASSIUM NITRATE
OR SALT PETER
75%
CHARCOAL
SULPHUR
15%
10%
Charcoal is the fuel,
potassium nitrate the
oxygen supplier gives the
mixture more density and
makes it more readily
ignitable
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PROPELLANT
Function: burns to produce large volumes of gases under
pressure.
Shape: sheets of smokeless powder cut into disc, flake or
cylinder shapes.
Alternatively produced as ball and flattened ball smokeless
powder (Winchester) which may be coated with silver-black
graphite.
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Chain of Events
Strike
Primer ignites
Powder charge burns
Temperature increases
Gases produce
Chamber pressure increases
Bullet/Shot charge moves
Exit of bullet
Chamber pressure zero
Gases produced: Carbon dioxide, Carbon monoxide
Nitrogen, Sulphurated hydrogen
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CHAMBER PRESSURE:i- Revolver:- 4 tons
ii- Pistol:6 tons
iii-Rifle:- 20 tons
Bullet:Forward & rotational motion.
Shot charge:- Forward movement.
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Exterior Ballistics
“ Knowledge of forces acting on the shot while it
leaves the barrel till it reaches the target “
Interactions of forces:1- Forces originating from the bullet motion
a- Velocity:-
i- Forward (Rate of motion (speed) and
Direction
ii- Rotational :- It varies (length of the barrel)
b- Velocity of bullet at the muzzle end for various firearms:i- Revolver:- 600 – 900ft/sec
ii- Pistol:- 1200 – 1440 ft/sec
iii- Rifle:2000 – 3500 ft/sec
2- Forces present in the medium
a- Air resistance
b- Gravity
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Forces originating from the projectile
Velocity
1- Speed or Rate of motion also called Muzzle
velocity
 Rifles upto 2000 – 3000 fps
2- Direction of motion
 Forward motion
 Also Rotational motion in bullets
Bullets do
not typically
follow a
straight line
to the target.
Rotational
due to rifling forces are in
effect that
keep the
bullet off a
straight axis
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of flight. 32
DEFINITIONS
 YAW: is the oscillation around the long axix of
the bullet.
 PRECESSION: is a circular Yawabout the center
of gravity which takes the shape of a
decreasing spiral.
 Nutation: is a rotational movement in a small
circle which forms a rosette pattern like a
spinning top.
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Forces present in the medium
Projectile
Follows..
1- Air resistance
2- Gravity
Curved path
Trajectory of bullet
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Trajectory of bullet
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Tail wag phenomenon
Tail wag
 Inside barrel projectile is
supported by walls of barrel
 Entering new medium loses
Initial
Terminal
tail wag
balance due to air
resistance & force of gravity tail wag
 Regains balance after
covering some distance
Intermediate
tail wag
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Bullet through a glass
Intermediate tail
wag
Secondary
misslies
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Tail wag phenomenon
For pistol up to 60 yards
For Rifle up to 200 yards
Medicolegal importance
Atypical firearm entry wounds
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Terminal / Wound Ballistics
“ It is concerned with the effect of bullet on the
target at impact until it comes to rest “
by Naseeb R. Awan
Mechanism of Wound production
Laceration & Crushing
Shock waves
Cavitation
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Mechanism of Wound production
INTERACTION BETWEEN THE FIRE – BLAST AND PART STRUCK
FORCES IN THE FIRE - BLAST
FACTORS IN THE PART STRUCK
PROJECTILE & ITS
RESISTANCE OF THE TISSUE
DIAMETER
DEPENDS UPON
SHAPE
NATURE,
WEIGHT
DESIGN &
RIGIDITY
DENSITY
TERMINAL VELOCITY (MOST
IMPORTANT)
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Laceration & Crushing
Kinematics is the science of motion. In gunshot
wounds we can use this to determine the extent of
injury from the forces and motion involved.
 Velocity is a key factor to the overall extent of gunshot
wounds
 According to the kinetic energy equation: (kinetic energy =
mass/ 2 x velocity2) Doubling the mass doubles the energy,
however doubling the velocity quadruples the energy
 Therefore a small-caliber bullet traveling at high speed can
produce a more extensive injury than larger caliber bullet
traveling at a lower speed
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Laceration & Crushing
…. produced by the direct effect of bullet
1- Missile velocity
2- Shape & composition of
projectile or Frontal area
3- Angle of impact
4- Flight characteristics as
yaw, tumbling & nutation
5- Fragmentation
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LOW VELOCITY BULLET
a.
PART STRUCK SOFT AND ELASTIC TISSUE
b.
PUSHES & STRETCHES THE SKIN & UNDERLYING TISSUE.
c.
ROTATES UPON ITS AXIS
d.
INDENTATION IS PRODUCED
e.
PERFORATION OF TISSUE
f.
PASSAGE OF BULLET
g.
ENERGY OF BULLET RADIATES LATERALLY
h.
DAMAGE PROPORTIONATE TO DIAMETER OF THE BULLET
i.
REPRESENTED BY THE PATH OR TRACK OF THE BULLET
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SHOCK WAVES
DEMONSTRATED ONLY BY HIGH SPEED PHOTOGRAPHY OR RADIOGRAPHY
II. IN HIGH VELOCITY BULLETS
III. TRACK IS FORCED THROGH SOLID TISSUE.
IV. MEDIUM IS COMPRESSED BY MISSILE IN FRONT OF IT
V. REGION OF COMPRESSION MOVES AS A SHOCK WAVE OF SPHERICAL FORM,
4800/FT/S
VI. CHANGES OF PRESSURE REMAINS FOR A MILLIONTH OF SECOND BUT MAY
REACH PEAK VALUE UP TO 100atm.
I.
VII. So damage at a distance from wound track.
VIII. Solid tissues like Muscle, Liver, Spleen & brain are very susceptible.
IX. Conducted particularly well along tube filled tubes like arteries & veins to
cause damage at a distance.
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Shock Waves
Shock waves
…. generated in tissues by high velocity bullets, greater than
2,500/feet/sec
 Last only for 15-25 microseconds
 Are of high energy creating over 1000 lbs/sq inch of
pressure
 Easily rupture gas filled organs
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Types of cavitations
 Temporary:
 Permanent:






High velocity missile
Main destructive effect
Release of energy, absorbed by the local tissue.
Accelerated violently forwards & outwards.
Continue to move even after passage of missile.
A large cavity is produced (temporary cavity), reaches its maximum size,
have sub atmospheric pressure, collapses in a pulsatile fashion and
permanent cavity left.
 Soft tissues pulped, blood vessels disrupted and bone may be shattered.
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Cavitation
…. created by the bullets travelling at speeds > 1000 ft/sec
 Size & shape depends upon the capacity of the bullet to disperse




energy in the surrounding tissues
Tissues are moved forward & laterally away from the bullet
Continues for few milliseconds after bullet has passed
This creates a cavity which sucks air in from entry & exit wounds & may
be 30 times more in diameter than that of the bullet
Permanent cavity if exists is much smaller than the temporary cavity
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M/L Importance of Wound
Ballistics
1- Recognition of Entry & Exit wounds
2- Distance of Fire
3- Direction of fire & Wound track
4- Relative position of weapon/victim & angle of fire
5- Cause of death
6- Manner of death
7- Identification of firearm
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Components of a Shot responsible for damage
1- Shot charge
(bullet/pallet)
2- Flame & heat
3- Hot explosive gases
4- Smoke
5- Wad
6- Unburnt gun powder
7- Grease from the barrel
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 All these elements affect:
I. Body of the victim as signs & symptoms
II. At the place of strike or target produce
characteristic changes
 Result is FIREARM WOUND COMPLEX
 This has two components:
a. Wounding component
b. Non – wounding component
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 Firearm-wound complex has four parts:
1. An entry wound
2. A track with its direction
3. Place of resting of bullet or shot-charge.
4. Exit wound
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ENTRY WOUND
 SINGLE HOLE:
 SIZE : depends upon skin elasticity, tail wag, explosive
blast effect of gases so either proportionate to the
diameter of the bullet, SMALLER or much larger having
STELLATE SHAPE.
 SHAPE: depending upon the angle of firearm with the
target. Circular, Oval, Elliptical, An elongated furrow.
 Inverted margins. May be everted.
 Collar of abrasion: shape depends upon the angle of
firearm with the target.
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FLAME
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BURNING
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SMOKE
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Carbon particles
scattered on
HISTOLOGICAL
examination
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Burning: Few inches in case of
revolver & one foot in case of a
Shotgun
by Naseeb R. Awan
Blackening: Absent after one
yard
by Naseeb R. Awan
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57
TATTOOING
(DUE TO UNBURNT GUNPOWDER
PARTICLES)
“ They pierce under the superficial skin layers causing
punctate abrasions of smaller blood vessels under the
skin “
4/8/2015
Beyond 2 yards,
tattooing is not
present
by Naseeb R.
Awan
58
Un-burnt gunpowder particles pierce the skin while blood
stains are washable
Tattooing
Blood stains
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Skin changes
 Gross splitting: Seen in high velocity bullet & contact
wound of low velocity bullet . Tail wag/range/gas
penetration. BLOW BACK PHENOMENON
 Bruising (at or around entry wound due to general tissue
trauma) MUZZLE IMPRINT, Gases of the blast ballooning
& bruising the skin/Vital reaction / Inflammatory reaction
 Collar of Abrasion: Rub raw of the superficial skin layers
while projectile enters the skin. More prominent in rifled
firearms due to their rotational motion
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Tail wag phenomenon
Medicolegal importance
Atypical firearm entry wounds
Bigger entry wound
X-shaped entry wound
Key hole or slit like entry wound
Multiple entry wounds of a single fire
Skin deep / muscle deep wounds
40
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5/3/2004
Key hole or Slit like entry wound
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Collar Of Abrasion
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Classification of Firearm Rifled Entry wound
depending upon distance/range
Contact entry
wound
Hard/Firm
contact
Loose contact
Close range:
Up to 2 yards
Distant range:
Beyond 2 yards
Near distant:
within six
inches
Intermediate
range:
1 – 2 yards
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FEATURES OF ENTRY WOUND
FIRM CONTACT
LOOSE CONTACT
 Lacks exterior residue.
 As small gap between body &
 No imprints of components of
fire externally.
 Burning, blackening, tattooing
present in the track or interior of
wound or on intervening bone.
 Pinkish discoloration due to
CoHb.
 Muzzle imprint on close
examination.
 Entry wound of variable shape







weapon.
Circular defect.
Collar of abrasion.
Circular soot material.
Tattooing, blackning & burning
in the wound track.
No scorching, singeing
externally.
Muzzle imprint.
Pinkish discoloration
with collar of abrasion.
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FEATURES OF ENTRY WOUND
NEAR DISTANT
INTERMEDIATE RANGE
 Barrel is held close to skin in
 Within 1 – 2 yard




the range of flame & smoke.
Central defect.
Collar of abrasion.
Inverted margins.
Burning, scorching,
singeing, blackening &
tattooing present.
 Hole
 Collar of abrasion.
 Inverted margins.
 Blackening fades.
 Tattooing present
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FEATURES OF ENTRY WOUND:
DISTANT RANGE
 Hole
 Collar of Abrasion
 Grease collar inside the collar of abrasion also
called smudge ring
 No flame & gun powder effect.
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Contact Firearm Entry wound
Stellate Firearm wound
 Muzzle of firearm pressed hard on some hard
bony area as forehead / skull
 Gases can’t enter skull & escape from sides
causing lacerations in the scalp
 Star shaped projections in scalp
 Components of shot present inside skull in the
track
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Close Range Firearm Entry wound
 Examination of clothes is important
 Burning, blackening, tattooing present
 Collar of abrasion present
 Grease collar / Dirt collar may be present
 Margins may be inverted
 Wad maybe present in the track in case of smooth bored
firearm
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Shotgun Cartridge
 Construction:chamber primer/powder/wad/shot
 Shot types Bird, Buck, Slugs
 Pellets Rarely exit
 Variable factors
Range
Gauge
Choke
HIGH ENERGY TRANSFER
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Plastic WAD struck with the wall
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Firearm Exit Wound
 There may be no exit wound
 May be multiple exit wounds of one entry wound due to
Secondary missiles
 May be large typical exit wound with everted margins
 No close range characteristics
 Shored exit wound: Collar of abrasion present
Bullet through a glass
Intermediate
Intermediatetail
tail
wag
wag
Secondary
Secondary
misslies
misslies
25
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5/1/2004
72
Shot gun wounds
 Contact shotgun wound are most destructive
 Bursting rupture of head is rule rather than
exception
 Skull may be largely fragmented leading to
Egg-shell fractures
 Scalp is extensively lacerated
“ The unfavourable ballistic shape of shotgun pallets combined
With lack of stabilizing spin, causes a rapid fall-off in velocity &
Thus Kinetic energy “ by Naseeb R. Awan
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Contact Shotgun wound
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Shotgun Entry wound complex
Fanning
phenomenon
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Pallets traveling in a single mass & wad getting behind
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Shot gun Firearm wounds
Entry Wound
 By contact to 2 ft birdshot
produces a single wound
 By 3 ft there will be Rat-hole
type of entry wound
 By 4 ft scattered satellite pallet
holes
 By 10 ft there is great variation
in type of entry wound
 The diameter of spread of
pallets on body in “inches “ is
roughly equal to the distance
from muzzle in “yards”
 Wad may travel upto 6 ft & may
be found in track of injury
within that distance
 Biliard Ball Ricochetting
phenomenon: Important in
giving distance of fire
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This “cookie cutter” type wound shows a few
separate pellet injuries forming as the distance increases.
This
is not a suicide.
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Loose contact shotgun wound and a larger, more
ragged exit wound.
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Biliard Ball Ricochetting
phenomenon
Misguides
distance of fire
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Important definitions
Beveling of skull bone
 Bone of skull is dipoc (has 2 layers).
 Table which is struck first by projectile is supported from
below so has comparatively small circular hole & clean
margins.
 Table which is 2nd to be struck has no support so has a
bigger irregular hole & beveled margins.
M/L importance
• Gives direction of fire
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Beveled margins
Blackening in the track
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Important definitions
 Birdshot
 Buckshot
 Dustshot
 Blank
ammunition
 Dum dum
bullets
Size of pallet is 2-9
Pallets larger than size 9
Pallets smaller in size
Only powder no projectile present
Either non-jacketed or partially
jacketed. They may expand or flatten
on impact thus increasing energy
dissipation & tissue destruction
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Important definitions
 Ballistic coefficient
 Efficiency of a bullet in overcoming air resistance
 Fragmentation
 Breaking up of a jacketed bullet through some
 Embolised bullets
 Swallowed bullets
 Tandem bullets
bone or non-jacketed bullet through soft tissues
 Bullet gains access to blood circulation & carried
away to distant location
 Bullet that enters GI tract & carried away by
peristalsis
 Bullets remaining in barrel due to defect & then
come out subsequently one after the other
 Ricochetted bullet
 Bullet which deviates from its course by striking
an intermediate object
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DUM-DUM BULLET
A hollow point is an
expanding bullet that has a
pit or hollowed out shape in
its tip, generally intended to
cause the bullet to expand
upon entering a target in
order to decrease
penetration and disrupt more
tissue as it travels through
the target. It is also used for
controlled penetration,
where over-penetration
could cause collateral
damage (such as on an
aircraft).
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Tandem bullet
 Tandem cartridge if used could result in
multiple entrance wounds in a single fire.
 If the first bullet fails to leave the barrel and is
ejected by the subsequent fired bullets,The
bullets are ejected one before the other and
are called as tandem bullets.
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KENNEDY PHENOMENON
 Surgical alteration or suturing of gunshot
wounds creates problem. in this situation the
evaluation of the wound whether it was an
entrance or exit wound becomes difficult.
This phenomenon is called as Kennedy
phenomenon.
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BILLIARD BALL RECHOCHETTING
 Diagnosing long-range injury based on the pattern of pellet spread is
difficult. When shotgun pellets are tightly clustered or widely spread
out, close-range injury or long-range injury (respectively) is usually
suspected. However, in close-range injuries, the billiard-ball effect may
cause considerable pellet spread.16 When the tightly clustered group of
shot at close range contacts the skin, the pellets at the front of the
group are slowed. The pellets behind them in the group strike the
pellets in front, with an effect like a billiard-ball break. This causes much
more pellet spread in tissue than would be expected at close range. On
radiographs, particularly in trunk wounds, this effect can simulate the
pellet spread of a longer-range injury.16 Correlate the physical
examination with the radiologic findings. If there is only one entrance
wound hole, it is a close-range injury. If the distribution of the multiple
skin entrance wounds is the same as the pellet spread on the
radiograph, the injury occurred at longer range.
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Gun Shot Wound in mouth
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Gun Shot Wound in mouth
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Multiple Firearm
Wounds
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Shotgun pellets 1
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Shotgun pellets 2
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Gun Shot Wound on Head
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Groin Gun Shot Wound
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Groin Gun Shot Wound
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Gun Shot Wound on hand
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Gun Shot Wound on hand in x-ray
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Gun Shot Wound on shoulder
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Firearm wounds are one type of wounds you may never
get hold on. Even 1000th case of your professional life
will bring another chapter of mystery & new learning
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THANKYOU !
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