Weapon craniocerebral wounds in peacetime. Features of craniocerebral weapon wounds in peacetime Injuries from pneumatic weapons

Design and interior 20.07.2019
Design and interior

Surface singing of textile fabrics was noted at shot distances up to 10 cm.

Powder particles were observed during shots up to 200 cm. At first they were located near the edges entrance wound, and with distance the targets were scattered over a larger area. Shot metals (mainly copper) were detected at distances up to 300 cm. At short distances, the metallization was continuous, at extreme distances - the appearance of individual points.

The polyethylene guide tip almost always collapsed immediately after leaving the bore, and its fragments had a local damaging, mostly superficial, mechanical effect. The intact tip was capable of causing deep damage to soft tissues at a distance of 2-3 cm. When using cartridges with wads, the latter caused the formation of shallow wounds that did not penetrate beyond the subcutaneous fat.

It should be emphasized that the experiments cited by A.P. Tsykunov were made with SMP brand ZM with cartridges only type B5. Quite naturally, the use of other SMP samples and cartridges of a different power will lead to the appearance of a different morphology of damage, a different effect of the shot products. Therefore, the data presented can be supplemented by published cases from expert practice.

As practice shows, many incidents are associated with the defeat of dowels, ricocheted from solid barriers. Although interaction with the barrier reduces kinetic energy dowel, the remaining energy is enough for penetrating and even penetrating wounds.

When investigating incidents during which damage was caused from the SMP, it is mandatory to conduct a forensic or engineering examination of the serviceability of the SMP and the degree of its compliance technical requirements and documentation. The data of these studies should take into account forensic doctors who solve the following tasks as their main tasks: establishing group signs characteristic of injuries caused by shots from the SMP, reconstructing the conditions for causing damage (direction and distance of the shot, properties of the used projectile-dowel, mutual position of the victim and the SMP in moment of damage, etc.).

The dowel removed from the body during a blind wound was preserved. Forensic research can not only prove the type, type and lot of the used cartridge, but also identify a specific instance of the used SMP.

DAMAGE FROM PNEUMATIC WEAPONS

As emphasized in Chap. 1. Pneumatic weapons, outwardly similar to firearms, are, in fact, not such, since it does not use the energy of powder gases, but the energy of compressed air, to eject a projectile. However, the equipment pneumatic weapon small bullets capable of acquiring when fired initial speed from 140 to 170 m / s and, therefore, a certain damaging energy sufficient to receive even a fatal bullet wound, gives reason to consider the resulting damage in publications devoted to gunshot trauma, primarily because they have to be differentiated from true gunshot wounds.

Air rifles are fired with lead, steel and ceramic bullets of 4.5 mm caliber. Lead bullets are divided into expansion and solid. Common in the design of expansion bullets is the presence of a cavity or recess in the body. When fired, a jet of air, penetrating into such a cavity, expands the body of the bullet and causes it to fit more tightly to the surface of the bore, which ensures the correct movement of the bullet along the rifling of the barrel and reduces air loss. Solid bullets with a monolithic body do not have recesses, belts and other design features. As a bullet, lead balls (usually shot No. 2 and No. 4), as well as bullets made in a home-made or artisanal way from lead or its alloys, can be used.

As follows from the experimental data, bullets fired from an air rifle with a low barrel wear have the highest penetrating power at a shot distance of up to 5 m, and from heavily worn bullets - up to 1 m. a pronounced rubdown belt, the holes have the shape of a truncated cone, with a wide base facing the outlet. In elastic objects, holes have a slit-like or irregularly round shape due to the formation of a tissue defect.

According to V.B. Zhivkovich (1961), when fired from a distance of 3-5 m, in most cases blind wounds of soft tissues are formed, less often bullets bounce, leaving abrasions on the skin, or penetrate into cavities, damaging flat bones, including bones adult skull. The entrance holes are round in shape, the tissue defect is up to 4 mm in diameter, around the hole there is a clear closed belt of sedimentation up to 1.5 mm wide, and along its peripheral edge there is an even, but not always complete, rubdown belt. A small area of ​​lead deposition detected using the method of color prints and the absence of other signs of a shot (soot, gunpowder), regardless of the distance of the shot, make it possible to distinguish damage from an air rifle from damage from small-caliber firearms [Movshovich A.A., 1972].

During x-ray examination in the area inlet irregularly located rather large lead particles are visible, and when examined under the rays of a mercury-quartz lamp using a Wood filter, a blue fluorescence of an oil ring appears around the inlet on the skin.

The exit holes, which were observed extremely rarely, as well as with ordinary gunshot injuries, are slightly larger than the diameter of the bullet with uneven, ragged edges. GV Merezhko and Yu.A. Karnasevich (1991) carried out experimental work on the study of damage to biological objects and their non-biological imitators after being hit by shots from air rifles.


We began to study peacetime gun wounds (PTWR) in 1990. This is due to the fact that until 1990, no more than two wounded patients were admitted with PTWR per year, which is why they did not represent a problematic interest. After 1992, the number of such wounded increased sharply, which required a focus on the features of the diagnosis and treatment of such victims.

Gunshot wounds. Gunshot wounds are wounds inflicted from any firearms or device (pistol, gun, gun, mine, improvised firing device, etc.), the projectile from which (regardless of its type: bullet, gas, shot, "chop", fragments primary or secondary, etc.) is ejected by means of an explosion explosive(gunpowder, plastic, dynamite, etc.).

Weapon wounds. Weapon wounds mean wounds inflicted from any non-firearm weapon or device (bow, crossbow, wind (pneumatic) gun or pistol, speargun, production device (dowel), etc.), the projectile from which, regardless of its type (bullet, arrow, metal rod, etc.), is released by means of any throwing device that is not associated with an explosion (spring, bowstring, compressed air).

We explain the sharp increase in the number of such victims with the criminalization of Russia, when disputes between individual groups of "business" began to be resolved not on the legal, but on the criminal field, and the stratification of society into the very poor, the poor and the very rich gave rise to flourishing banditry. The acquisition of firearms (including service weapons) is not difficult.

In peacetime, in the first two hours after being wounded, 78.8% of the wounded enter the neurosurgical hospital, and after 7 hours from the moment of injury, they do not arrive at all, or such admissions are single and amount to tenths or hundredths of a percent.

This leads to two fundamental provisions:

  • in neurosurgical hospitals, in peaceful and war time, the structure of the wounded (in terms of type and severity of PMR) is different;
  • Specialized medical care in peacetime is provided faster than during war.

    The rapid, within the first hours, delivery of the wounded to the neurosurgical department leads to the fact that the wounded, who die on the battlefield in wartime, end up in a specialized hospital. These are usually victims in a coma with radial, diametrical (completed or incomplete) wounds, as well as injuries of the posterior cranial fossa. These injuries (especially the posterior cranial fossa) are classified as very severe. In addition to unusually severe gunshot craniocerebral wounds inflicted from service weapons, there are other features of gunshot wounds in peacetime.

    The features of gunshot wounds in peacetime include wounds from a gas pistol. Shots are usually fired either at close range or from a short distance (1-2 meters). In this case, especially if the injury is inflicted in the area of ​​the scales of the temporal bone, it can be penetrating and accompanied by damage to the brain not only by charge particles (wad-type pads) or bone fragments, but also by the charge itself (gas). The degree of damage to the brain by the charge depends on the composition of the gas (tear, nerve, etc.). Such an injury may be accompanied by the development of specific encephalitis, and a purulent infection that has joined can significantly aggravate the condition of the wounded.

    Also specific are the OCMR, applied from a smooth-bore: long-barreled - hunting rifles or short-barreled - converted to a gas pistol shot charge, or a foreign-made shotgun. The charge of such a pistol most often contains shot number 9 - "snipe".

    Wounds inflicted from a short distance (up to 2 meters) can be penetrating and be accompanied by damage to the dura mater and brain substance, both by the charge itself and by bone fragments. A shot charge usually does not penetrate deep into the brain; it is located compactly in the cortical regions of the brain, although individual pellets can also penetrate deep enough into the white matter.

    The severity of gunshot wounds inflicted by hunting long-barreled non-rifled weapons depends on the caliber of the gun, drilling of its barrel (cylinder, choke, pay) and charge (shot, bullet). Shot of various calibers is used here, most often No. 3 and larger, up to buckshot. Such a charge, released from a short distance, when it hits the human body, behaves like an explosive bullet, causing a deep, lacerated wound with massive damage to the brain substance.

    Other wounds are also possible, inflicted from self-propelled guns, usually made by handicrafts and teenagers. Such a device is a metal smoothbore tube, tightly sealed on one side (breech) and having a hole for the fuse. The powder charge can be either gunpowder (most often hunting or extracted from live ammunition), as well as a home-made explosive (a mixture of saltpeter, crushed coal, sulfur, potassium permanganate powder and other ingredients in an arbitrary proportion). The weapon is extremely unstable, dangerous to use, often explodes in the hands of the shooter. The imperfection of such a weapon leads to the fact that almost equally often both the charge (“chop”, shot, steel balls) and the breech (the last in the head of the shooter) fly out of it.

    When fired at close range, a gunshot wound is complicated by thermal and chemical burns, especially if potassium permanganate is included in the explosive mixture. Such burns can lead to toxic encephalitis, which is difficult to treat.

    Penetrating wounds to the skull can occur when fired from "harmless" non-firearms. Such injuries are quite common when fired at close range from a pneumatic (“wind”) weapon, especially if it is loaded with steel balls or lead bullets, and the weapon is automatic and several charges hit the head at once (especially in the scales of the temporal bone).

    No less serious craniocerebral wounds can be wounds inflicted by an arrow fired from a bow. An arrow fired from a crossbow can pierce through the chest of an adult elk. Getting into the human skull, it can cause a diagonal (radial) penetrating wound of the skull.

    There are two main tasks in the diagnosis of PTSD:

  • assessment of the general condition of the wounded and the identification of life-threatening disorders and
  • definition of the very nature of the PTSD.

    Under all circumstances (the ability to quickly after injury) the provision of specialized medical care is of paramount importance.

    The main principle of surgical treatment of gunshot wounds of the skull and brain is their early, radical sanitation by primary surgical treatment with the removal of all foreign bodies, liquid blood and blood clots, brain detritus and necrotic brain tissue with active wound drainage, free dura mater plasty and wound suturing tightly (around the drain).

    During surgical primary treatment of a gun wound, it must be remembered that the most infected foreign bodies of the brain (during the first half of the year) are bone fragments, headgear particles, and not the bullet itself. Therefore, the actions of the surgeon should be aimed at removing all foreign bodies. Chasing the "bullet" is not an end in itself of the operation, although its removal (along with other foreign bodies) is desirable. In addition, we should not forget that the wound channel is not a smooth-walled tube. Due to the fact that when passing through the brain, a temporarily pulsating cavity arises, cracking of the brain occurs at a distance from the main wound channel. As a result, from the main wound channel, along its entire length, many microcracks extend into the depths, into the substance of the brain. These cracks are infected as well as the main wound channel.

    It should also be borne in mind that foreign bodies (bone fragments, hair, parts of a headgear, etc.) at the inlet penetrate deep into the skull and brain, and at the exit, on the contrary, into soft tissues, into the integument of the skull. The bulk of foreign bodies (except for a bullet) is concentrated in the cranial cavity at the inlet at a depth of up to 5-7 cm. The pursuit of individual pellets located in the depths of the brain, in its nuclei or ventricles, is far from always appropriate. It should be borne in mind that in this case, the surgical intervention itself can cause more trauma than the gunshot wound itself. At the same time, the more radically the primary surgical treatment of a gunshot wound was performed, the less chances of purulent complications (meningitis, meningoencephalitis, brain abscess, purulent ventriculitis) - one of the main causes of mortality in PMT.

  • Veterinary clinics located in large cities and in rural areas regularly encounter gunshot wounds to animals. The weapons used vary to some extent depending on the terrain. Light firearms are more common in large cities and their suburbs, while rifles and hunting rifles are more common in rural areas. Gunshot wounds inflicted by smoothbore airguns and airguns with rifled barrel are most likely the result of teenage shootings.

    Pointed bullets or spherical bullets (balls) fired by firearms can have a different diameter (caliber), mass (weights), material composition, shape, design and speed. The ballistics of a particular bullet, i.e. the characteristics of its flight, from its movement along the barrel to the final passage through the target, also differ depending on these variables. As a result, the severity of tissue damage varies depending on the characteristics of the bullet, the kinetic energy absorbed on impact, and the tissue being impacted by the pointed bullet.

    Bullets usually contain a lead core and can be made with an outer jacket (or jacket) to control bullet deformation. Partially jacketed bullets contain an exposed lead core - the shape and design of the exposed lead end can be modified to increase bullet deformation or fragmentation on impact. For example, hollow areas or grooves increase the ability of the bullet to flatten, thereby slowing its movement through the target and increasing the absorption of the kinetic energy of the bullet, which causes more severe tissue damage. Bullet fragmentation also increases tissue destruction as the bullet penetrates tissue or travels through tissue.

    The destructive potential of a bullet is determined by its kinetic energy.

    Kinetic Energy (KE) = Mass x Velocity2/2

    Doubling the mass of a bullet doubles its kinetic energy, while doubling its speed quadruples its kinetic energy. Bullets can be classified according to their speed: low-velocity (less than 1000 fps), medium-velocity (1000 to 2000 fps), high-velocity (more than 2000 fps). Most light firearms are in the low to medium velocity range, while most ball guns are in the medium to high velocity range. With increasing speed, the destructive ability of the bullet also increases.

    When a bullet strikes tissue, it causes damage through several processes: tissue tearing and crushing, shock wave, and cavitation. The bullets move at low speed through the tissue in a straight line, creating a stable wound channel. Only tissues in direct contact are affected, and tissue damage is predominantly tissue crushing or tearing. High-velocity bullets cause significant tissue damage. As the bullet travels through tissue, it transfers energy to nearby tissue, causing high frequency shock waves and cavitation.

    Cavitation is a short-term rapid expansion or swelling of tissues located near the trajectory of the bullet, and the width of this area can be 30 times the diameter of the bullet.

    The shock waves generated during the movement of the bullet compress and stretch the tissues located on the sides and in front of the bullet. This momentary phenomenon also creates a vacuum effect that can suck impurities deep into the wound. Tissues are destroyed, regional blood circulation is disrupted, and soft tissues located outside the bullet's path can be severely damaged. The risk of infection is higher with injuries caused by high-velocity bullets due to extensive tissue damage and circulatory failure.

    During the flight, bullets can lose stability and deviate from the longitudinal axis. As a result, before hitting the body area, the bullet may deviate from the course and begin to tumble, thereby increasing the profile of its contact during movement through the tissues. The tumbling of high-velocity bullets increases tissue destruction and can increase bullet fragmentation, further increasing tissue damage. Bullets bouncing off a hard surface (ricochet) can warp and tumble, so they have the potential to inflict more severe wounds despite reduced velocity. Tissue destruction is greater if all of the bullet's kinetic energy is absorbed, compared to a bullet that has passed through a body site and exited relatively intact.

    Shotguns are capable of firing round pellets, the size and quantity of which can vary. The shot pattern usually expands as you move away from the barrel and has a conical configuration. Compared to a single bullet, at a similar range of velocities, a shotgun is capable of generating tremendous kinetic energy and causing massive tissue destruction due to the concentrated density of the pellets and the coverage of a large target surface area.

    The relative elasticity of the tissue affects the severity of tissue damage - elastic tissues that can stretch better withstand gunshot trauma than less elastic tissues. Dense tissues such as bone absorb most of the bullet's kinetic energy; in turn, the bone fragments can travel into the surrounding tissue as secondary bullets, causing additional damage. The skin and lungs have more pronounced elastic properties and are more capable of absorbing the kinetic energy of the bullet. Although skeletal muscle and liver tissue are of the same density, the liver is more resilient, making it more vulnerable to rupture or delamination, particularly due to the cavitation effects of high-velocity bullets.

    In many cases, the pet owner is unaware that their pet has been shot. Most injuries occur when a pet runs away or is left unattended and can be mistaken for bite wounds or car accidents. High-velocity bullets are more likely to pass through most soft tissue without leaving obvious metal fragments visible on x-rays. Wounds that are on opposite sides of the animal or appear to be visually oriented (entrance and exit wounds) should be the most suspicious.

    Most animals with gunshot wounds are admitted through the ambulance service, so if the patient is unstable (if necessary), emergency measures must be taken. A complete set of x-rays of the affected area of ​​the body should be obtained. If penetrating wounds are found with one or more bullets, then additional x-rays should be taken cranially and caudally relative to the inlet and outlet.

    The definitive diagnosis of a gunshot wound is often difficult, except in cases where metal fragments of the bullet are preserved in the wound. In patients with severe injuries, it is recommended to determine the expanded blood count and serum biochemical profile, which will help assess the patient's condition and identify organs that could be damaged by a bullet.

    Depending on the location and nature of the wounds, ultrasonography, pulse oximetry, electrocardiography, and blood gas analysis may be used to further assess the condition of a critically injured patient.

    Once life-threatening injuries are identified and the patient is stabilized, a thorough examination of the wound area should be performed. For some wounds, assessing the severity of the injury can be difficult. Initial wound cleaning, light debridement, and temporary dressing of the wound are preferred over aggressive wound debridement, as they allow time for tissue damage to stabilize more. Immediate aggressive debridement in these cases may result in the removal of tissue that was actually viable but in vascular stasis. Sedating or anesthetizing a patient for a procedure that may need to be repeated later may create unnecessary risk for the patient. The level of tissue damage can usually be adequately assessed within 24 hours. During this waiting period, wound support with dressing and analgesia should be provided and systemic antibiotic therapy initiated. The most common bacteria found in external wounds are coagulase-positive staphylococci and Escherichia coli.

    In the case of patients with severe trauma or severe pain, sedation may help to adequately clean the wound. Trimming the hair around the wound makes it easier to assess the wound. Placing a sterile water-soluble gel in the wound or filling the wound with a sterile saline-soaked dressing prevents further contamination of the wound with hair. Hair from the edges of the wound can be removed using scissors, the blades of which are coated with a sterile gel to trap the hair. Tap water has been shown to be cytotoxic to fibroblasts, but can be used in case of severe contamination. If contamination is minimal or moderate, initial wound cleaning can be done using sterile saline or a diluted antiseptic solution (1:9 dilution of povidone-iodine or 1:40 dilution of chlorhexidine). Since the physical aspect of rinsing is of primary importance, antiseptic solutions may not be necessary; it depends on the level of pollution. Appropriate pressure (4-15 psi) can be applied with a 20 ml syringe and 18 gauge needle. More high pressure can lead to the movement of debris and bacteria into the depths of the tissues, and not to their removal. Small hemostatic mosquito clips can be used to gently dilate the wound to help flush and drain the area. A careful examination (probing) of the wound should be performed to assess the affected tissues and the extent of damage. Wounds located above body cavities must be examined very carefully to prevent accidental contamination of deep tissues or opening of the pleural or peritoneal cavities. During the initial examination of the wound, sterile instruments and aseptic technique should be used, regardless of the degree of contamination of the wound. If possible, a sterile dressing should be applied to the wounds. The frequency of dressing changes depends on the amount and type of discharge. It is not recommended to suture wounds to allow drainage during the wound healing process. Periodic debridement of the wound may be required until a healthy granulation bed is formed.

    Lead poisoning is rarely seen with trapped bullets, as they are usually surrounded by connective tissue over time. Removal of bullets should only be considered if they are easily accessible and their removal does not pose additional risk to the patient.

    Most bullets are capable of causing bone fractures, depending on the mass and velocity of the bullet, the amount of muscle surrounding the bone, and the area of ​​impact (tubular bone versus cancellous bone). Softer cancellous bone is less susceptible to fragmentation. High-velocity bullets are capable of crushing bone, directing fragments into adjacent soft tissues and increasing tissue destruction. Penetration of bullets into the joints requires arthrotomy to remove metal fragments and fragments of cartilage and bone. Lead slowly dissolves in joint fluid and is absorbed into the systemic circulation over time.

    In the stable patient, radiography is usually followed by wound examination, debridement, and copious lavage. Fracture stabilization depends on the individual fracture, but maintaining blood flow to local tissues and bone segments is critical to a positive outcome. Extensive dead space is usually treated using a closed suction drainage system. In the case of extensive trauma to the limbs, amputation may be appropriate.

    Most patients with severe gunshot injury the brain is usually euthanized. However, for many patients with minimal neurological impairment, supportive care and antibiotics may be sufficient. a wide range actions.

    Patients with suspected spinal injury should be immobilized to prevent movement. A complete neurological examination is recommended prior to sedating the patient, but care should be taken when interpreting the results of the neurological examination if the patient is still unstable. X-rays and CT scans are used to assess the severity of the injury and determine whether fracture stabilization or spinal cord decompression is necessary.

    Bite wounds

    Bite wounds in dogs and cats account for 10% to 15% of all veterinary injuries, although the exact incidence is unknown. All bite wounds should be considered contaminated, whether they are open (penetrating the skin) or closed (crushing the skin). The most common pathogen found in culture is Pasteurella multocida. The jaws of dogs can develop pressure from 150 to 450 psi. inch. Canine incisors and canines can apply shear forces to the skin if they act perpendicular to the surface of the skin and cut tissue sharply. At angles less than 90 degrees, tensile forces can cause skin avulsion, as well as hernia and necrosis of the underlying tissues. Compressive forces are caused by the classic puncture wounds left by canine fangs or crush wounds left by premolars or molars.

    The unique pathological results (in the case of bite wounds) are due to the penetration of elastic skin into less elastic underlying tissues with damage to the large direct cutaneous artery and vein and impaired collateral blood supply. Lifting and shaking the skin often results in seemingly innocuous superficial injury with the potential for severe damage to deeper tissues and underlying organs (the so-called "iceberg effect").

    Multiple and severe bite wounds can cause systemic inflammatory response syndrome (SIRS), in which overactivation or loss of local regulation of inflammation leads to a generalized immune response. After the inflammatory stage, wound healing will not occur until dead or infected tissue is removed from the wound and the presence of such tissue potentiates SIRS.

    Bite wounds, depending on their severity and anatomical position, can cause a wide range of life-threatening problems. All patients with bite wounds should be evaluated for cardiovascular or respiratory abnormalities. It is necessary to determine the degree of hemodynamic disturbances and correct them by intravenous administration of electrolytes, colloidal solutions or blood products. Vessels that continue to bleed despite pressure bandages should be found and ligated. Extremities, head and neck are the most common sites of bite wounds followed by tissues chest or belly. Perineal wounds are the least common. Among small breed dogs, chest and abdominal wounds are the most common.

    Bite wounds should be examined to assess the degree of injury to the underlying organs. Before an aseptic surgical operation, the hair on a large area around the bitten wound should be cut off, the skin should be treated and covered with sterile napkins. In the case of chest and abdominal wounds, the operating field should be large enough to allow thoracotomy or exploratory laparotomy to be performed if necessary.

    The viability of the bitten limb can be assessed by the color of the damaged tissue, the temperature of the limbs, by the presence of bleeding from a cut claw on the hind paw (with sufficient systemic blood pressure), as measured by peripheral pulse oximetry or Doppler ultrasonography, interdigital membrane temperature measurements, or selective angiography.

    Puncture wounds can be surgically excised by creating an opening into which a sterile hemostatic material can be placed or a gloved finger can be inserted in order to spread the underlying tissues and gain access to the skin, fascia, and muscles. Wounds with little or minimal tissue trauma may be left open for drainage and healing by secondary intention, or closed with skin sutures after careful lavage. In case of more contaminated wounds, hair is removed and foreign material. Crushed or necrotic muscles, fat and fascia are excised. Ideally, wound debridement is carried out in one stage. If there is loose skin on the neck or torso, more aggressive debridement is possible. The limbs need a more conservative approach.

    Each bite wound must be considered individually, taking into account how long ago the injury was inflicted, the severity of the injury, whether a single wound or several wounds, the degree of contamination and the quality of the blood supply. Delay wound closure if in doubt. In bite wound closure, extensive local excision of all contaminated and injured tissue allows standard closure without dead space, without undue tension, and with minimal use of absorbable suture material. If there is any doubt about the condition of the tissues, then a drain should be installed. An alternative may be a delayed primary closure with alternating wet and dry dressings for 3-5 days, which will distinguish between viable and non-viable tissues.

    Wound healing by secondary intention healing should provide the benefits of granulation, contraction, and epithelialization with optimal wound drainage versus the length and high cost of wound treatment, the risk of over-joint scar contracture leading to joint dysfunction, and the potential for poor cosmetic outcome. Drainage is needed to prevent dead space and seroma formation. Depending on the wound, simple straight incisions, passive drains, or active drains should be used.

    In the presence of infection, aerobic and anaerobic cultures of the wound discharge are recommended to select appropriate antibiotics. Cultures from acute, uninfected bite wounds are not useful for identifying potentially infectious organisms. It is best to choose broad-spectrum bactericidal antibiotics. The antibiotics of choice are intravenous penicillin or penicillin derivatives. Fluoroquinolones can be used against resistant Gram-positive and Gram-negative infections. Antibiotics are not a substitute for appropriate surgical management of bite wounds.

    // Mat. VI All-Russian. congress of forensic doctors. - M.-Tyumen, 2005. - S. 55.

    On the possibility of causing life-threatening injuries when fired from a gas-cylinder pneumatic pistol

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    On the possibility of causing life-threatening injuries when fired from a gas-balloon pneumatic pistol / Breskun M.V., Namakonov A.I., Maltsev S.V. // Mat. VI All-Russian. congress of forensic doctors. - M.-Tyumen, 2005. - S. 55.

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    One of the conditions that make up human security is the ability to protect one's own life and health. One of the ways is the possibility of using special means permitted by law. In 1996, the State Duma adopted the Federal Law of the Russian Federation "On Weapons", aimed, in particular, at protecting the life and health of citizens, property, and ensuring public safety. The law regulates legal relations arising from the circulation of civil, official, as well as military hand-held small arms and edged weapons on the territory Russian Federation. So citizens of the Russian Federation have the right to acquire, without obtaining a special license and registration, pneumatic weapons with a muzzle energy of not more than 7.5 J and a caliber of up to 4.5 mm inclusive. Such weapons are classified by law as pneumatic and are designed to hit a target at a distance with a projectile that receives directed movement due to the energy of a compressed, liquefied or rejected gas (which is hallmark him from firearms).

    The availability of legal purchase of airguns is causing an increase in the number of cases of injury caused by firing from them. In the available literature, there is information about the occurrence of damage during shots from spring-piston samples of pneumatic weapons, however, there are rare cases of publication of observations of damage during shots from gas-balloon samples (Lotter M.G., Konovalov A.I., 2003).

    We carried out experimental shots from a pneumatic gas-cylinder pistol of the A-101 brand, which satisfies the conditions without registration and unlicensed purchase. This pistol model is designed for target shooting during training, training and sports shooting in open areas and indoor shooting ranges. The gun is a pneumatic device in which an autonomous source of carbon dioxide (a cylinder with 12 g of CO 2) is used to throw steel (copper-plated) or lead balls weighing 5.5 g with a caliber of BB CAL (4.5 mm). The muzzle velocity of the projectile at an ambient temperature of 18 ± 5 0 C is 140 m / s, and muzzle energy- less than 5 J. Magazine capacity 15 balls. The number of shots from one cylinder is at least 50. The dangerous firing range is 300 m.

    In total, we made 21 shots in the area of ​​the head, chest, anterior abdominal wall and thigh of the corpse of a man of average build with satisfactory nutrition. The distance varied from the distance of a tight stop to 15 meters.

    During the shots, blind wounds were received with signs of entrance gunshot wounds - they had defects in the “minus” fabric and belts of deposition. The edges of the defects were wavy with multiple radially outgoing breaks. Sedimentation had an annular shape and a diameter of 0.2 cm to 0.4 cm.

    Shots in the head were made from a distance from a tight stop up to 2 meters in the left temporal region and in the face. Wounds of the scalp penetrated through the aponeurosis and, depending on the thickness of the bones, either left a rounded impression on the outer bone plate, or pierced it, the diploe, and the inner bone plate with the formation of a typical perforated gunshot fracture. In one observation (when fired from a distance of 2 m), the projectile pierced the large wing of the sphenoid bone along the parietal surface, penetrated into the cranial cavity with damage to the hard shell, and was found above the bifurcation of the basal artery. The depth of the wound canal was 9 cm; the middle cerebral artery was damaged along its course. In other cases, when projectiles penetrated into the cranial cavity, they were located in the epidural space.

    When shot in the face from a distance of 0.5 m, the shells penetrated into the cavity of the orbit without damaging its walls, as well as into the maxillary sinus with damage only to the front wall.

    In the region of the left half of the chest of the corpse, 8 shots were fired from a distance from a tight stop to 3 m. In all cases, the wounds penetrated into the pleural cavity. When shot from a distance of up to 0.5 m and hit in the rib, through perforated fractures of the ribs, blind and through damage to the lung tissue were found. In one case, damage to the adventitia of the aorta was recorded in the form of a limited hemorrhage under the serous membrane.

    5 shots were fired into the abdomen from a distance of 6 to 15 m. In three cases, when shots were fired from 6-10 m, through injuries of the anterior abdominal wall were obtained, in one case with a through injury to the anterior wall of the body of the stomach. In one case, the wound penetrated only into the subcutaneous fat and muscles.

    The wound channels in the thigh area were blind and penetrated into the muscles to a depth of 15 cm.

    During the experiment, a decrease in the damaging ability of shells with an increase in the number of shots was noted, which is explained by a decrease in gas pressure in the cylinder. It was also found that the pressure of the gas in the cylinder also decreases when the weapon is stored.

    Thus, taking into account the experimental data, it should be recognized that there is real opportunity causing life-threatening injuries when fired from an approved airgun.

    They are quite popular for amateur shooting or as a self-defense weapon.

    This is facilitated by the fact that pneumatics are relatively easy to buy. It is worth noting that any weapon requires certain skills and knowledge for the normal use.

    For example, a shot from a short distance may well kill a person. At the same time, now you can easily go to jail for several years.

    Moreover, according to the Ministry of Internal Affairs, air guns kill more people than hunting rifles. In most cases, this happens through malicious intent, and not because of unsuccessful self-defense.

    An air pistol does not need (if the muzzle energy of the air pistol is less than 7.5 J). Due to the lack of difficulties when buying pneumatics, such a pistol is purchased not only by the townsfolk for self-defense, but also by attackers to commit attacks or murder.

    The effectiveness of pneumatics for self-defense


    According to research, even a few rubber bullets can't always stop an attacker.

    This may be due to the large distance or low power of the traumatic weapon model.

    The attacker's outerwear also reduces the effect of shots. At the same time, each painful blow can only anger the attacker, which will only lead to a worsening of the situation.

    Not many cases have been recorded when the victims managed to fight off the criminals with the help of traumatic weapons. But in the case of an air pistol, the chance to fight off an attacking person is much higher.

    However, the attack often occurs at night in dimly lit areas, so it is very difficult for a defending person to hit an intruder, and defense with a weapon can provoke the attacker to use another type of weapon, for example, or traumatic pistol.

    It is worth visiting a special shooting gallery at least once every few months to learn how to shoot from a pneumatic gun.

    Such periodic training will help you feel more confident when you need to use a gun.

    In addition, the accuracy of shooting will improve.

    This will increase the chance of hitting an intruder, but will greatly reduce the chance of causing injury to him, which will lead to lethal outcome.

    Take into account: if necessary apply air gun, is best aimed at the legs.

    If hitting this part of the body does not work or it is protected by tight clothing, you need to aim at the hands. The main task of self-defense is to cause a traumatic shock in the attacker due to injury, but not to cause severe harm.

    The most dangerous parts of the body - scheme

    There are several areas of the human body that, if hit by airguns (especially from a short distance), can cause serious injury or death:

    1. Eyes.
      A shot to the eye can seriously injure this organ, and this damage can lead to blindness.
    2. Temple.
      Hitting the temple with any object can lead to death.
    3. Heart.
      A strong point blow to this area can cause cardiac arrest.

    It is worth avoiding getting into these areas of the body, as the consequences can be very serious.

    In any case, before using a pneumatic weapon, you should try to assess the situation and try to do without a weapon.

    For example, you can start hitting nearby cars on the wheels. This will cause an audible alarm to sound, which will draw attention and the attacker may be afraid to attack.

    Thus, the air pistol is dangerous! The use of airguns may well lead to death.

    Therefore, you can not treat him as a simple "scarecrow". Shooting range training will help increase your shooting efficiency and reduce the chance of accidentally killing your attacker.

    Watch the video, which tells what injuries and wounds air weapons can cause to a person and what factors the damage depends on:

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