Management of High Velocity Gunshot Wounds in Pediatric Patients-Handout - Management of High Velocity Gunshot Wounds in Pediatric Patients

Handout - Management of High Velocity Gunshot Wounds in Pediatric Patients

Pdf Summary

This document discusses the management of high-velocity gunshot wounds (GSW) in the pediatric population. The presenter, Dr. Eubanks, discusses various aspects of penetrating trauma management, including resuscitation goals and operative decision-making. The physics of penetrating injuries are explained, with different types of projectiles and their velocities described.<br /><br />The document highlights important terms related to ballistics and bullet characteristics, such as cavitation, energy transfer, and wound characteristics. The effects of high-velocity GSW on different types of tissues are discussed, with more elastic tissues (bowel, lung) experiencing less damage compared to less elastic tissues (muscle, liver).<br /><br />Several case presentations are included to illustrate the management of pediatric patients with high-velocity GSW. The first case involves a low-velocity GSW, where a 5-year-old accidentally shot by his older brother requires surgical repair of bowel injuries. The second case involves a high-velocity GSW with multiple injuries, including liver, colon, and bile duct injuries. The surgical approach and repairs performed are described.<br /><br />The final case involves a 7-year-old with a GSW to the right arm and chest, resulting in injuries to the brachial artery, nerves, liver, colon, and bile duct. The timeline of repair and specific procedures for each injury are outlined.<br /><br />The document emphasizes the significance of high-velocity GSW and the extensive damage it can cause. The importance of prompt and thorough exploration of multi-compartment injuries is emphasized, as well as the need for early repair of bile duct injuries. The conclusion highlights the potential severe consequences of GSW in pediatric patients and suggests a proactive approach to surgical management.

Keywords

high-velocity gunshot wounds

pediatric population

penetrating trauma management

resuscitation goals

operative decision-making

ballistics

bullet characteristics

cavitation

energy transfer

wound characteristics