Gunshot wounds: A review of ballistics, bullets, weapons, and myths

Gunshot wounds are, by any definition, an epidemic in the United States. We as health care providers need to know about the truths regarding guns, their ballistic bullets, and gunshot wounds. We have to address this silent injury as we seem to ignore it because of its common daily occurrence. Suicides by guns are a major factor in the number of deaths from guns. People attempt suicides everywhere in the world but are particularly successful in the United Stated because guns are ubiquitous. The statement "Guns don't kill people, people kill people" may be true; however, it is difficult to kill with an ineffective weapon. Availability of a potentially lethal weapon will increase injury severity. The United States has more guns available than most of the other countries in the world and has more gunshot wounds per annumthan any other country in the world not involved in awar within its borders. It is indisputable that where there are guns, there will be gunshot wounds, and where there are more guns, there are more gunshot wounds than where there are no guns. More than 33,800 deaths are reported because of firearm-related injuries in the United States per year, making it one of the top 10 causes of mortality in our country. The rate of firearm ownership per capita in the United States is the highest in the world, which is almost double that of the second highest country on earth. In addition, firearm-related injuries also negatively burden the financial system, costing US citizens approximately $100 billion annually. A relative lack of firearm legislation in the United States has been thought to contribute to the burden of firearm-related injuries. The understanding ofwhy our country has so many firearms and what the effects in comparison with other countries and societies is hampered by the (some would say intentional) lack of funding on this topic. Because of concerns regarding increased government controls on freedom and guns, federal-funded research that attempts to understand this problem, firearm injury, epidemiology, violence, and injury prevention is minimal. Pressure exerted by the National Rifle Association, the gun lobby, and even some gun owners apparently is highly effective in preventing research to study or any effective legislation to help understand and perhaps change the course of this epidemic. People do kill people, but guns are a major factor in this ability.We have to address numerous issues to prevent gunshot wounds including the costs, regulation of weapons, mental health issues, and better enforcement of current regulations while balancing these needs with citizen's rights. As firearms are ubiquitous in our country, knowledge of their wounding power is paramount in the care of the wounded patient.