When did a denim jacket become a bullet proof vest?

[TGO David]

Daddy O:____________

Lotsa dead commies in eastern europe in WW2. Lots of em wearin big coats. Like you;

i'm skeptical of the "pundits". The military is the place to look if you want to see

whow this stuff works on a day in day out basis.

Leroy

Disagree. The law enforcement community is a better indicator of what works on a daily basis in the sort of settings you are likely to be exposed to. Unless you are personally somehow bound by the Geneva Convention in respect to ammo choice, or the government issues you your weapon(s), your own gear selection shouldn't necessarily be swayed by what the military uses.

And as for the Russians in their big heavy coats... logic would seem to dictate that the South Pole parka worn by the hoodlum holding you up at the ATM has very little in common with the construction of whatever garments the Russians were wearing during WWII.

All things being equal, nothing here is equal.

[MikePapa1]

Deltoid

Death rate from handgun, long guns and knife wounds

Peter H. Proctor writes: 2) The main factor was apparently the substitution of handguns for long guns as home defense weapons. For penetrating trunchal wounds, the mortality rate for handguns is 15-20 %, roughly the same as for equivalent knife...

Death rate from handgun, long guns and knife wounds

Category: knives

Posted on: February 24, 1997 1:26 AM, by Tim Lambert

Peter H. Proctor writes:

2) The main factor was apparently the substitution of handguns for long guns as home defense weapons. For penetrating trunchal wounds, the mortality rate for handguns is 15-20 %, roughly the same as for equivalent knife wounds. For (e.g) shotguns, the mortality rate is 70% or so. If memory serves, for high power rifles, about 30-40 %, BTW, the mortality rate from those wicked "assault weapons" is close to that for handguns, since they shoot a relatively low-powered round

Please provide a source for these claims.

This is what I was taught in my training as a pathologist and seem to be pretty standard figures. Also, I saw roughly these figures presented at a Path convention and see no reason to question them. But I suppose I could find the reference somewhere.

Please do so. I've appended about 20 studies that all contradict this.

I looked in Medline for studies on gun shot and stab wound mortality and turned up dozens. There was a consistent pattern across different countries and wound locations -- gunshot wounds were far more lethal. For example a study in The Journal of Trauma (36:4 pp516-524) looked at all injury admissions to a Seattle hospital over a six year period. The mortality rate for gunshot wounds was 22% while that for stab wounds was 4%. Even among patients that survived, gunshot wounds were more serious -- the mean cost of treatment for these patients was more than twice that for stab wounds.

Apples and Oranges. I suspect the difference is " for equivalent trunchal wounds" which I carefully specified.. If you include superficial knife wounds and wounds that do not penetrate the peritoneum, your figures do sound about right. These are easy to treat and nobody ever dies from them.

Sorry, as I specifically stated those rates were for wounds serious enough to warrant hospital admission, not superficial ones. Further, the other studies mostly looked at equivalent wounds in equivalent locations. Without exception, gunshot wounds were more serious and more likely to lead to death. I've appended the abstracts of the studies from Medline.

But wait until you penetrate a viscous or ( especially ) cut a great vessel. The lesser energy involved in knife wounds is more than made up for by their larger size.

This does not seem to be the case. See the attached studies.

As for handgun vs long gun wound mortality, I suggest you look at table 5.10 of "Point Blank" which presents the results of a multivariate analysis based on NCS and SHR data and shows no significant difference.

Er, this just does not sound right. Long guns ( particularly shotguns) are much more destructive than handguns. Compare about 200 ft-lbs for 38 Special to 2000 ft lbs for a high-power military round.

The kinetic energy of the projectile is obviously not the only thing that matters.

One possibility---These figures are for people who actually make it to the hospital alive.

No. They are are based on the the NCS (victim survey) for the number and type of woundings and the FBI's supplementary homicide reports for the number and type of deaths.

Date: 21-Feb-97

Name: T13752_8Nbgjvm

Database: Medline <1992 to January 1997>

Set Search Results

---------------------------------------------------------------------------

001 *wounds, gunshot/ 1071

002 *wounds, stab/ 293

003 1 and 2 52

004 from 3 keep 6,9,11,17,21-22,25,27-30,33-36,43-44,47-48,50-51 21

1. Authors Muckart DJ. Meumann C. Botha JB. Title The changing pattern of penetrating torso trauma in KwaZulu/Natal--a clinical and pathological review. Source South African Medical Journal. 85(11):1172-4, 1995 Nov. Abstract The number of patients who sustained penetrating torso trauma and were admitted to King Edward VIII Hospital and the surgical intensive care unit were reviewed over 10- and 5-year periods respectively. For the last 4 months of 1992, a comparison was made between victims of trauma admitted to hospital and those whose bodies were taken directly to the South African Police medicolegal laboratories in Gale Street, Durban, where the majority of medicolegal autopsies in the Durban metropolitan area are performed. The total number of hospital admissions has not changed during the last decade, but the aetiology of injury has altered considerably. Stab wounds have declined by 30% whereas gunshot wounds have increased by more than 800%. The ratio of stab to gunshot wounds admitted to the intensive care unit reversed within the 5-year period 1987-1992. Direct admission to the mortuary was three times as common in cases of gunshot compared with stab wounds. The hospital mortality rate for gunshot wounds was 8 times that for stab wounds. The establishment of dedicated trauma centres is essential for the treatment of these injuries, and strategies to control the use of firearms are vital.
   
2. Authors Heary RF. Vaccaro AR. Mesa JJ. Balderston RA. Title Thoracolumbar infections in penetrating injuries to the spine. Source Orthopedic Clinics of North America. 27(1):69-81, 1996 Jan. Abstract A detailed review of the TJUH experience and the published literature on gunshot and stab wounds to the spine has been presented. The following statements are supported. (1) Military (high-velocity) gunshot wounds are distinct entities, and the management of these injuries cannot be carried over to civilian (low-velocity) handgun wounds. (2) Gunshot wounds with a resultant neurologic deficit are much more common than stab wounds and carry a worse prognosis. (3) Spinal infections are rare following a penetrating wound of the spine and a high index of suspicion is needed to detect them. (4) Extraspinal infections (septic complications) are much more common than spinal infections following a gunshot or stab wound to the spine. (5) Steroids are of no use in gunshot wounds to the spine. In fact, there was an increased incidence of spinal and extraspinal infections without a difference in neurologic outcome compared with those who did not receive steroids. (6) Spinal surgery is rarely indicated in the management of penetrating wounds of the spine. The recommendations for treatment at TJUH of victims of gunshot or stab wounds with a resultant neurologic deficit are as follows. (1) Spine surgery is indicated for progressive neurologic deficits and persistent cerebrospinal fluid leaks (particularly if meningitis is present), although these situations rarely occur. (2) Consider spine surgery for incomplete neurologic deficits with radiographic evidence of neural compression. Particularly in the cauda equina region, these surgeries may be technically demanding because of frequent dural violations and nerve root injuries/extrusions. These cases must be evaluated in an individual case-by-case manner. The neurologic outcomes of patients with incomplete neurologic deficits at TJUH who underwent acute spine surgery (usually for neural compression secondary to a bullet) were worse than the outcomes for the patients who did not have spine surgery. A selection bias against the patients undergoing spine surgery was likely present as these patients had evidence of ongoing neural compression. (3) A high index of suspicion is necessary to detect spinal and extraspinal infections. (4) Do not use glucorticoid steroids for gunshot wound victims. (5) Conservative (nonoperative) treatment with intravenous broad spectrum antibiotics and tetanus prophylaxis is the sole therapy indicated in the majority of patients who sustain a penetrating wound to the thoracic or lumbar spines.
   
3. Authors Madiba TE. Mokoena TR. Title Favourable prognosis after surgical drainage of gunshot, stab or blunt trauma of the pancreas [see comments]. Source British Journal of Surgery. 82(9):1236-9, 1995 Sep. Abstract The records of 152 patients with pancreatic injury treated over a 5-year period were reviewed. The diagnosis was made at laparotomy in all patients. Gunshot wounds, stab wounds and blunt trauma occurred in 63, 66 and 23 patients respectively with mean ages of 28, 28 and 30 years. Multiple organ injury was most common after gunshot wounds. Intraoperative management was by drainage of the pancreatic injury site alone in the majority of patients in all aetiological groups. The rate of fistula formation was 14 per cent after gunshot wounds, 9 per cent after stab injury and 13 per cent after blunt trauma. Death occurred after 24 h in 8, 2 and 10 per cent of patients following gunshot wounds, stab wounds and blunt trauma respectively, and was attributable to other organ damage. It is concluded that gunshot injury to the pancreas may be more extensive than other injuries, but conservative management with surgical drainage of pancreatic injury is justified irrespective of the mechanism of injury.
   
4. Authors Velmahos GC. Degiannis E. Hart K. Souter I. Saadia R. Title Changing profiles in spinal cord injuries and risk factors influencing recovery after penetrating injuries. Source Journal of Trauma. 38(3):334-7, 1995 Mar. Abstract OBJECTIVE: The changing profiles of spinal cord injuries in South Africa are addressed in this study. DESIGN: A retrospective analysis of 551 patients with spinal cord injury. MATERIALS AND METHODS: The cause of injury was motor vehicle crashes in 30%, stab wounds in 26%, gunshot wounds in 35%, and miscellaneous causes 9%. MEASUREMENTS AND MAIN RESULTS: There was a significant shift from stab wounds towards bullet wounds over the last five years. Bullet spinal cord injuries increased from 30 cases in 1988 to 55 cases in 1992, while stab spinal cord injuries decreased from 39 cases in 1988 to 20 cases in 1992. The incidence of spinal cord injuries following a motor vehicle crash showed a declining tendency after a transient increase (28 cases in 1988, 40 in 1990, 31 in 1992). Moreover, the problem of severe septic complications has been investigated and various risk factors for sepsis that might impair the rehabilitation process have been examined. The risk of developing septic complications was higher in gunshot spine injuries (21 cases out of 193) than in knife injuries (5 cases out of 143). The presence of a retained bullet did not seem to increase the chances for sepsis. In seven patients the sepsis was the direct consequence of the retained bullet while in 14 patients sepsis developed with no bullet in situ. Furthermore, the site of the injury (cervical, thoracic, lumbar spine) did not correlate with the abovementioned risks. CONCLUSIONS: Gunshots carry a heavier prognosis. Only 32% of our gunshot cases underwent a significant recovery as opposed to 61% of stab cases and 44% of the motor vehicle crash victims.
   
5. Authors Degiannis E. Velmahos GC. Florizoone MG. Levy RD. Ross J. Saadia R. Title Penetrating injuries of the popliteal artery: the Baragwanath experience. Source Annals of the Royal College of Surgeons of England. 76(5):307-10, 1994 Sep. Abstract This study describes the management of 43 patients with penetrating injury of the popliteal artery. Of these patients, 33 (76.5%) had bullet wounds, four patients (9.5%) pellet wounds and 6 (14%) knife wounds. Patients with 'hard' signs of arterial injury underwent exploration without preoperative angiograms. There were no negative explorations. Patients with only 'soft' signs of arterial injury underwent preoperative angiograms. Of this group, 75% had positive angiograms and underwent exploration. There were no false-positive or false-negative preoperative angiograms in the group of patients with 'soft' signs in this study. Definitive orthopaedic management of associated fractures followed vascular reconstruction. There was no difference in the short-term patency of autologous saphenous vein graft as against PTFE grafts. Fasciotomy was performed on patients who had arterial and venous injury or presented late. Overall amputation rate was 14% and for bullet injuries 18%.
   
6. Authors Rothlin M. Vila A. Trentz O. Title [Results of surgery in gunshot and stab injuries of the trunk]. [German] Source Helvetica Chirurgica Acta. 60(5):817-22, 1994 Jul. Abstract Between 1981 and 1990, 105 patients suffering from gunshot and stab wounds were admitted to the Department of Surgery of Zurich University Hospital. There were 17 female and 88 male patients aged 16-74 years (average 31 years) whose charts were studied retrospectively. 44 patients demonstrated gunshot injuries, while 60 suffered from stabwounds and 1 patient had both. The injuries were the result of a crime in 59, a suicide in 33 and an accident in 11 cases. In 2 patients the cause was not conclusive proven. Injuries to the lung (n = 54), the liver (n = 27) and to the stomach (n = 23) were seen most frequently. 45 patients underwent laparotomy, while 16 had a thoracotomy performed. Both thoracotomy and laparotomy were necessary in 10 cases. Complications were observed in 29.5% of the cases. They were significantly more frequent in patients with gunshot injuries (p < 0.0004). Overall mortality amounted to 14.3% (n = 15). Patients with gunshot wounds had a significantly higher mortality rate (p < 0.0005). Debridement and selective closure of the wounds (n = 25) did not result in a higher rate of abscess formation than open treatment (n = 17).
   
7. Authors Coimbra R. Prado PA. Araujo LH. Candelaria PA. Caffaro RA. Rasslam S. Title Factors related to mortality in inferior vena cava injuries. A 5 year experience. Source International Surgery. 79(2):138-41, 1994 Apr-Jun. Abstract Forty-nine patients sustaining Inferior Vena Cava (IVC) injuries, during a 5 year period were retrospectively analyzed in order to assess those factors related to early deaths. Mean age was 32 and 45 were male. GSW was the most frequent mechanism of injury (59.2%), followed by SW (28.6%) and blunt trauma (12.2%). There were 4 injuries in the supra diaphragmatic IVC, 14 retrohepatic, 16 suprarenal and the remaining 15 were in the infrarenal portion of the IVC. Twenty patients were in shock and 8 were unstable on admission. The liver was the most frequently injured organ in association with IVC and there were also 7 concomitant abdominal vascular injuries. Venorrhaphy was performed in 28 patients, IVC ligature in 5, intracaval shunt in 3 and in the remaining 13, only temporary hemostasis was attempted. Mortality rate was 100% in supra diaphragmatic injuries, 71.4% in retrohepatic, 68.8% in suprarenal and 33% in infrarenal injuries. There was a significant difference when comparing mortality rate in stable against shock or unstable patients on admission (p < 0.001), as well as in those with diaphragmatic IVC injuries compared with all other injury sites together (p < 0.05). Hemodynamic instability on admission was the most important cause of early deaths, and all patients with concomitant abdominal vascular injuries also died.
   
8. Authors Degiannis E. Velmahos G. Krawczykowski D. Levy RD. Souter I. Saadia R. Title Penetrating injuries of the subclavian vessels. Source British Journal of Surgery. 81(4):524-6, 1994 Apr. Abstract A study was made of 76 patients with subclavian vessel injury. The mechanism of trauma was stabbing in 40 patients (53 per cent) and gunshot in 36 (47 per cent). There were marked differences between the two groups in clinical presentation, operative management and outcome. The group with gunshot injury was characterized by a more immediate threat to life, and a greater need for a median sternotomy and use of interposition grafts. The mortality rate in patients with gunshot wounds was more than twice that in the group with stab injury.
   
9. Authors Tang E. Berne TV. Title Intravenous pyelography in penetrating trauma. Source American Surgeon. 60(6):384-6, 1994 Jun. Abstract Intravenous pyelograms (IVPs) are routinely used in the workup of suspected urologic injuries. The indications for obtaining IVPs have not been well characterized. This study examined 67 patients with penetrating trauma who received formal IVPs with nephrotomography in the radiology department. Of 35 stab wounds, 19 patients presented without hematuria and accounted for only one positive IVP. No intervention was undertaken in this patient. There were 14 stab wound patients with microscopic hematuria, with three positive IVPs. No intervention was necessary in any of these patients. The two remaining stab wound patients both had gross hematuria and renal injuries requiring intervention. However, only one of the two had a positive IVP, showing a blurred kidney margin. One patient had a pseudoaneurysm of a branch of the renal artery, and the other had an arteriovenous fistula. Of 32 patients with gunshot wounds, 15 presented without hematuria. Of the 15, one had a positive IVP but did not have a renal injury on exploration. None of the other 13 patients in this group undergoing exploration had renal injuries. Of the 11 patients with microscopic hematuria, three had hematomas and one had gross extravasation on IVP. Of the six patients with gross hematuria, three had positive IVPs, showing a hematoma, a renal fracture, and indistinct renal outline, respectively. In this limited study, omitting IVPs on the patients with negative urinalyses would not have missed any significant injuries. We suggest that more study is needed in this area because our present standard may lead to unnecessary expense and delay.
   
10. Authors Velmahos GC. Degiannis E. Souter I. Saadia R. Title Penetrating trauma to the heart: a relatively innocent injury. Source Surgery. 115(6):694-7, 1994 Jun. Abstract BACKGROUND. The purpose of this study was to examine the mortality rate of penetrating cardiac trauma in a large urban hospital. METHODS. This was a retrospective study over a period of 5 years and 5 months of all patients admitted alive with a stab or a gunshot cardiac injury. RESULTS. There were 310 patients with a stab wound and 63 with a gunshot wound. The overall mortality rate was 19%. The mortality rates for the stab and the gunshot groups were 13% and 50.7%, respectively. In the 296 patients with a cardiac stab wound confined to a single chamber and with no other associated extracardiac injury the mortality rate was 8.5%. CONCLUSIONS. An isolated cardiac stab wound is a relatively innocent injury in a patient at a hospital accustomed to managing penetrating trauma expeditiously.
    
11. Authors Mock C. Pilcher S. Maier R. Title Comparison of the costs of acute treatment for gunshot and stab wounds: further evidence of the need for firearms control [see comments]. Source Journal of Trauma. 36(4):516-21; discussion 521-2, 1994 Apr. Abstract Gun control is proposed primarily to decrease the incidence of injury and death from gunshot wounds (GSWs). We hypothesize that decreasing the number of GSWs will also produce significant economic savings, even if personal violence were to continue at the same rate, maintaining the same overall incidence of penetrating trauma. We analyzed charges and reimbursements for the treatment for all patients with GSWs (n = 1116) and stab wounds (SWs) (n = 1529) admitted to a level I trauma center from 1986 through 1992. Mean and median charges were higher for GSWs ($14,541; $7,541) than for SWs ($6,446; $4,249) (p < 0.05). There was a 12% per year increase in the annual number of GSWs (p = 0.001), leading to a disproportionate increase in the annual total charges for GSWs (p = 0.013), compared with SWs. Public expenditures, including bad debt and government reimbursement, increased for GSWs (p = 0.019) but not SWs. Thus, if all patients with GSWs instead suffered SWs, there would be an annual savings of $1,290,000 overall and of $981,000 of public funds from this institution alone. Treatment costs for GSWs are higher than those for SWs and are rising more rapidly, with an increasing amount of public funds going to meet these costs. Considerable savings to society would accrue from any effort that decreased firearm injuries, even if the same level of violence persisted using other weapons.
    
12. Authors Rizoli SB. Mantovani M. Baccarin V. Vieira RW. Title Penetrating heart wounds. Source International Surgery. 78(3):229-30, 1993 Jul-Sep. Abstract In 3 years, 26 patients were operated for penetrating heart wounds at our institution, the majority between 30 to 60 minutes after injury. Twenty-two patients with a possible heart wound were immediately taken to the operating room for thoracotomy. One patient initially underwent laparotomy while 2 were observed before operating-room thoracotomy. One patient underwent emergency-room thoracotomy. Three patients with no vital signs on admission died, 82.6% of the remainder survived. Stab wounds determined the best survival rate: 94%, whereas for gunshot wounds it was only 50%. Our experience at this Brazilian Trauma Center reveals that delay in reaching the hospital selected the patients, that clinical condition on arrival, method of injury (knife or gunshot), emergency room staffed with trauma surgeons and aggressive operating room treatment for penetrating heart wounds results in a remarkable survival rate. Emergency-room thoracotomy should be reserved for patients "in extremis" or when there is no operating room available.
    
13. Authors Macho JR. Markison RE. Schecter WP. Title Cardiac stapling in the management of penetrating injuries of the heart: rapid control of hemorrhage and decreased risk of personal contamination. Source Journal of Trauma. 34(5):711-5; discussion 715-6, 1993 May. Abstract The resuscitation of patients with cardiopulmonary arrest from a penetrating injury of the heart requires emergency thoracotomy and control of hemorrhage. Suture control may be technically difficult in patients with large or multiple lacerations. Emergency cardiac suturing techniques expose the surgeon to the risk of a contaminated needle stick. After we determined that rapid control of hemorrhage from cardiac lacerations could be achieved in anesthetized sheep with the use of a standard skin stapler, the technique was applied in the clinical setting. Twenty-eight patients underwent emergency stapling of 33 cardiac lacerations at our institution from September 1987 to December 1991. Seventy-nine percent (22) of the patients sustained stab wounds, and 21% (6) were injured by gunshots. Fifty-eight percent (19) of the injuries involved the right ventricle, 27% (9) involved the left ventricle, 9% (3) involved the right atrium, and 6% (2) involved the left atrium. In 93% (26) of the patients, control of hemorrhage was achieved within 2 minutes of exposure of the injuries. Both patients in whom control could not be achieved had sustained large-caliber gunshot injuries. Fifteen (54%) of the patients survived, including one patient with two cardiac lacerations and another with three lacerations. Of the surviving patients, two had mild neurologic deficits. No personal contamination occurred related to the use of the stapler. We conclude (1) cardiac stapling is highly effective in the management of hemorrhage from penetrating injury, particularly in the setting of multiple cardiac lacerations; (2) the technique may not be effective with certain types of gunshot wounds; and (3) the use of the stapler for emergency cardiorrhaphy eliminates the risk of personal contamination from a needle stick. [Full paper reveals survival rate of 17% for gunshot wounds and 64% for stab wounds. TL]
    
14. Authors Mitchell ME. Muakkassa FF. Poole GV. Rhodes RS. Griswold JA. Title Surgical approach of choice for penetrating cardiac wounds. Source Journal of Trauma. 34(1):17-20, 1993 Jan. Abstract One hundred nineteen patients suffered penetrating cardiac trauma over a 15-year period: 59 had gunshot wounds, 49 had stab wounds, and 11 had shotgun wounds. The overall survival rate was 58%. The most commonly injured structures were the ventricles. Twenty-seven patients had injuries to more than one cardiac chamber. Thirty patients had associated pulmonary injuries. Emergency thoracotomy was performed in 47 patients with 15% survival. Median sternotomy was used in 30 patients with 90% survival. Seventeen of the 83 patients with thoracotomies required extension across the sternum for improved cardiac exposure or access to the contralateral hemithorax. Only one patient with sternotomy also required a thoracotomy. All pulmonary injuries were easily managed when sternotomy was used. We conclude that sternotomy provides superior exposure for cardiac repair in patients with penetrating anterior chest trauma. We feel it is the incision of choice in hemodynamically stable patients. Thoracotomy should be reserved for unstable patients requiring aortic cross-clamping, or when posterior mediastinal injury is highly suspected. [Full paper reveals survival rates of 46% for gunshot wounds, 78% for stab wounds, and 36% for shotgun wounds. TL]
    
15. Authors Kaufman JA. Parker JE. Gillespie DL. Greenfield AJ. Woodson J. Menzoian JO. Title Arteriography for proximity of injury in penetrating extremity trauma. Source Journal of Vascular & Interventional Radiology. 3(4):719-23, 1992 Nov. Abstract Arteriography for proximity of injury was studied prospectively at a trauma center. Findings in 85 patients with penetrating extremity wounds were analyzed to determine the prevalence and types of vascular abnormalities seen with these injuries. Ninety-two limb segments were studied for 77 gunshot and 15 stab wounds. Arteriographic findings were positive in 24% overall but in only 5% for injuries confined to major vessels. A 60% positive rate was seen in a small subgroup of 10 patients with fractures due to gunshot wounds. The most frequently injured vessels were muscular branches of the deep femoral artery (59%); the most common injury was focal, non-occlusive spasm (42%). All patients were treated conservatively, without sequelae at follow-up. In this study, the vascular injuries found at arteriography for proximity of injury in penetrating trauma due to bullets of knives, particularly in the thigh, did not require surgical or radiologic intervention.
    
16. Authors Nagel M. Kopp H. Hagmuller E. Saeger HD. Title [Gunshot and stab injuries of the abdomen]. [German] Source Zentralblatt fur Chirurgie. 117(8):453-9, 1992. Abstract From 1973 to 1991 a total of 422 patients underwent surgery because of an abdominal trauma. 12 patients had gunshot wounds and 46 patients stab wounds. In a retrospective study the diagnostic and therapeutic procedure and the indication for surgery are analysed. After gunshot wounds of the abdomen we always performed a laparotomy. In 11 od 12 cases we found serious intra-abdominal injuries. Only in one case the laparotomy was "unnecessary", because of a tangential wound without penetrating of the abdominal wall. After stab wounds the diagnostic and therapeutic management was more selective. Indications for mandatory laparotomy after stab wounds were a manifest hemorrhagic shock, evisceration and a still left weapon in the abdomen (n = 22). The first clinical examination was completed by ultrasound or peritoneal lavage. Pathological findings like free intraperitoneal fluid or a positive lavage also were indications for laparotomy (n = 9). The other patients were observed closely, including repeated physical examination. The indication for surgery then based on the development of clinical signs. The time between first examination and laparotomy was never more than 12 hours. 39 patients (84.7%) had injuries of intraabdominal organs. 5 patients (10.8%) had a negative laparotomy. The mortality rate was 3.4%, but there was no death as a result of the selective approach.
    
17. Authors Saltzman LE. Mercy JA. O'Carroll PW. Rosenberg ML. Rhodes PH. Title Weapon involvement and injury outcomes in family and intimate assaults. Source JAMA. 267(22):3043-7, 1992 Jun 10. Abstract OBJECTIVE--To compare the risk of death and the risk of nonfatal injury during firearm-associated family and intimate assaults (FIAs) with the risks during non-firearm-associated FIAs. DESIGN--Records review of police incident reports of FIAs that occurred in 1984. Victim outcomes (death, nonfatal injury, no injury) and weapon involvement were examined for incidents involving only one perpetrator. SETTING--City of Atlanta, Ga, within Fulton County. PARTICIPANTS--Stratified sample (n = 142) of victims of nonfatal FIAs, drawn from seven nonfatal crime categories, plus all fatal victims (n = 23) of FIAs. MAIN OUTCOME MEASURES--Risk of death (vs nonfatal injury or no injury) during FIAs involving firearms, relative to other types of weapons; risk of nonfatal injury (vs all other outcomes, including death) during FIAs involving firearms, relative to other types of weapons. RESULTS--Firearm-associated FIAs were 3.0 times (95% confidence interval, 0.9 to 10.0) more likely to result in death than FIAs involving knives or other cutting instruments and 23.4 times (95% confidence interval, 7.0 to 78.6) more likely to result in death than FIAs involving other weapons or bodily force. Overall, firearm-associated FIAs were 12.0 times (95% confidence interval, 4.6 to 31.5) more likely to result in death than non-firearm-associated FIAs. CONCLUSIONS--Strategies for limiting the number of deaths and injuries resulting from FIAs include reducing the access of potential FIA assailants to firearms, modifying firearm lethality through redesign, and establishing programs for primary prevention of violence among intimates.
    
18. Authors Mercer DW. Buckman RF Jr. Sood R. Kerr TM. Gelman J. Title Anatomic considerations in penetrating gluteal wounds. Source Archives of Surgery. 127(4):407-10, 1992 Apr. Abstract A retrospective study of 81 patients with penetrating gluteal wounds was performed to determine if the site of penetration was useful in predicting the likelihood of associated vascular or visceral injury. There were 53 gunshot wounds and 28 stab wounds, including one impalement. The gluteal region was divided into upper and lower zones by determining whether entry occurred above or below the greater trochanters. Sixty-six percent of all penetrating gluteal wounds entered the upper zone. Thirty-two percent of patients with upper zone penetration had associated vascular or visceral injury. Only one of 27 patients with lower zone penetration sustained major injury. The site of entry plays a critical role in determining the likelihood of serious injury associated with penetrating gluteal wounds. Wounds penetrating above the greater trochanters demand thorough evaluation, especially gunshot wounds. Death rate from handgun, long guns and knife wounds : Deltoid
    

[leroy]

David:__________

OK with me:

...Disagree. The law enforcement community is a better indicator of what works on a daily basis in the sort of settings you are likely to be exposed to. Unless you are personally somehow bound by the Geneva Convention in respect to ammo choice, or the government issues you your weapon(s), your own gear selection shouldn't necessarily be swayed by what the military uses.

You can do it your way; its ok with me. I still believe the whole caliber thing is a "tempest in a teapot". All the major calibers are killers in the right hands. It is my personal belief that to learn about mayhem and killing, you need to go to the killers. I do not believe that the police data are the ultimate authority. They simply dont shoot and hit enough folks to have a good feel for what's going on. In their defense, they to wear out looking at it and rehashing it.

RE: Military stuff: You just made my point again; military stuff is limited by treaty to solid rounds . We have better stuff today. The germans used solid round nose 124 or 125 grain bullets 70 years ago and killed everybody in their way until they froze to death. We have a better choice of ammo today if it's loaded hot enough to penetrate what you are shooting at. The point is that all this stuff has worked; and is still working in the right hands.

RE: Commmie coats. I agree. The commie coats were probably thicker and tougher than the "hoodlum" coats of today (...unless they have vests...).

To each his own.

Leroy

Edited November 2, 2010 by leroy
spelling and grammar!!!!

[DaveTN]

As usual, lots of claims being made without any reliable sources to back it up.

I personally am not interested in opinions about ammunition, only facts.

Okay.

Well…. You won’t get anyone to agree on the facts because they can’t even agree on the question.

Is the question penetration? Is it force/Energy? Is it velocity? Is it the ability to cause death? Or is it the ability of a given round to stop the threat?

This is physics. We routinely see here where people want to throw physics out the window and rely on black magic or smoke and mirrors. How often do we see “What is the velocity?†Velocity is only one part of the equation. What is the mass, what is the surface area? Does it expel all its energy in the body, or does it pass right through?

Everything is application driven….. Period. I look at what is going to be the best carry round based on my application. I don’t say.… 9mm is cheap to shoot and so that’s the gun I bought. And then to convince everyone on the forum I know what I’m talking about. You look silly when you do that. People that try to make the argument that 9mm is a better round than .45ACP just look silly. Unless of course they make the argument that it is the best round for their application. If you feel you need 15 rounds in a carry gun then 9mm will be a better round for your application. If you want a small pocket pistol; .45ACP won’t be a good choice for you.

Or…. Just throw physics/Ballistics out the window all together and say “shot placement†is what matters.

“More often than not people shot with any pistol caliber won’t die.†How do you know that, and who cares? I need to stop the threat. I need to make an armed opponent unable or unwilling to fire his weapon at me. If I shoot someone and my rounds are passing through them leaving them on their feet returning fire; I could be in bad trouble.

All the rounds made have applications. But you need to see if they meet your requirements.

So…. You want facts. Good luck with that. Every shooting I have ever responded to has been different. Will a .45ACP to center body mass kill you instantly? No. Will a .22LR to the forehead at point blank range kill instantly? More than likely. Does that make a .22LR a better round than a .45ACP? Of course not.

I have seen the study quoted where the guys shot sheep with different rounds and timed how long it took them to die and tried to use that to prove a point. Are you kidding me?? How ignorant can you be?

[Mechanic_X]

I have Hornady Critical Defense 9mm. From the website:

Unaffected by thick and heavy clothing, including denim and leather.

[JAB]

One of the big turning-points in the transition to larger calibers in law enforcement was the Hollywood bank robbery and shootout when the LAPD encountered those two crims wearing full body armor. After the incident, many officers blamed their inability to take down the bad guys was the small 9mm bullet.

Also, it is said that one of the main incidents that lead to the development of the .40 in the first place was the FBI shootout in Miami. After two agents were killed and others wounded in a gun battle with two bank robbers, the FBI decided that they needed 'more gun' than the 9mm pistols they had been using. The thing is, though, what cartridge seems to have ended the battle? 10mm? Nope. .45acp? Nope. .40 S&W? Nope - it hadn't been developed yet. So, maybe a higher capacity magazine played a role in stopping the BGs? Again, nope. In reality, the fight was ended when one of the agents fired six .38 Special +P rounds from a .357 and actually managed to hit the bank robbers in effective areas. The agents didn't need 'more gun'. They needed more hits on vital areas of their targets.

Edited November 3, 2010 by JAB

[monkeylizard]

the guys over at Box O Truth tested against frozen clothing. No difference in balistics.

The Box O' Truth #36 - Frozen Clothing And The Box O' Truth - Page 1

[leroy]

....the guys over at Box O Truth tested against frozen clothing. No difference in balistics.

The Box O' Truth #36 - Frozen Clothing And The Box O' Truth - Page 1

Monkey:__________

Thanks for posting this. I THOUGHT i had seen something somewhere else that talked about this issue. Now i remember where it was!

Many thanks,

Leroy

[Spiffy]

those are the same guys that switch to a heavier grain bullet in the winter. I'm not a ballistic expert but that just seems odd to me.

It's the Sherpa Lining in the Carhartt coats that stop the 9mms and 40 Short and Weak.......... I just carry 45 230 +P because I can't conceal the grip of a 500 S&W LOL.

[East_TN_Patriot]

Also, it is said that one of the main incidents that lead to the development of the .40 in the first place was the FBI shootout in Miami. After two agents were killed and others wounded in a gun battle with two bank robbers, the FBI decided that they needed 'more gun' than the 9mm pistols they had been using. The thing is, though, what cartridge seems to have ended the battle? 10mm? Nope. .45acp? Nope. .40 S&W? Nope - it hadn't been developed yet. So, maybe a higher capacity magazine played a role in stopping the BGs? Again, nope. In reality, the fight was ended when one of the agents fired six .38 Special +P rounds from a .357 and actually managed to hit the bank robbers in effective areas. The agents didn't need 'more gun'. They needed more hits on vital areas of their targets.

Exactly. Shot placement trumps caliber every time. Here is proof of this obvious fact. First, here is data from the following study:

Zimring, Franklin E. (1972). The medium is the message: Firearm caliber as a determinant of death from assault. The Journal of Legal Studies, 1:1 (Jan., 1972), pp. 97-123

Zimring examined fatal shootings in Chicago and presented the following data on the percentage of known caliber attacks that resulted in death. These numbers show that shot placement is what is important and not caliber. Caliber was only marginally better in shots to the head or chest, but was totally meaningless when the shots hit the victim elsewhere.

.22 .25 .32 .38 >.38

Head and chest 36% 70% 67% 76% 83%

Abdomen, back, neck 35% 29% 10% 38% - -

Shoulder, arm, leg 0% 5% 0% 0% 0%

Here is a real-world case that offers proof of these findings. This link is to the Officer Down Memorial Page of South Carolina State Trooper Mark Coates. Coates was killed by a single shot fired from a .22 NAA derringer by the killer, who was firing it using his weak hand after sustaining 5 of 6 shots from Coates' .357 magnum duty revolver. The Trooper was struck in the armpit and the bullet traveled to his aorta and killed him within minutes. The killer was struck in the arm, legs, and abdomen. He is still alive serving a life sentence in state prison.

Let me say this again: SHOT PLACEMENT TRUMPS CALIBER EVERY TIME.

[jay1313g]

Geeez! You're all overlooking the most simple answer!

Just put the second, third, and fourth shot in the same hole as the first shot. Use whatever caliber you like.

CAPTIAN OBVIOUS

[Guest chaplain tom]

I think the difference in who died from gun shot wounds and who didn't, (exept for the lucky or unlucky shot, dependening on which end you're on) is the intent of the shooter. If all you're trying to do is STOP the attack then many of those shot are going to survive. If on the other hand, you are determined to KILL the attacker, you just keep shooting (providing of course you're in the fight long enough) UNTIL your attacker is DEAD. Nobody ever said you only get to shoot once.

[nightrunner]

9mm penetrates better than .40 or .45

actually I have thought about getting a 10mm, .357mag or .44mag to carry in the winter for better penetration

[Guest Halfpint]

I carry a 1911 in .45 because I shoot it well. .45 is a big and heavy bullet, and generally does very bad things to whatever it hits. I carry ball ammunition about 99.99999999% of the time, for the simple fact that I've had issues over the years with various hollow-point rounds feeding 100.000000% reliably in my pistol of choice.

Agreeing 100% with "East_TN_Patriot" and "JAB" . . . From what I've heard, read, and seen in my own EXTREMELY UNSCIENTIFIC ballistics tests (Hey, let's go shoot X object and see what happens...) hollow-point bullets DO fail to expand as advertised when shot through various mediums--some clothing, car doors, wood, drywall, etc. Does that mean if I could find a hollow-point that functioned absolutely reliably in my carry gun that I'd NOT use it, because of that diminished expansion? Absolutely not-- I'll take what improvements I can get, without question. A .45 ball round to the chest might not immediately STOP whoever it hits, but it will make them aware that I'm not defenseless, while hopefully doing quite a bit to take the fight out of them.

Before I started carrying my 1911, I had an H&K USP Compact in .45 -- to this day, it's still my absolute favorite pistol and I hate that I sold it. It ate whatever I put in it, in whatever conditions I shot. It worked with dirty, handloaded, under-loaded, and over-loaded ammunition. It worked dry, wet, spotless, dripping oil, caked in mud, whatever. But if I didn't do my part to hit the target, all of that meant nothing. I've never had to use a weapon against another human being and I pray I never do -- but if I do, I want to know two things without a doubt. I want my weapon to work -- meaning that whatever round is in the chamber exits at sufficient velocity to damage/stop/kill what it hits. And I want to be able to hit what I'm supposed to. Whether I'm shooting ball or hollowpoint ammunition is going to be the last thing on my mind.

I run ball ammo in my 1911 ONLY because I can't find a hollow-point round I trust to function 100% reliably. My old J-frame backup had lead semi-wadcutters in it. My USP, Glock, AR's, etc. all run hollow-points in varying size and weight. But the most important things are that all of them function 100% of the time, and I can hit the target with them. Everything else is secondary.