The Clinical Significance of Wound Ballistics

“Tell me about this wound, Nurse, what are your thoughts?” The attorney looks at you expectantly.

You may have heard of ballistics (the science of projectiles and firearms), but have you heard of wound ballistics? Wound ballistics is the study of injuries caused when there is a penetration of the body with projectiles ejected from a gun barrel due to the ignition of gunpowder (Shrestha, Kanchan, & Krishan, 2021).

When you evaluate photographs of a wound before or after the patient dies, you can draw conclusions about the direction and distance of firing, manner of injury (suicidal, homicidal, accidental), and the nature and type of firearm. (Shrestha, Kanchan, & Krishan, 2021).

Wound ballistics research uses physics to evaluate the mass, velocity, and kinetic energy of the projectile to analyze the tissue destruction and wound trajectory (Pinto et al, 2019).

The field of wound ballistics evaluates the injury track and the disruption of tissue AWAY from the injury tract (referred to as temporary cavitation).

External findings such as flame burns, singeing, tattooing from metal scraps, and the presence of an abrasion rim, distinguishes an entry wound from an exit wound, while also helping determine if the gun was shot at point blank, close range, mid-range, or from a distance.

The same analysis of pellets from shotgun wounds can determine the distance, based upon the dispersion of those pellets and how far they enter the body. (Shrestha, Kanchan, & Krishan, 2021)

While bullets are not always recovered, the wound ballistics are an incredible source of forensic evidence. You’ll likely receive photographs created by a forensic photographer who uses forensic photography guidelines. Swabs for evidence collection are also used in evaluating for gunshot residue and the presence of DNA.

As a legal nurse consultant, you’ll analyze the medical chart, diagnostic tests, photographs, and collected evidence to evaluate the wound ballistics. This evidence may be used in a court of law.

Legal nurse consultants assist attorneys handling criminal cases using their detail oriented, analytical skills to bring critical facts to light.

Tristan Ashly Wristen MSN BSN RN FN-CSA, SANE-A spent ten years as an Emergency Department RN. She is board-certified as a Sexual Assault Nurse Examiner and has qualified as an expert in sexual assault, strangulation, and injury causation. Tristan is a professor and teaches undergraduate nursing students at Ocean County College and precepts graduate students in forensic nursing at Monmouth University in New Jersey.

Meet Tristan at our 2-day virtual conference, the Path of the Bullet taking place January 27 and 28, 2022. Get your seat here or invest in the recordings.

References
Pinto, A., Russo, A., Reginelli, A., Iacobellis, F., DiSerafino, M., Giovine, S., & Romano, L. (2019). Gunshot Wounds: Ballistics and Imaging Findings. Seminars in Ultrasound, CT, and MRI, 40(1), 25–35. https://doi.org/https://doi.org/10.1053/j.sult.2018.10.018
Shrestha, R., Kanchan, T., & Krishan, K. (2021). Gunshot Wounds Forensic Pathology. NIH StatPearls. https://doi.org/https://www.ncbi.nlm.nih.gov/books/NBK556119/?report=printable