Journal articles: 'Gunshot wound simulation'

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Santomauro, Chiara, Daniel Host, Davin Arthur, Marissa Alexander, and Colin King. "Simulating a self-inflicted facial gunshot wound with moulage to improve perceived realism, immersion, and learning in simulation-based airway management training." BMJ Simulation and Technology Enhanced Learning 6, no. 5 (January 14, 2020): 289–92. http://dx.doi.org/10.1136/bmjstel-2019-000492.

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Moulage is used to create mock wounds and injuries for clinical education and training. We developed a moulage technique to simulate a facial gunshot wound for use in simulation-based training. We removed sections of a manikin’s face and used moulage materials to mock various aspects of the wound. The manikin was used in a simulated scenario that teaches clinicians how to manage a complicated airway. The moulage was evaluated with a self-report questionnaire that assessed participants’ perceptions of the realism of the wound, the degree to which the wound contributed to their scenario immersion, and the degree to which the wound enhanced their learning experience on a 5-point Likert scale ranging from ‘strongly disagree’ to ‘strongly agree’. Participants’ average response to each item was significantly higher than the neutral midpoint, and the median response was ‘strongly agree’. Our work suggests that the simulated facial gunshot wound contributed to perceived scenario immersion and enhancement of the learning experience, supporting existing literature that suggests moulage is a valuable tool in healthcare simulation. Future work could investigate the effect of moulage using objective measures and explore the potential to use extended reality technology in conjunction with moulage to improve immersion even further.

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Kol'bin, A. A., A. N. Kulikov, S. V. Churashov, and D. R. Zdorovtsov. "Development of high-speed video fixation method to study wound ballistics and macroscopic changes during reproduction of experimental open globe injury." Modern technologies in ophtalmology, no. 1 (March 25, 2022): 299–301. http://dx.doi.org/10.25276/2312-4911-2022-1-299-301.

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Purpose. To develop a method of high-speed video fixation of a standardized model of gunshot open globe injury type B. Material and methods. The study was divided into several stages. Literature analysis, simulation of different types of gunshot open globe injury, and visualization of changes by high-speed video fixation were carried out in the course of the work. Gunshot open globe injury type B: was reproduced on 9 cadaver rabbits (18 eyes), projectile used: modified dart, rifle cylinder pumping: 1 compression, average projectile velocity: 24 m/s. A lighting system consisting of 5 Gauss elementary 150 W LED lamps (Moscow, Russia), Iphone 7 (Apple, USA), Sony RX100 V (Sony, Japan), and Phantom Miro 310 (Vision Research, USA) were used for shooting. Results. The study has shown that only using the Phantom Miro 310 camera for filming such a fast-moving process as the formation of a gunshot open globe injury is reasonable and optimal. The trajectory of the projectile and the projectile itself can be clearly seen and the type of injury can be determined. Conclusions. A method of video fixation of a standardized model of gunshot open globe injury type B of the eye has been developed. This method is highly informative, easily reproducible and used for investigation of projectile ballistics, kinetics and macroscopic changes of the model of not only gunshot open globe injury type B, but also other types of eye trauma and also closed globe trauma. The study was performed at the Department of Ophthalmology of Prof. V.V. Volkov of the Military Medical Academy. Keywords: gunshot open globe injury, high-speed video fixation, model, technique.

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Kol'bin, A. A., A. N. Kulikov, S. V. Churashov, and D. R. Zdorovtsov. "Development of high-speed video fixation method to study wound ballistics and macroscopic changes during reproduction of experimental open globe injury." Modern technologies in ophtalmology, no. 1 (March 25, 2022): 299–301. http://dx.doi.org/10.25276/2312-4911-2022-1-299-301.

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Purpose. To develop a method of high-speed video fixation of a standardized model of gunshot open globe injury type B. Material and methods. The study was divided into several stages. Literature analysis, simulation of different types of gunshot open globe injury, and visualization of changes by high-speed video fixation were carried out in the course of the work. Gunshot open globe injury type B: was reproduced on 9 cadaver rabbits (18 eyes), projectile used: modified dart, rifle cylinder pumping: 1 compression, average projectile velocity: 24 m/s. A lighting system consisting of 5 Gauss elementary 150 W LED lamps (Moscow, Russia), Iphone 7 (Apple, USA), Sony RX100 V (Sony, Japan), and Phantom Miro 310 (Vision Research, USA) were used for shooting. Results. The study has shown that only using the Phantom Miro 310 camera for filming such a fast-moving process as the formation of a gunshot open globe injury is reasonable and optimal. The trajectory of the projectile and the projectile itself can be clearly seen and the type of injury can be determined. Conclusions. A method of video fixation of a standardized model of gunshot open globe injury type B of the eye has been developed. This method is highly informative, easily reproducible and used for investigation of projectile ballistics, kinetics and macroscopic changes of the model of not only gunshot open globe injury type B, but also other types of eye trauma and also closed globe trauma. The study was performed at the Department of Ophthalmology of Prof. V.V. Volkov of the Military Medical Academy. Keywords: gunshot open globe injury, high-speed video fixation, model, technique.

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PEKEDIS, MAHMUT, and HASAN YILDIZ. "NUMERICAL ANALYSIS OF A PROJECTILE PENETRATION INTO THE HUMAN HEAD VIA MESHLESS METHOD." Journal of Mechanics in Medicine and Biology 14, no. 04 (July 3, 2014): 1450059. http://dx.doi.org/10.1142/s0219519414500596.

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In recent years, physicists, engineers and medical scientists have tried to demonstrate the biomechanics of gunshot wounds with numerical methods and experimental observations. Currently, the finite element method (FEM) is the most widely used numerical method among the studies related to ballistic wound injuries. However, when the FEM is used for the penetration analysis, the path of the projectile in the skull is subjected to extremely large deformations which will introduce errors due to distortion of elements. To overcome this error, the meshfree technique was established to simulate the gunshot wound as a preliminary study in which the skull was modeled by smoothed particle hydrodynamics (SPH) and the projectile was modeled by nondeformable rigid elements. In order to simulate a realistic penetration phenomenon, orthotropic material properties were defined for different regions (forehead, zygomatic and mandible) with material principal axis along the surface of the bones. Human response to the ballistics impacts were determined in terms of force occurring along the pathway of the bullet in the skull, residual velocity of the projectile and penetration depth. The obtained results were compared with the data reported in literature. As a result, mechanical behavior of the head under ballistic impacts simulated by the SPH, compared well with the results determined by the data given in literature, which indicates the applicability of the SPH method as a powerful technique in simulating different gunshot wound mechanisms.

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Radford, G. E., M. C. Taylor, J. A. Kieser, J. N. Waddell, K. A. J. Walsh, J. C. Schofield, R. Das, and E. Chakravorty. "Simulating backspatter of blood from cranial gunshot wounds using pig models." International Journal of Legal Medicine 130, no. 4 (July 9, 2015): 985–94. http://dx.doi.org/10.1007/s00414-015-1219-x.

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Tang, Zhen, Wenbing Tu, Gang Zhang, Yubin Chen, Tao Lei, and Yinghui Tan. "Dynamic simulation and preliminary finite element analysis of gunshot wounds to the human mandible." Injury 43, no. 5 (May 2012): 660–65. http://dx.doi.org/10.1016/j.injury.2011.03.012.

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Tsokos, Michael. "Heat-induced post-mortem defect of the skull simulating an exit gunshot wound of the calvarium." Forensic Science, Medicine, and Pathology 7, no. 2 (January 7, 2011): 227–28. http://dx.doi.org/10.1007/s12024-010-9215-4.

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Stefanopoulos, Panagiotis K. "Comment on “Dynamic simulation and preliminary finite element analysis of gunshot wounds to the human mandible”." Injury 44, no. 11 (November 2013): 1658. http://dx.doi.org/10.1016/j.injury.2013.02.005.

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TANG, Zhen, Zhong-hua ZHOU, Shao-xiang ZHANG, Gang ZHANG, Yu-bin CHEN, Tao LEI, and Ying-hui TAN. "Dynamic simulation and finite element analysis of gunshot wounds to the center of mandible mental region in human." Academic Journal of Second Military Medical University 31, no. 8 (December 27, 2011): 845–50. http://dx.doi.org/10.3724/sp.j.1008.2011.00845.

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Rubeis, Giovanni, and Florian Steger. "Is Live-Tissue Training Ethically Justified? An Evidence-based Ethical Analysis." Alternatives to Laboratory Animals 46, no. 2 (May 2018): 65–71. http://dx.doi.org/10.1177/026119291804600206.

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Trauma training is a crucial element of medical education in the civilian sector, as well as in the military sector. Its aim is to prepare physicians, medics and nurses for stressful and demanding emergency situations. Training methods include live-tissue training (LTT) on animal models and simulation-based trauma education. For LTT, blast, gunshot or stab wounds are inflicted on anaesthetised animals, mostly goats and pigs, but sometimes non-human primates. This training method raises ethical concerns, especially in the light of increasingly sophisticated simulation-based methods. Despite these non-animal alternatives, LTT is still widely used due to its presumed educational benefits. In this paper, the question of whether LTT can still be justified, is discussed. We developed a normative framework based on the premise that LTT can only be ethically justified when it yields indispensable benefits, and when these benefits outweigh those of alternative training methods. A close examination of the evidence base for the presumed advantages of LTT showed that it is not superior to simulation-based methods in terms of educational benefit. Since credible alternatives that do not cause harm to animals are available, we conclude that LTT on animal models is ethically unjustified.

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Taylor, Seth C., Benjamin Ondruschka, David C. Kieser, Niels Hammer, Matthew Lee, Gary J. Hooper, and Elena Kranioti. "Ballistic trauma caused by military rifles: experimental study based on synthetic skull proxies." Forensic Science, Medicine and Pathology 18, no. 1 (January 1, 2022): 30–36. http://dx.doi.org/10.1007/s12024-021-00432-7.

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AbstractRifles are often involved in violent deaths such as homicide and suicide. Consequently, expert knowledge and experimental forensic investigations are important to clarify the nature of ballistic trauma when applied to the human head and neurocranium. This study investigated differences in entrance wound morphology with Synbone® spheres which are described as being comparable to human flat bones. A series of ballistic experiments were conducted using two different rifle calibers (5.56 × 45 mm and 7.62 × 39 mm Full Metal Jacket (FMJ)). Synbone® spheres were used for close-range 0.3 m simulated executions as well as at 25 m and 35 m to simulate urban and military engagements. Results were compared with previously published experimental studies using similar military ammunition. In our study, entry wound morphology closely resembles real forensic cases compared to exit wound and overall shape morphology independently of the distance and the caliber. Circumferential delamination was clearly visible with full metal jacket (FMJ) rounds, yielding similar damage pattern morphology to the human crania. This study documented the presence of hydraulic burst or shock in all ten rounds from all three distances. Krönlein shots were also observed in some cases. Synbone® spheres constitute an acceptable synthetic surrogate for ballistic experiments. The present study offers new initial data on the behavior of Synbone® proxies in ballistic testing of military ammunitions; FMJ gunshot injuries to the human head, for distances that have not previously been published, suggesting that efficient tests can take place under these conditions. Further research on experimental ballistics with a larger number of controlled factors and multiple repetitions is recommended to verify the results of this pilot study before applied in forensic simulations.

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Argintaru, N., A. Petrosoniak, C. Hicks, K. White, M. McGowan, and S. H. Gray. "P010: Code Silver: Lessons learned from the design and implementation of Active Shooter Simulation In-Situ Training (ASSIST)." CJEM 19, S1 (May 2017): S80—S81. http://dx.doi.org/10.1017/cem.2017.212.

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Introduction: Hospital shootings are rare events that pose extreme and immediate risk to staff, patients and visitors. In 2015, the Ontario Hospital Association mandated all hospitals devise an armed assailant Code Silver protocol, an alert issued to mitigate risk and manage casualties. We describe the design and implementation of ASSIST (Active Shooter Simulation In-Situ Training), an institutional, full-scale hybrid simulation exercise to test hospital-wide response and readiness for an active shooter event, and identify latent safety threats (LSTs) related to the high-stakes alert and transport of internal trauma patients. Methods: A hospital-wide in-situ simulation was conducted at a Level 1 trauma centre in downtown Toronto. The two-hour exercise tested a draft Code Silver policy created by the hospital’s disaster planning committee, to identify missing elements and challenges with protocol implementation. The scenario consisted of a shooting during a hospital meeting with three casualties: a manikin with life-threatening head and abdomen gunshot wounds (GSWs), a standardized patient (SP) with hypotension from an abdominal GSW, and a second SP with minor injuries and significant psychological distress. The exercise piloted the use of a novel emergency department (ED)-based medical exfiltration team to transport internal victims to the trauma bay. The on-call trauma team provided medical care. Ethnographic observation of response by municipal police, hospital security, logistics and medical personnel was completed. LSTs were evaluated and categorized using video framework analysis. Feasibility was measured through debriefings and impact on ED workflow. Results: Seventy-six multidisciplinary medical and logistical staff and learners participated in this exercise. Using a framework analysis, the following LSTs were identified: 1) Significant communication difficulties within the shooting area, 2) Safe access and transport for internal casualties, 3) Difficulty accessing hospital resources (blood bank) 4) Challenges coordinating response with external agencies (police, EMS) and 5) Delay in setting up an off-site command centre. Conclusion: In situ simulation represents a novel approach to the development of Code Silver alert processes. Findings from ethnographic observations and a video-based analysis form a framework to address safety, logistical and medical response considerations.

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Strelbytska, I., and A. Hudyma. "Dynamics of violations the absorption function of the small intestine in conditions of acute blood loss complicated by ischemia-reperfusion of the limbs and their correction." Journal of Education, Health and Sport 11, no. 1 (January 29, 2021): 351–60. http://dx.doi.org/10.12775/jehs.2021.11.01.035.

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Introduction. In the structure of modern injuries in wartime and peacetime the share of gunshot wounds increased significantly. The timeliness of applying a tourniquet is one of the main methods of saving lives on the battlefield. The patterns of formation of enteral insufficiency syndrome in conditions of acute blood loss complicated by ischemia-reperfusion of the limb have not been studied enough. There are no data on the features of violations of the absorption function of the small intestine in these conditions and the effectiveness of correction with Carbacetam, which is able to reduce the manifestations of acute hemic hypoxia and ischemic-reperfusion syndrome.The objective of research: To establish the peculiarities of the absorption function of the small intestine in the pathogenesis of acute blood loss, ischemia-reperfusion of the limb and their combination. To evaluate the effectiveness of Carbacetam in the correction of identified abnormalities.Materials and methods. The experimental studies were conducted on 108 white nonlinear male rats weighing 200-220 g, which were housed in standard vivarium conditions. All animals were divided into five groups: control and four experimental. Under thiopental-sodium anesthesia in the first experimental group was simulated ischemia-reperfusion of the limb, in the second group – acute blood loss, and in the third group – these injuries were combined. In the fourth experimental group, animals with acute blood loss and ischemia-reperfusion of the limb were intraperitoneally administered Carbacetam at a dose of 5 mg per kilogram of animal weight. After 1 and 2 hours, as well as after 1, 7 and 14 days studied the absorption function of the intestines by D-xylose test.The results and discussion. Simulation of limb ischemia-reperfusion compared with the control group causes a decrease in the content of D-xylose in the urine after 1 day of the reperfusion period. Also, acute blood loss is accompanied by a significant decrease in this indicator after 1 day. Until the end of the experiment the rate increases, but up to 14 days does not reach the level of control. The combination of acute blood loss and ischemia-reperfusion of the limb causes a decrease in the content of D-xylose in the urine starting from 1 hour of the experiment, which reaches a minimum after 1 day and remains at the same level until 14 days. In these terms the rate was the lowest compared to other studied groups. The use of Carbacetam for corrective purposes in rats with acute blood loss complicated by ischemia-reperfusion of the limb, compared with animals without correction significantly reduces the detected abnormalities after 7 days and more after 14 days of use.Conclusions. Complications of acute blood loss by ischemia-reperfusion of the limb causes a significant decrease in the absorption function of the small intestine after 1 day of the experiment. The intensity of disorders was significantly higher compared to other experimental groups. The use of Сarbacetam for 7-14 days in the reperfusion period in animals with acute blood loss complicated by limb ischemia-reperfusion, compared with animals without correction, causes a significant increase in the absorption function of the small intestine. This indicates the protective effect of the drug under the conditions of simulated pathology.

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Strelbytska, I., and A. Hudyma. "Dynamics of endogenous intoxication indicators in condition of acute blood loss complicated by ischemia-reperfusion of the limb, and their correction by carbacetam." Journal of Education, Health and Sport 10, no. 12 (December 24, 2020): 394–405. http://dx.doi.org/10.12775/jehs.2020.10.12.039.

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Introduction. In the structure of injuries from gunshot wounds dominate the limb injuries that are often complicated by massive bleeding from the main vessels. The only means of rescue on the battlefield is a timely application of a tourniquet. This ensures complete exsanguination of the limb. The duration of exsanguination should not exceed 2 hours. It is proved that in conditions of acute blood loss complicated by ischemia-reperfusion of the limb, there are prerequisites for the development of dysfunction of internal organs, which in turn exacerbates dysmetabolic and functional disorders, stimulates endotoxicosis and may be complicated by multiple organ failure. However, the patterns of formation of the syndrome of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combinations have not been studied. There are no data on the effect of Carbacetam on these processes. It is known that Carbacetam has proven itself to reduce the manifestations of dysfunction of internal organs in the conditions of ischemic-reperfusion syndrome of the limb.The objective of research: To establish the dynamics of endogenous intoxication in the conditions of ischemia-reperfusion of the limb, acute blood loss and their combination. To evaluate the effectiveness of Carbacetam in the correction of identified abnormalities.Materials and methods. The experimental studies were conducted on 108 white nonlinear male rats weighing 200-220 g, which were housed in standard vivarium conditions. All animals were divided into five groups: control and four experimental. Under thiopental-sodium anesthesia in the first experimental group was simulated ischemia-reperfusion of the limb, in the second – acute blood loss, and in the third – these injuries were combined. In the fourth experimental group, animals with acute blood loss and ischemia-reperfusion of the limb were intraperitoneally administered Carbacetam at a dose of 5 mg per kilogram of animal weight. After 1 and 2 hours, as well as after 1, 7 and 14 days in the blood serum was determined the content of middle-mass molecules (MMM254, MMM280).The results and discussion. It was found that ischemia-reperfusion of the limb in comparison with the control group is accompanied by a significant increase of the MMM254 fraction in the blood serum content. From the first hour of the experiment with a maximum after 1 day and normalization of the index up to 14 days. The content in the blood serum of the MMM280 fraction became significantly higher, from the control only after 1 day with subsequent normalization in the following terms of the experiment. After simulation of acute blood loss, both studied fractions of MMM increased from 1 hour of the experiment, reached a maximum after 1 day and did not return to the control level after 14 days. For the first time it was found that two-hour ischemia-reperfusion of the limb significantly aggravates the course of acute blood loss, which revealed a significantly higher content in the serum of fractions MMM254 and MMM280 compared to other experimental groups in almost all periods of the experiment. Due to the use of Carbacetam, the content of both studied fractions of MMM in the serum compared with animals without correction was significantly reduced after 7 and 14 days of the experiment. Although the studied parameters did not return to the level of the Carbacetam control group, it can be considered a pathogenetically justified means of reducing the level of endotoxicosis in the conditions of ischemia-reperfusion of the limb and acute blood loss.Conclusions. Simulation of limb ischemia-reperfusion is accompanied by accumulation of MMM254-280 fractions with a maximum after 1 day of the experiment and normalization up to 14 days. Acute blood loss causes an increase in the serum content of fractions MMM254-280 from 1 hour of the experiment, which up to 14 days do not reach the level of control. The detected disorders are significantly exacerbated after a combination of acute blood loss and ischemia-reperfusion of the limb. The use of Carbacetam in comparison with animals without correction is accompanied by a significant decrease in the content of MMM254-280 fractions in the serum after 7 and 14 days of the experiment.

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Hoit, G., C. Hinkewich, J. Tiao, V. Porgo, L. Moore, L. Moore, J. Tiao, et al. "Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review." Canadian Journal of Surgery 56, no. 2 Suppl (April 2013): S1—S42. http://dx.doi.org/10.1503/cjs.005813.

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Rubin, Aaron, and Raymond Ten Eyck. "Gunshot Wound Simulation Case." MedEdPORTAL 8, no. 1 (January 2012). http://dx.doi.org/10.15766/mep_2374-8265.9084.

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Lurin, I. A., Ie V. Tsema, K. V. Gumenuik, Ya V. Susak, D. Ye Dubenko, and Ye Ie Tsema. "EXPERIMENTAL MODELING OF A RESIDUAL WOUND CAVITY ON A BALISTIC PLASTICINE USING CONVENTIONAL AND HOLLOW POINT BULLETS." Medical Science of Ukraine (MSU) 17, no. 4 (December 30, 2021). http://dx.doi.org/10.32345/2664-4738.4.2021.02.

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Relevance. Local armed conflicts of recent decades around the world are characterized by the use of hollow point (HP) bullets, which is another challenge for military surgeons. This confirms the importance for scientific research, in particular, experimental, aimed at studying the ballistic properties of various types of ammunition and the characteristics of the injuries caused by them in the wounded people. Simulation of a gunshot wound canal is an integral stage in the study of the gunshot wounds formation mechanism and is the subject of research in wound ballistics. Objective of the work is to develop an experimental model for ballistic imitation of the plastic deformation of biological tissues caused by the action of HP and non-HP bullets. Materials and methods. The studies were carried out on 40 blocks of ballistic plasticine, in each of which one shot was fired from an AKS-74 assault rifle and a ZBROYAR Z-10 carbine. Depending on the type of ammunition, the blocks of ballistic plasticine were divided into 4 groups: group I - 10 blocks, into which shots were made with non-HP military cartridges 5.45 mm with "PS" bullets with a steel core "7N6"; Group II (10 blocks) - 5.45x39 mm cartridges with V-Max HP bullets; group ІІІ (10 blocks) - with cartridges 7.62x39 mm; group IV (10 blocks) - cartridges 7.62x39 mm with HP bullets of the "SP" type. Results. It was found that when using non-HP bullets, the outer area of the inlet ball hole correlates with the projectile caliber (1.6 times more than when using 7.62 mm bullets). For HP bullets, the caliber of the projectile does not significantly affect the area of the entrance opening (P <0.05). The expanding properties of the bullet significantly increase the area of the bullet hole by 14.87-31.2 times compared to non-HP ammunition. An increase in the caliber of non-HP bullets leads to a significant increase in the area of the sagittal section of the residual wound cavity by 1.59-2.03 times; The expanding properties of bullets of different calibers have a different effect on the volume of the residual wound cavity: for 5.45 mm bullets, the residual wound cavity increases 1.49 times, for 7.62 mm bullets it decreases 1.65 times. Conclusions. The type of small arms, the caliber of the cartridge, its expanding properties affect the spatial configuration of the main ballistic indicators arising in the proposed model of plastic deformation of soft tissues. The use of HP bullets leads to the formation of a larger volume of irreversible damage due to plastic deformation in comparison with non-HP analogs.

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Bunin, Yu V., R. N. Mikhaylusov, V. V. Negoduyko, O. P. Nechuiviter, Iu I. Pershyna, and O. V. Yasinsky. "Mathematical simulation of radiation diagnostics of foreign bodies of lungs of fire origin." Medicine Today and Tomorrow 90, no. 2 (June 30, 2021). http://dx.doi.org/10.35339/msz.2021.90.2.bmn.

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According to spiral computed tomography, it is difficult to accurately determine the size of a foreign body, due to the observed artifact in the form of "shine" of metal in the tissues. A mathematical model for determining the size of foreign bodies of the lungs of gunshot origin has been developed to improve the results of diagnosis of gunshot wounds penetrating the chest with lung damage. For mathematical modeling of the process of diagnosing foreign bodies of the lungs, we used the dimensions of 32 foreign bodies of lungs of fire origin, detected during spiral computed tomography and removed during surgery. To more accurately determine the length, width and height of a real foreign body, it is necessary to take into account the correction factor, which depends on the X-ray density of the foreign body. Measuring the exact size of foreign bodies allows you to more adequately determine further surgical tactics. Keywords: mathematical simulation, gunshot wounds, lungs, foreign bodies.

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Pekedis, Mahmut, Firat Ozan, Semmi Koyuncu, and Hasan Yildiz. "The finite element method-based pattern recognition approach for the classification of patient-specific gunshot injury." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, March 18, 2022, 095441192210863. http://dx.doi.org/10.1177/09544119221086397.

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Violence related injuries and deaths mostly caused by firearms are a major problem throughout the world. Understanding the factors that control the extent of hard-soft tissue wound patterns using computer imaging techniques, numerical methods, and machine learning algorithms may help physicians to diagnose and treat those injuries more properly. Here, we investigate the use of computational results coupled with the pattern recognition algorithms to develop an approach for forensic applications. Initially, computer tomography (CT) images of the patient whose leg was shot by a 9 × 19 parabellum bullet are used to construct the FE models of that patient’s femoral bone and the surrounding soft tissues. Then, Hounsfield units-based material properties are assigned to elements of the bone. To simulate the full range of loading conditions encountered in ballistic events, a constitutive model that captures the strain-rate dependent response is implemented. The entrance pathway vector of the bullet is directed in accordance with the patient’s wound and the simulations are deployed for the cases having various inlet velocities such as 150, 200, 250, 300, and 350 m/s. Once the FE results for each case are obtained, they are processed with supervised machine learning algorithms to classify the wound and inlet velocity correspondence. The results demonstrate that they can be diagnosed with a percent accuracy of 97.3, 97.5, and 98.3 for the decision tree (DT), k-nearest neighbors (kNN) and support vector machine (SVM) classifier, respectively. This approach may provide a useful framework in classifying the wound type, predicting the bullet impact velocity and its firing distance.

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Schyma, Christian, Fabienne Baumann, Burkhard Madea, and Walther Gotsmy. "Study of backspatter using high-speed video of experimental gunshots." Forensic Science, Medicine and Pathology, December 14, 2020. http://dx.doi.org/10.1007/s12024-020-00326-0.

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AbstractBackspatter is biological material that is ejected from the entry wound against the line of fire. This phenomenon was also observed in wound ballistic simulations using so called "reference cubes" (12 cm edge length, 10% gelatin, 4 °C, paint pad beneath the cover). High-speed video records from 102 experimental shots to these target models using full metal jacketed bullets in the calibers .32 auto, .38 special, 9 mm Luger and .357 Magnum were analyzed for chronology, morphological appearance and velocity of fluid ejection. Generally, a short tail splashing of surface material occurred when the bullet was penetrating the target. In 51 shots from distance (≥ 5 cm), regardless of caliber and shot range, a linear jet of fluid started in connection with the first collapse of the temporary cavity. The initial velocity of the jet was measured between 6 and 45 m/s. The jet was streaming on for about 60 to 100 ms with a stochastic deviation of ± 13° to the horizontal. Close range and contact shots showed earlier and faster (up to 330 m/s) backspatter depending on the cartridge and the gap between muzzle and target. Gaseous aerosol-like spray and cone-like spatter indicated an increasing influence of muzzle gases with decreasing shot range. Even under standardized experimental conditions, variations of backspatter were observed in near/contact shots.

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Journal articles on the topic 'Gunshot wound simulation'

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