Early Clinician Exposure to the Physiologic Damage of Firearms: A Feasibility Study

Abstract

Introduction:

In comparison to many nations in the developed world, the United States has more cases of civilian ballistic injuries. Both low and high velocity firearm injuries are frequently encountered in American urban trauma centers, and physicians become familiar with these traumatic injury patterns. Physicians from other nations may rarely encounter such injuries. With an increase in international conflict, there is an increased need for clinicians to participate in international medical aid which may include patients with ballistic injuries. Clinicians with limited familiarity of such injuries may result in under-triage and delayed recognition of injury severity, resulting in increased morbidity and mortality of patients. This study aims to show that a course on ballistic injuries will improve clinician recognition of injury patterns and comfort levels managing these patients.

Method:

Clinicians participated in a course which was designed to introduce ballistic injury patterns. The course was reviewed and supported by emergency medicine physicians who work in a large level I trauma center in the Southeastern United States and serve in clinical roles with EMS and community law enforcement. Course content included demonstrations of firearm injuries by discharging weapons into gels and models designed to replicate human body tissue. Participants were surveyed prior to and after completing the course regarding their comfort with firearms and firearm related injuries.

Results:

Participants reported increased comfort level with the management of ballistic injuries. The course requires a full day of expert physician time, approximately US$600 in supplies if performing live demonstrations, and the cost of designated space for safe firearm discharge and use.

Conclusion:

This course or a similar course with pre-fired demonstration rounds proved to be feasible and beneficial for those who will likely encounter firearm injuries in their clinical environment. There are both quantifiable and perceived benefits for physicians.