Gender Ethnicracial And Life Span Considerations

Penetrating injuries are on the increase across all ages of the life span, particularly among adolescents and young adults in their teens and 20s. GSWs are more common in males than in females. African American males between the ages of 15 and 24 have the largest death rate from GSWs in the United States.

^ ASSESSMENT

HISTORY. Establish a history of the weapon, including the type, caliber, and range at which it was fired. Determine if the GSW was self-inflicted, as well as the patient's hand dominance and tetanus immunization history.

PHYSICAL EXAMINATION. The initial evaluation is always focused on assessing the airway, breathing, circulation, disability (neurological status), and exposure (completely undressing the patient), which are done simultaneously by the trauma resuscitation team. The secondary survey is a head-to-toe assessment, including vital signs.

After completing the primary survey, begin the secondary survey with a complete head-to-toe assessment. Examine the patient's entire skin surface carefully for abrasions, open wounds, powder burns, and hematomas, paying special attention to skin folds, groin, and axillae. Assess the patient's abdomen, back, and extremities for lacerations, wounds, abrasions, and deformities. Some high-velocity weapons may cause extensive tissue destruction and fractures. Inspect the patient for both entrance and exit wounds (Table 1).

390 Gunshot Wound

• TABLE 1 Types and Descriptions of Gunshot Wounds
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