Characteristics of Terrorist Related Gunshot Injuries

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Aside from bombs and explosions, terrorists still widely use other means of violence such as gun shooting, stabbing, and stoning. The outcomes of terrorist-related gunshot and stab wounds are similar to those seen in criminal and military scenarios. In the Israeli experience, most gunshot wounds were inflicted by sniper shootings at high velocity into passing cars or at pedestrians, though a few incidents of gunshots from automatic weapons into crowds ofpeople were also encountered (Amir et al. 2005). Correspondingly, while explo sion victims usually arrive at the hospital as a part of a mass casualty event, gunshot victims typically arrive as individuals (Peleg et al. 2004; Singer et al. 2005). Gunshot victims, compared with explosion victims, had a higher proportion of open wounds (63% vs 53%) and fractures (42 % vs31 %), more frequent abdominal, spinal, and chest wounds, and overall they presented with a double incidence of moderate-severity injuries (ISS 9-14) (Mintz et al. 2002; Peleg et al. 2004; Singer et al. 2005). Explosion victims, on the other hand, had higher proportions of both minor and critical injuries (related to the distance from the focus of the explosion). The inpatient death rate is not significantly different (7.8 % vs 5.3%), perhaps because the available data exclude many patients who die at the scene in an explosive incident or subsequently arrive dead at the hospital; however, a larger proportion of gunshot victims died during the first day (Peleg et al. 2004).

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