Talk:Gunshot wound

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 27 January 2020 and 14 May 2020. Further details are available on the course page. Student editor(s): Nhooloo1, Omurphy5. Peer reviewers: Lyang82, CellFay.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 22:52, 16 January 2022 (UTC)

Medical management of GSW

Dear fellow Wikipedia editors,

In light of the growing public interest in gunshot wounds with recent events, I thought this page could use a significant overhaul especially from a medical management perspective since that section is currently not present. As a medical student at UCSF, I will be using reliable secondary and tertiary sources to provide an overview of how gunshot wounds are medically approached and treated. Adhering to Wikipedia’s policies, all my additions will remain politically neutral. My outline for intended edits is as follows:

- Lead: Update to be more comprehensive about topics covered in the page

- Rename “Destructive effects” section to “Physics of ballistic trauma” and separate out the medically relevant information to a new section entitled “Medical management”

- Flush out the “Epidemiology” section of GSW

- Remove “Medical treatment” and “Surgical treatment” subheadings in the “History” and consolidate the existing material under a new “Medical history” section so that readers do not confuse history with current medical practice

- Generate a new “Medical management” section that explains current medical practice for GSW including medical and surgical management depending on the entry site, bullet, organs damaged, extent of damage, etc. (This section will be the bulk of my additions.)

- Review existing citations

Changes will occur over the coming few weeks. I appreciate any suggestions or contributions from the Wikipedia community. Thank you!

Best, Solomon.lee (talk) 00:38, 9 March 2018 (UTC)

WikiMedicine Project: Medical Management of GSW Peer feedback

Hello everyone!

I am a fellow medical student at UCSF who will be providing @Solomon.lee: with feedback on his edits to this article, keeping in mind his goals for improvement (see above). I will primarily focus on the "Medical management" section and the lead.

Overall impression: The article is well organized and flows in a logical fashion. It incorporates some technical material from several disciplines, which may be of interest to a variety of readers with different backgrounds. Each section contains an appropriate amount of detail, with references to other helpful Wikipedia pages (i.e. in the epidemiology and see also sections). However, given that the article is quite technical, I would recommend expanding the lead to include an overview of the medical management in simpler language. I would also try to link out as many technical words as possible, if there are corresponding Wikipedia pages (e.g. for pericardial tamponade).

Signs and symptoms: This section is a good overview of potential consequences of a gunshot wound, but could benefit from defining some of the medical terms including pneumothorax (similar to the way that hypovolemic shock was explained). I also wonder if the second paragraph could use a citation?

Medical management: The organization of this section into basic ATLS management and anatomic regions is fantastic. Each subsection is also consistently organized, first discussing the anatomic structures that may be injured before moving on to management and what factors play into decisions about interventions. I would recommend defining some of the medical terms that are used frequently (pneumothorax, hemopericardium, tamponade, hemothorax). Some of the sentence structures and language are also quite complex with some medical jargon, and may be able to be simplified (e.g. "less responsive" or "acting differently" in place of "altered").

Epidemiology: I think the level of detail in this section is perfectly appropriate, especially given that you linked out another article.

This article is much improved from the initial version on the Acrolinx report, and I hope this feedback is helpful! Great job! JennDS (talk) 19:34, 23 March 2018 (UTC)

WikiMed: Response to Peer Review

Dear JennDS,

Thank you for the helpful peer review! I wholeheartedly agree with all your comments. I have gone through the article and added dozens of links to external pages in order to help the reader navigate through the more complicated medical terminology. I did not simplify some medical language if there was another Wikipedia page that explained the condition in greater detail (e.g. pneumothorax). If there wasn't a good page to explain the term, I tried to simplify the language (e.g. changing hemorrhage to bleeding).

In response to other users, I've also replaced the word 'patient' throughout the article to adhere to Wikipedia's policies. The lead has been made more reflective of the overall page as well. I would like to thank the Wikipedia community for continuing to better this page. The new firearms section is a great addition from AlyssaA14 although I would steer away from quotes by individual doctors as a reflection of generalized medical management.

Solomon.lee (talk) 16:53, 30 March 2018 (UTC)

POV tag?

What is the tag about? --K.e.coffman (talk) 17:57, 31 March 2018 (UTC)

I'd added the tag because IP editors, and comments on this talk page thought that much of the content was biased and were repeatedly removing them. I was expecting that 66.91.240.103 would fill his views here, but apparently that didn't happen.

Re-reading WP:NPOVD I shouldn't have added the tag, and simply requested the IP user do so. Apologies.

deadwikipedian (talk) 23:24, 31 March 2018 (UTC)

Rifle section

The whole rifle section needs to be rewritten in my opinion. Most of the sources are extremely misleading, if not outright wrong. Afootpluto (talk) 13:59, 15 July 2018 (UTC)

@Afootpluto:, it looks like one of the HughD socks added most of the material. It appears to be well sourced but that is in part because HughD was happy to misstate information actually in an article in order to achieve an intended claim in the Wiki article. I recently added a verify tag here [[1]] because the statements added are not part of the actual medical article referenced. However, if one doesn't have access to the article in question it would be hard to dispute the statements. This would call into question any of the additions made by the sock account, AlyssaA14. I suspect many other claims sourced to medical articles are not correct. Springee (talk) 13:06, 13 August 2018 (UTC)

Shotguns?

The article has useful material on the effects of rifle and pistol bullets but no discussion of shotgun wounds.

I think that would be helpful - some of the particulars are very different. —40.142.140.74 (talk) 01:46, 27 September 2019 (UTC)

JHM Article Evaluation

Dear Wikipedia Editors,

After reviewing this article as well as the feedback provided by other editors, I'd like to briefly offer my feedback on the diagnosis section and the pathophysiology section.

The diagnosis section is well written. The information provided is extensive and relevant to the article, and the necessary supporting sources are given as well. Appropriate terminology as well as links to other WikiMed articles for further reading and clarification are used when necessary. The language used throughout this section is accessible and appeals to readers of varying interest levels and prior knowledge of the topic.

The pathophysiology indicates that different physics and bullet mechanics play a role in what kind of wound results. However, the section could benefit from some expansion. For example, the section does not include how wounds caused by shotgun pellets or higher caliber rifles differ from other gunshot wounds. The section also could benefit from an explanation of how different tissues react to the impact of the bullet. Currently the section indicates that bones often shatter due to the impact of the bullet, so an explanation of how muscle tissue, nervous tissue, connective tissue, and fat react to the impact would greatly enhance the depth of the section.

Finally, the overview section indicates that long-term complications often arise from gunshot wounds, such as lead poisoning and PTSD. However, in the article, while the treatment and the short-term effects induced by gunshot trauma are included, the long term effects are not included. Perhaps a section detailing these complications, under the "Management" section and after "Diagnosis" would increase the cohesion and completeness of the section.

Regards,

Nhooloo1 (talk) 05:14, 12 February 2020 (UTC)Nhooloo1

Here is a working bibliography of the sources I plan on using as I edit this article and contribute to it.

Nhooloo1 (talk) 16:21, 4 March 2020 (UTC)Nhooloo1

"Diagnosis" has internet debate.

The diagnosis section devolves into a "stopping power" and "caliber" debate without citation. I'm referring to these lines:

However, one must remember that high kinetic energy does not necessarily equate to high stopping power, as incapacitation usually results from remote wounding effects such as bleeding, rather than raw energy transfer. High energy does indeed result in more tissue disruption, which plays a role in incapacitation, but other factors such as wound size and shot placement play as big of, if not a bigger role in stopping power and thus, effectiveness. Muzzle velocity does not consider the effect of aerodynamic drag on the flight of the bullet for the sake of ease of comparison.

187.253.123.86 (talk) 04:55, 1 May 2020 (UTC)

Why was this removed?

"Before management begins it should be verified the area is safe.[8] This is followed by stopping major bleeding, then assessing and supporting the airway, breathing, and circulation.[8] Firearm laws, particularly background checks and permit to purchase, decrease the risk of death from firearms.[6] Safer firearm storage may decrease the risk of firearm-related deaths in children.[7]"

First ref was a major medical textbook

Second source was a systematic review from JAMA Internal Medicine

Third ref was a review published in Epidemiology reviews

Doc James (talk · contribs · email) 06:03, 9 May 2020 (UTC)

This "These factors may include the illegal drug trade, access to firearms, substance misuse including alcohol, mental health problems, firearm laws, and social and economic differences." which was supported by two high quality sources was replaced by

"There are many factors that can increase the likelihood of an individual to be affected by gun related. Ongoing research with the goal of reducing the incidence and mortality of gunshot wounds is being conducted."

Were the ref does not support the first bit. Doc James (talk · contribs · email) 06:06, 9 May 2020 (UTC)

References

article makes no mention of military service

if crime is a relevant risk factor for gunshot wounds, so should be enlisting in any kind of military force - after all, at least to my understanding, firearms are the most commonly used infantry weapon used in military conflicts worldwide. Spacebusdriver (talk) 15:21, 8 July 2022 (UTC)

"Prevention"

This section cites a single source for the purposes of reciting gun control rhetoric, which isn't particularly politically neutral, nor actually informative. Given the countless variety of circumstances where gunshot wounds can occur, including not just crime, suicide, and accidents, but also warfare, the section is inadequate even if this is considered neutral.

Ostensibly, it could be 'balanced' by adding parts citing different sources of different opinions, but that feels clumsy and awkward at best, and would at the very least need to acknowledge that legislation on weapons is a highly contentious and complex political subject, and it could still quickly spiral into some sort of gun control debate between disagreeing contributors.81.230.152.182 (talk) 21:06, 24 April 2023 (UTC)

Potential political content

Firearm laws, particularly background checks and permit to purchase, decrease the risk of death from firearms.[7] Safer firearm storage may decrease the risk of firearm-related deaths in children.

What does that have to do with the article's topic, which is gunshot wounds?  What I see is a poorly-disguised political statement.  Aside from that, statistics do not support the claim that firearm laws decrease any risk of death by gunshot.

216.152.18.132 (talk) 03:23, 10 January 2024 (UTC)