Type your tag names separated by a space and hit enter

Wound Ballistics

Wound Ballistics is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --



The physical forces that determine the wounding potential of gunshot and other penetrating wounds


  • Wounding potential of bullet is determined by mass and velocity.
  • The type and severity of a wound is determined by:
    • Wounding potential
    • Construction and shape of the bullet
    • Orientation of the bullet upon striking body
    • Deformity or fragmentation
    • What tissues the bullet traverse
  • Traditional distinction between low and high muzzle velocity does not differentiate kind and severity of wounding:
    • A civilian hunting rifle or a large-caliber handgun with a hollow-point bullet may produce a more severe wound than a bullet with a full metal jacket from a “high-velocity” military rifle.
  • Bullets wound by 2 main mechanisms—crush and stretch:
    • Sonic pressure wave that precedes bullet has no role in wounding.
    • Bullet crushes the tissue it directly passes through, forming a permanent cavity.
    • Stretch is produced by radial energy transferred from bullet as it slows down in tissue, forming a temporary cavity.
    • A bullet is stabilized in flight by spin transmitted from rifling in the barrel.
    • Spin minimizes yaw, which is the angle between the long axis of the bullet and its flight vector.
    • Without spin, a bullet would yaw to its most stable flight configuration, which is base and center of mass forward:
      • Not aerodynamically efficient
  • As bullet enters tissue, spin of bullet is reduced and bullet will yaw.
  • When yaw is 90°, a bullet crushes maximal amount of tissue, slows down the most, and maximal stretch injury occurs.
  • Bullets designed to deform in tissue (soft point, hollow point) will expand on impact:
    • Increases amount of crush injury
    • Moves bullet center of mass forward
  • Jacketed bullets prevent lead stripping in the barrel, which occurs at high muzzle velocities:
    • Jacketed bullets do not deform but may fragment.
    • Fragmentation increases surface area and crush injury.
  • Bullets striking bone often fragment and may cause bone fragments to become secondary projectiles.
  • Severity of wound also depends upon tissue composition and thickness:
    • Minimally elastic tissues, near-water-density tissue (brain, liver), fluid-filled (heart, bowel) and dense organs (bone) may be injured by the temporary cavity.
    • More elastic tissue, such as lung and skeletal muscle, may absorb the energy from temporary cavity formation and sustain minimal damage.
    • Extremities are often not thick enough for the bullet to fully yaw:
      • Temporary cavity formation is minimal.
      • Most damage is caused by direct crush injury of the bullet, its fragments, or secondary projectiles.
  • Short-range shotgun blasts can produce severe wounds with compromise of the blood supply:
    • In short-range shotgun injuries, pellets may be greatly scattered in tissue secondary to the pellets striking each other.
  • Stab wounds with knives and other sharp instruments are low-energy wounds with tissue injury from direct weapon contact.

-- To view the remaining sections of this topic, please or purchase a subscription --


Rosen, Peter, et al., editors. "Wound Ballistics." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307519/all/Wound_Ballistics.
Wound Ballistics. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307519/all/Wound_Ballistics. Accessed April 25, 2019.
Wound Ballistics. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307519/all/Wound_Ballistics
Wound Ballistics [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307519/all/Wound_Ballistics.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Wound Ballistics ID - 307519 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307519/all/Wound_Ballistics PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -