How to better treat a Gunshot patient

By: Akhtiar Ahmed Solangi


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I am Akhtiar Ahmed Solangi, and for several years in Emergency operation theatre COT JPMC Hospital karachi, I have dedicated my career to handling emergency gunshot cases, providing critical care and medical attention to patients in dire need and many more. Today, I am here to share vital information and insights about gunshot wounds, a topic of utmost importance in the field of emergency Surgery. Whether you are a healthcare professional, a concerned individual, or simply someone seeking to expand their knowledge, I hope to provide you with valuable information that can help save lives and improve our understanding of this critical aspect.

What is meant by gunshot?
A gunshot refers to the discharge of a firearm, which propels a projectile at high velocity. This projectile can cause significant damage upon impact, resulting in gunshot wounds. Gunshot patients are individuals who have sustained injuries as a result of being shot by a firearm. These injuries can vary in severity, depending on factors such as the type of firearm, the distance from which the shot was fired, and the location of the injury on the body.

What makes a gunshot surgery successful
According to me for a successful surgery these below are very important
 Good Surgical Team [Doctors,Nurses,Technicians,Supporting staff]
 Surgical and skillfull Experts
 Good Communication
 Surgery Duration time
When these are considered then it result in a successful surgery.

Gunshot cases Analysis?
As I am handling gunshots cases from since 2023 in emergency operation theatre COT at JPMC hospital Karachi.
And according to records approximately 5522 gunshot cases were operated from july-2004 till july-2023 only in emergency operation theatre COT at JPMC hospital Karachi.
And the most commonly injured organs were:
 Abdomen injury
 Small Bowel 60%
 Colon 41.6%
 Liver 29.3%
 Vascular structures 24.6%
 Stomach 17.3%
 Kidney 17%

Survival rate
Overall the survival rate of patients was 83.3%
And the death ratio was 16.7%
• Cause of death injury :
 1)Brain gunshots 2)chest gunshots 3)Vascular Avota 4)Fermual 5)Neck gunshot
 Blood loss

Is Gunshot the main cause of wound infection
Is a gunshot the primary cause of wound infection? My answer would be no. According to my knowledge, when a bullet is fired and enters the human body, it may potentially cause a wound infection. The bullet’s temperature is not fixed when it enters the human body, so it cools down quickly. In contrast, when we use an autoclave, we employ lower temperatures than the bullet’s initial temperature. However, we compensate for this by using a proper time duration, which the bullet does not follow. Therefore, it is not guaranteed to be 100% sterilized and may contain contaminants. However, we cannot consider it the primary or main source of infection.
So what are the primary/source sources of wound infection?
There are many factors like:
1. Operation theatre environment
2. No proper sterilization of surgical instruments
3. No proper Dressing
4. No proper disinfection of beds and sheets
5. No proper medication
6. Exceeding surgery time duration
7. Ward environment


Which antibiotic is good for gunshot injury patients
Although as I am a medical profession so according to me these minimum these anitbiotics should be used
1. Cephalosporins
Cephalosporins are beta-lactam antimicrobials used to manage a wide range of infections from gram-positive and gram-negative bacteria. The five generations of cephalosporins are useful against skin infection, resistant bacteria, meningitis, and other infections.

2. Gentamicin
Gentamicin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of the membranes that surround the brain and spinal cord) and infections of the blood, abdomen (stomach area), lungs, skin, bones, joints, and urinary tract.

Which Supplemental nutrition to consider

 Vitamin A
 Vitamin C
 Copper
 Zinc
 Healthy Food

Whenever cases of emergencies and accidents arrive, our team strives to minimize the patient’s loss, ensuring a successful recovery and their return home filled with happiness.

From 2004 to 2023, the emergency operation theatre at COT, JPMC Hospital in Karachi has handled over 64,000 cases of various types. Remarkably, according to my experience our patient survival rate
exceeded 80%.
When the entire team in the operating theatre handles such critical surgeries, utilizing our full
potential to save patients’ lives, that’s the moment of our happiness and joy

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