Trauma

Kinetic Impact Projectile

Kinetic Impact Projectile, Struck by Projectile, Rubber Bullet Injury, Nonlethal Projectile, Beanbag Round, Foam Tipped Round

Kinetic Impact Projectile (e.g. Rubber bullet)
1. Projectile missile used as a deterrent by law enforcement
2. Intended to incapacitate targets via nonlethal measures (esp. pain)

Originally developed by British for use in northern Ireland
Projectiles are fired from specialized platforms or launchers
Initial projectile velocity 155 to 255 mph (250 to 360 kph)
1. Projectiles rapidly lose velocity with distance due to large size and poor aerodynamics
Nonlethal Projectiles are intended to target extremities at medium to long range distances
1. Injuries are typically mild to extremities at target distances >100 feet
Projectiles may cause life threatening or lethal injuries at closer range
1. Highest risk with inuries to the head and neck (as well as trunk)
2. Flight path is unpredictable at close range

Background
1. Serious injuries account for roughly 15% of those presenting with projectile injuries
2. Most serious injuries involve the head, neck, chest and Abdomen
3. Many require ICU care (~20%), maxillofacial surgery (40%), orthopedic surgery (20%), neurosurgery (13%)
Lethal injury (2-3%, including both penetrating and blunt mechanisms)
Eye Injury (e.g. blindness, Globe Rupture, Retrobulbar Hematoma)
1. More common with Beanbag Rounds
Maxillofacial Injury (e.g. Facial Fractures)
Fractures
Retained Foreign Body
Head Injury
1. Depressed Skull Fractures
2. Subarachnoid Hemorrhage
3. Intracerebral Hemorrhage
4. Subdural Hematomas
5. Epidural Hematoma

Mild kinetic injuries to the extremities
1. Symptomatic management
2. Disposition home
Head, neck or Torso injury
1. See Trauma Primary Survey
2. See Trauma Secondary Survey
3. See Eye Injury
4. Exercise a low threshold in CT imaging