Firstly, the projectile crushes structures along its track, similar to other forms of penetrating injury.The extent of tissue and organ trauma will depend on terminal ballistics, which are influenced by the type of bullet, its velocity and mass as well as the physical characteristics of the penetrated tissue. The head and torso are the most vulnerable areas, with incapacitation due to CNS disruption or massive organ destruction and haemorrhage. The most important factors in causing significant injury or death are their placement and projectile path. On striking, the projectile element may travel at speeds of up to 1,500 metres/second, dependent on the ammunition and type of gun. There are many different types of bullets but the most common type is composed of a lead core with some type of casing. Expertise usually resides with military surgical services or pooled within regional trauma centres. Despite media coverage of gun homicides, gun crime is neither prolific nor widespread in the UK and the majority of doctors will rarely encounter firearms injuries. Peace time gunshot injuries occur in a variety of different situations - criminal and terrorist incidents (including shots fired by law enforcement agents), attempted suicides as well as unintended firearm 'accidents' (both civilian and amongst the armed forces). Gunshot injuries occur when someone is shot by a bullet or other sort of projectile from a firearm.
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