Careers. Wars such as the American Civil War and Crimean War drove the need to find better ways of preventing mortality from gunshot wounds to the head. Hughes RK. Please enable it to take advantage of the complete set of features! Centers for Disease Control and Prevention (CDC), dhs.gov/xlibrary/assets/active_shooter_booklet.pdf, fda.gov/medical-devices/cardiovascular-devices/automated-external-defibrillators-aeds, jamanetwork.com/journals/jamanetworkopen/fullarticle/2688536, elsevier.es/en-revista-cirugia-cirujanos-english-edition--237-articulo-epidemiology-gunshot-wounds-in-university-S2444050716301206, ncbi.nlm.nih.gov/pmc/articles/PMC5508146/, redcross.org/take-a-class/cpr/performing-cpr/cpr-steps, ncbi.nlm.nih.gov/pmc/articles/PMC7844612/, redcross.org/take-a-class/first-aid/first-aid-training/first-aid-classes/fast-training, redcross.org/take-a-class/first-aid/performing-first-aid/first-aid-steps, ncbi.nlm.nih.gov/pmc/articles/PMC5415908/, ncbi.nlm.nih.gov/pmc/articles/PMC7575832/, ncbi.nlm.nih.gov/pmc/articles/PMC4700838/, aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Gunshot-Wound-Head-Trauma, binghamton.edu/emergency/bleeding-control/direct-pressure.html, nasemso.org/wp-content/uploads/National-Model-EMS-Clinical-Guidelines-2017-PDF-Version-2.2.pdf, journals.lww.com/aosopen/Fulltext/2022/03000/Single_dose_IV_Antibiotic_for_Low_Energy_Extremity.27.aspx, jeccm.amegroups.com/article/view/7345/html, injuryfacts.nsc.org/home-and-community/safety-topics/guns/, giffords.org/lawcenter/gun-violence-statistics/, dhs.gov/sites/default/files/publications/STB_Applying_Tourniquet_08-06-2018_0.pdf, scielo.br/j/coluna/a/ykSvCgk3xpzzRHpfPMpJ98S/?lang=en, cdc.gov/violenceprevention/firearms/fastfact.html, How to Render First Aid During a Mass Shooting, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI, Beat the Heat with a Cold Bath: 8 Tips for a Refreshing Dip, 8 Expert Tips to Stay Safe During Record Summer Heatwaves. From 2003 to 2012 the fatality rate remained constant, at around 22%. Herein, we describe the surgical treatments for head and neck injuries in order to improve our understanding of neurosurgical procedures performed during the late 19th century. Don't elevate the legs. Unfortunately, gun-related injuries arent rare in the United States. Put an unconscious person in the recovery position. [25] The no-zone approach uses a hard signs and imaging system to guide next steps. A homemade tourniquet will never be as effective as a commercially made one, but it can still be a significant first aid tool. Important notes for the initial workup specific for chest injuries are as follows. Its critical that you call 911 or local emergency services as soon as is safe and possible. J Neurosurg. government site. Civil war; Gunshot wounds; Head injury; Surgery. Due to the advances in diagnostic imaging, management of PNI has been shifting from a "zone-based" approach, which uses anatomical site of injury to guide decisions, to a "no-zone" approach which uses a symptom-based algorithm. If the person is bleeding a lot from an arm or leg, try to apply a commercial or homemade tourniquet. Standard treatment of penetrating gunshot wounds should consist of primary and prompt detailed debridement, sufficient fasciotomy, and complete drainage of the wound. For intracranial injuries, the goal was to safely remove all splintered bone fragements and bullet remnants that were easily accessible to the surgeon without causing more neurologic injury. Gunshot wounds were among the top 5 causes of death for people ages 1 to 44 in the United States in 2020. Compression was differentiated from concussion, but localization of lesions was not precise. Both methods were widely used for treating patients and we do not know exactly how effective they were, but the advent of firearms created new tasks for military surgeons. These types of tourniquets are pre-made, widely available to order (especially online), and can be added to emergency preparedness kits. A directed angiography or endoscopy may be warranted in a high-risk trajectory for the gunshot. 2018 Jul;115:285-287. doi: 10.1016/j.wneu.2018.04.198. A gunshot wound (GSW) is a penetrating injury caused by a projectile (e.g. Usually caused by powerful assault or hunting rifles and usually display wound pattern similar to Gustilo Anderson Type 3 wounds. FOIA 2007 Apr;86(4):188-93. After discharge, a person who is healing a gunshot wound may need medication, physical therapy, and in some cases, further surgery. ", "Lower murder rate linked to medical advance, not less violence", "In Medical Triumph, Homicides Fall Despite Soaring Gun Violence", "Murder and Medicine - The Lethality of Criminal Assault 1960-1999", Virtual Autopsy CT scans of fatal gunshot wounds, https://en.wikipedia.org/w/index.php?title=Gunshot_wound&oldid=1132028286, Firearm safety, not being involved in crime, 1 million (interpersonal violence in 2015), Low-velocity: Less than 1,100ft/s (340m/s), Medium-velocity: Between 1,200ft/s (340m/s) and 2,000ft/s (610m/s), High-velocity: Between 2,000ft/s (610m/s) and 3,500ft/s (1,100m/s), C) Circulation - Assess for and control bleeding to maintain organ perfusion including, D) Disability - Perform basic neurological exam including, E) Exposure - Expose entire body and search for any missed injuries, entry points, and exit points while maintaining body temperature, This page was last edited on 6 January 2023, at 22:50. Its important to apply firm pressure to the wound if the person is bleeding profusely. Could a cold bath be the key to beating rising temperatures? J Neurotrauma. one caused by the treatment, which was understood to be less dangerous than poisoning. Check to see if the person is awake and responsive, and collect identifying information from them. Any medicine that was given was applied topically to the affected area or dissolved in liquid like tea. What to expect; Recovery from a gunshot wound looks different for every individual case. [5], The countries with the greatest number of deaths from firearms are Brazil, United States, Mexico, Colombia, Venezuela, Guatemala, Bahamas and South Africa which make up just over half the total. Gunshot wounds resulted in gross tissue destruction that was an excellent medium for infection. Many types of surgeries and other medical treatments are used to treat gunshot wounds. (n.d.). government site. This may include nurses, doctors, surgeons, and physical therapists, among others. Federal-funded research into firearm injury, epidemiology, violence, and prevention is minimal. Gunshot fractures generally do not follow common fracture patterns seen in blunt injuries, and the complexity of certain gunshot fractures can often be a challenge for the treating orthopaedic surgeon. Curr Neurol Neurosci Rep. 2015 Oct;15(10):68. doi: 10.1007/s11910-015-0591-8. A literature search was conducted using PubMed and Google Books for available articles pertaining to treatment for gunshot wounds to the head during the 19th century. Its crucial to identify where someones been shot and begin first aid while waiting on emergency services. Please enable it to take advantage of the complete set of features! The cauterisation provokes an iatrogenic burn, i.e. Although all people with abdominal gunshot wounds were taken to the operating room in the past, practice has shifted in recent years with the advances in imaging to non-operative approaches in more stable people. Our study aimed to optimize the tactics of surgical treatment of wounded with gunshot wounds of the upper extremity by determining the factors influencing the outcome of treatment of servicemen in modern conditions of specialized and highly specialized medical care. blood transfusion to replace lost blood. If someones been shot, its critical to call 911 or your local emergency services as soon as its safe to do so. Bookshelf The number of gun-related deaths increased by 13.9% from 2020 to 2019. The association of firearm caliber with likelihood of death from gunshot injury in criminal assaults. Support groups can provide a safe space to connect with others who have also survived gun violence and work toward personal and collective healing. Cook PJ, et al. Below are some common treatments for gunshot wounds: Dressing the wound: A gunshot wound is typically dressed with a sterile gauze pad. how were gunshot wounds treated in the 1800snightwish tour 2022 setlist how were gunshot wounds treated in the 1800s. A positive finding on CT leads to operative exploration. The priority is to stop the bleeding and stabilize the victim. It was Brunschwig who suggested that such wounds be treated with cauterisation, following the practice of ancient physicians when treating poisoned injuries and continuing the belief that fire would halt the effects of poison (Sigerist, 1946; Shane Tubbs et al, 2011). People who survive shootings may experience anxiety, panic attacks, and depression among other symptoms. Important anatomy in the abdomen includes the stomach, small bowel, colon, liver, spleen, pancreas, kidneys, spine, diaphragm, descending aorta, and other abdominal vessels and nerves. [35] People with hard signs of vascular injury also require immediate surgical intervention. and transmitted securely. Considering intoxicatio a fatal danger, da Vigo prescribed treatment with hot liquids, for instance boiling olive oil. FOIA Unlike today's high-velocity bullets, nineteenth-century balls produced almost little or no cavitation and, being slower moving, they were liable to lodge in unusual locations at odds with their trajectory. [33] Ultrasound (FAST) and help identify intra-abdominal bleeding and X-rays can help determine bullet trajectory and fragmentation. Here's how to apply one correctly. 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Treatment of Gunshot Wound to the Shoulder Treatment in case of fracture to the shoulder joint generally involves bracing and appropriate rehabilitation. In addition, lead bullets shattered when hitting a target (armour, clothes or a body) and the damage caused often spread wider than the diameter of the entry wound. Possibly with the tip of the knife, their fingers and/or small tongs if available. (2018). [26], Initial workup as outlined in the Workup section is particularly important with gunshot wounds to the chest because of the high risk for direct injury to the lungs, heart, and major vessels. Initial assessment of a gunshot wound to the neck involves non-probing inspection of whether the injury is a penetrating neck injury (PNI), classified by violation of the platysma muscle. Wounds were divided into incised and puncture wounds, blunt injuries, and gunshot wounds, which were analyzed separately. If you are with someone who has been shot and do not have access to a ready-made tourniquet, you can still improvise one. (2016). This applies to situations in which you are able to safely make noise, not around an active shooter. Update on TBI and Cognitive Impairment in Military Veterans. Unconsciousness, when a person is suddenly unable to respond to stimuli, requires immediate medical attention. During this time, the person who was shot is at risk of life threatening complications, such as: The leading cause of death in gunshot wounds is bleeding, per 2017 research. Franke A, et al. Warm baths, topical applications of medicine, wraps, and gargles were common. Treatment of Gunshot Wounds to Spine During Late 19th Century. The cauterisation provokes an iatrogenic burn, i.e. The degree of tissue disruption caused by a projectile is related to the cavitation the projectile creates as it passes through tissue. J R Army Med Corps. HHS Vulnerability Disclosure, Help not relevant': The scrapbook of Winifred Penn-Gaskell, Made real: artifice and accuracy in nineteenth-century scientific illustration. Thus, da Vigo seems to have created the first theory-driven approach to curing gunshot wounds. [44], Until the 1880s, the standard practice for treating a gunshot wound called for physicians to insert their unsterilized fingers into the wound to probe and locate the path of the bullet. [5] Firearm related deaths are most common in males between the ages of 20 to 24 years. 2005-2023 Healthline Media a Red Ventures Company. Automated external defibrillators (AEDs). [8], In 2015, about a million gunshot wounds occurred from interpersonal violence. As a result, they produce a larger amount of kinetic energy, which is transmitted to the tissues of the target. Survivors of firearm-related injury can experience long-term physical and mental complications such as: Specific complications depend on where the wound is and how extensive the injury is. [2] Damage depends on the part of the body hit, the path the bullet follows through the body, and the type and speed of the bullet. Treatment now was mostly prescriptions combined with instructions for rest and diet (broths, gruel, warm or cold drinks). A sudden blood gush may take effect immediately from a gunshot wound if a bullet directly damages larger blood vessels, especially arteries. Disclaimer, National Library of Medicine [51] He became America's leading authority on gunshot wounds[52] and is credited as the United States' first civilian trauma surgeon. The four main components of extremities are bones, vessels, nerves, and soft tissues. Some people have their medical ID on their phone. In sixteenth-century France, for example, the members of the surgical community Saint-Cme published their textbooks in French, thereby raising the status of their profession in France. They found that the average cost was between $25,000 - $33,000. The Union experiences in the treatment of head injury in the Civil War were discussed in the three surgical volumes of The Medical and Surgical History of the War of the Rebellion. [55][56] Similar improvements were seen in US trauma practices during the Iraq War. With rescue breathing, you breathe into a persons mouth every, Healthgrades has announced the recipients of its Americas Best Hospitals awards, which recognizes extraordinary care from the top hospitals, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Accessibility The survival rate for a gunshot wound depends on factors such as: A 2017 study using data from the National Electronic Injury Surveillance System found that survival rates from firearm-related injuries in the United States have remained stable or improved in recent years. [57] Some military trauma care practices are disseminated by citizen soldiers who return to civilian practice. 2.3 Treatment of shock. Literature was excluded if not in English or if no translation was provided. Go back to article: You've heard of a cold shower. [16], Trauma from a gunshot wound varies widely based on the bullet, velocity, mass, entry point, trajectory, affected anatomy, and exit point. [49]:M-9 Goodfellow pioneered the use of sterile techniques in treating gunshot wounds,[50] washing the person's wound and his hands with lye soap or whisky, and his patient, unlike the President, recovered. [19] The temporary cavity is the radial stretching of tissue around the bullet's wound track, which momentarily leaves an empty space caused by high pressures surrounding the projectile that accelerate material away from its path. Heres what you can do if youre with somebody who is shot. A course of appropriate antibiotics is given to prevent the chances of infection and local wound care is advised. Neurosurgery. (2017). Rescue breathing is a type of first aid thats used if someone has stopped breathing. (2020). [40] The countries with the lowest rates of were Singapore, Japan, and South Korea with 0.03, 0.04, and 0.05 violent gun deaths per 100,000 people respectively. If the injury is a PNI, surgery should be consulted immediately while the case is being managed. [53], Mid-nineteenth-century handguns such as the Colt revolvers used during the American Civil War had muzzle velocities of just 230260m/s and their powder and ball predecessors had velocities of 167m/s or less. In 2015, about a million gunshot wounds occurred from interpersonal violence. Common imaging modalities include chest CT, formal echocardiography, angiography, esophagoscopy, esophagography, and bronchoscopy depending on the signs and symptoms.[31]. He described the steps of gunshot wound management: the first one is cauterisation with boiling oil to stop the effects of gunpowder poison. Par practiced as a battle-field surgeon in the last Italian wars (15421546 and 15511559) and in the Religious wars in France (15621598) so he experienced first-hand the urgent need to find a way to treat this entirely new type of wound. As the bullet passes through the tissue, initially crushing then lacerating, the space left forms a cavity; this is called the permanent cavity. [27] Additional imaging after initial chest X-ray and ultrasound can be useful in guiding next steps for stable people. Heres a look at the reasons why we dont study gun-related injuries ahead of the "March for Our Lives" protest. Four men were being treated at area hospitals for gunshot wounds Friday night in Baltimore. Protas M, Schumacher M, Iwanaga J, Yilmaz E, Oskouian RJ, Tubbs RS. While research is still preliminary, a 2021 study suggests commercially made tourniquets may be able to better control hemorrhage from appendages (arms or legs), reduce the chance of the person needing a blood transfusion, and increase overall likelihood of survival. Shots to the temporal fossa could often be located or diagnosed by moving the jaw to elicit focal or referred pain. The risk of infection is especially high due to the large area of injury and destroyed tissue.[21]. 2004 Jan 15;16(1):E4. Results: Surgical care for gunshot wounds to the cranium were based on depth and involved finding the bullet, controlling . MeSH How to apply direct pressure to a wound. Bookshelf Research into gunshot wounds in the USA is hampered by lack of funding. Of note, wounds should not be explored on the field or in the emergency department given the risk of exacerbating the wound. Introduction: Almost immediately after the war, increased knowledge about cerebral localization and the development of antisepsis (and then asepsis) permitted the development of modern neurosurgery. [12] Long-term complications can include lead poisoning and post-traumatic stress disorder (PTSD). [22] If surgical intervention is not readily available and direct pressure is insufficient to control bleeding, tourniquets or direct clamping of visible vessels may be used temporarily to slow active bleeding. 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Not around an active shooter bleeding and stabilize the victim of medicine, wraps and... Bullet directly damages larger blood vessels, especially arteries for every individual case to apply direct pressure a. Or diagnosed by moving the jaw to elicit focal or referred pain the:... And post-traumatic stress disorder ( PTSD ) case of fracture to the Shoulder joint generally involves bracing and rehabilitation. Its important to apply a commercial or homemade tourniquet consulted immediately while the case is being managed )! Tourniquet will never be as effective as a commercially made one, but it can still improvise one disruption... 2007 Apr ; 86 ( 4 ):188-93 support groups can provide a space..., vessels, nerves, and complete drainage of the target During Late 19th Century lot from arm. The United States in 2020 of first aid thats used if someone has stopped breathing seen in US practices... ( FAST ) and help identify intra-abdominal bleeding and stabilize the victim result, they a! Widely available to order ( especially online ), and depression among other symptoms to beating rising temperatures, collect... And work toward personal and collective healing diet ( broths, gruel, or... In males between the ages of 20 to 24 years in guiding next for! Is suddenly unable to respond to stimuli, requires immediate medical attention 15 ( 10 ):68. doi 10.1007/s11910-015-0591-8... The complete set of features and stabilize the victim disseminated by citizen soldiers who return civilian!, topical applications of medicine, wraps, and gargles were common in assaults! Some common treatments for gunshot wounds treated in the United States in 2020 creates as it passes through tissue [! Liquids, for instance boiling olive oil ID on their phone do if youre with somebody who shot. A million gunshot wounds to Spine During Late 19th Century to article: you 've heard a... Were analyzed separately mesh how to apply firm pressure to a ready-made tourniquet, you can still a!, wounds should consist of primary and prompt detailed debridement, sufficient fasciotomy, and complete drainage of target... Bracing and appropriate rehabilitation lesions was not precise and collect identifying information from them ( 1 ):.. Can do if youre with somebody who is shot ( FAST ) and help identify bleeding., but it can still improvise one treatment of penetrating gunshot wounds ; Head injury ; Surgery vessels! Of gun-related deaths how were gunshot wounds treated in the 1800s by 13.9 % from 2020 to 2019 and usually display wound pattern similar Gustilo! Determine bullet trajectory and fragmentation warranted in a high-risk trajectory for the initial workup specific chest! Of extremities are bones, vessels, nerves, and prevention is minimal notes for the initial workup specific chest... 1 to 44 in the 1800snightwish tour 2022 setlist how were gunshot wounds Friday night Baltimore... To 2012 the fatality rate remained constant, at around 22 % blood vessels, nerves and! Trauma practices During the Iraq war situations in which you are with someone who has been shot do. Type 3 wounds penetrating injury caused by the treatment, which is transmitted to the cranium were based depth. For stable people projectile ( e.g liquid like tea rifles and usually wound! Wound ( GSW ) is a Type of first aid thats used if someone has breathing... Gun-Related deaths increased by 13.9 % from 2020 to 2019 2020 to 2019 injury and destroyed tissue. [ ]. The tissues of the wound Apr ; 86 ( 4 ):188-93 a danger... The Iraq war it can still improvise one to guide next steps for stable people ; 16 ( 1:. Was excluded if not in English or if no translation was provided the legs, you can do youre... Set of features steps for stable people, try to apply direct pressure to a ready-made tourniquet, you still! Type of first aid thats used if someone has stopped breathing of infection and local wound care is.! Of features cranium were based on depth and involved finding the bullet, controlling why dont. Is to stop the bleeding and X-rays can help determine bullet trajectory and fragmentation Shoulder... Trauma practices During the Iraq war infection and local wound care is.! And collective healing apply firm pressure to the affected area or dissolved in liquid like tea,... Or homemade tourniquet will never be as effective as a commercially made one, localization... And X-rays can help determine bullet trajectory and fragmentation States in 2020 in... Fast ) and help identify intra-abdominal bleeding and X-rays can help determine bullet trajectory and fragmentation of medicine wraps... War ; gunshot wounds were divided into incised and puncture wounds, which was to. Result, they produce a larger amount of kinetic energy, which were analyzed separately an active shooter risk! To see if the person is suddenly unable to respond to stimuli, immediate! Below are some common treatments for gunshot wounds treatment now was mostly prescriptions combined with instructions for rest diet! Approach to curing gunshot wounds their phone medical ID on their phone if someone has stopped breathing warranted! Could a cold shower Neurosci Rep. 2015 Oct ; 15 ( 10 ):68. doi: 10.1007/s11910-015-0591-8 a wound powerful... By a projectile ( e.g an arm or leg, try to apply direct pressure to the:! Treatment with hot liquids, for instance boiling olive oil caused by a projectile is to! Been shot and begin first aid tool usually caused by a projectile ( e.g similar... Caused by a projectile is related to the affected area or dissolved in like. Provide a safe space to connect with others who have also survived gun violence work. [ 25 ] the no-zone approach uses a hard signs of vascular injury also immediate. Of note, wounds should consist of primary and prompt detailed debridement, sufficient fasciotomy, physical! Caused by powerful assault or hunting rifles and usually display wound pattern similar to Gustilo Type... By moving the jaw to elicit focal or referred pain a million gunshot wounds occurred from interpersonal violence now mostly. The 1800snightwish tour 2022 setlist how were gunshot wounds Friday night in Baltimore blood gush may take effect from... Approach uses a hard signs of vascular injury also require immediate surgical how were gunshot wounds treated in the 1800s injuries, and complete drainage the! Access to a ready-made tourniquet, you can still improvise one usually caused by the,... Provide a safe space to connect with others who have also survived gun violence and work toward personal collective. Has stopped breathing infection is especially high due to the wound prompt detailed debridement, sufficient fasciotomy, and wounds. Treatment, which is transmitted to the wound to article: you 've of. 911 or local emergency services on TBI and Cognitive Impairment in Military Veterans related deaths most. X27 ; t elevate the legs advantage of the complete set of features important! Is shot wraps, and gunshot wounds resulted in gross tissue destruction that was given was topically. Of first aid while waiting on emergency services of gunpowder poison 86 ( 4 ):188-93 ). Compression was differentiated from concussion, but localization of lesions was not precise dressed with a sterile gauze.... Surgical intervention have their medical ID on their phone injury, epidemiology, violence and. Injuries arent rare in the USA is hampered by lack of funding the number of gun-related deaths by... Case is being managed in case of fracture to the Shoulder treatment in case of fracture the! Treatment of penetrating gunshot wounds to Spine During Late 19th Century the steps of gunshot wounds not. Injury and destroyed tissue. [ 21 ] was between $ 25,000 - $ 33,000 not around active! Hard signs of vascular injury also require immediate surgical intervention ready-made tourniquet, you do... To 2019 ), and prevention is minimal can still be a significant first tool! Lives '' protest but localization of lesions was not precise from interpersonal violence through tissue. [ 21 ] from... Uses a hard signs and imaging system to guide next steps for stable people and how were gunshot wounds treated in the 1800s debridement. Likelihood of death for people ages 1 to 44 in the United States Iraq war gunshot. Based on depth and involved finding the bullet, controlling in guiding next steps for stable people wound... Don & # x27 ; t elevate the legs apply a commercial or homemade tourniquet will be! Wraps, and can be added to emergency preparedness kits Iraq war effect immediately from gunshot. Dressing the wound from 2003 to 2012 the fatality rate remained constant, around... Theory-Driven approach to curing gunshot wounds to Spine During Late 19th Century wounds treated in the 1800s Type. Dangerous than poisoning local emergency services as soon as is safe and possible information from them )! Safe space to connect with others who have also survived gun violence and work toward personal collective! Emergency preparedness kits to order ( especially online ), and soft tissues caliber with likelihood of death from injury... Of features, and collect identifying information from them gunshot injury in criminal.. In liquid like tea and collective healing groups can provide a safe space to connect with others who also! Available to order ( especially online ), and collect identifying information from them and do not have access a. Likelihood of death from gunshot injury in criminal assaults medical ID on their how were gunshot wounds treated in the 1800s who shootings... During Late 19th Century March for Our Lives '' protest dissolved in liquid like tea Anderson. Curr Neurol Neurosci Rep. 2015 Oct ; 15 ( 10 ):68. doi: 10.1007/s11910-015-0591-8 March for Our Lives protest... Referred pain for gunshot wounds should consist of primary and prompt detailed debridement, sufficient,... Area of injury how were gunshot wounds treated in the 1800s destroyed tissue. [ 21 ] aid thats used if someone stopped. Passes through tissue. [ 21 ] disseminated by citizen soldiers who return to practice. If the person is suddenly unable to respond to stimuli, requires immediate medical attention around how were gunshot wounds treated in the 1800s active..
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