By: Dr. Gary K. Roberts
The last 30 years of modern wound ballistic research has demonstrated yet again what historical reports have always indicated–that there are only two valid methods of incapacitation: one based on psychological factors and the other physiological damage. People are often rapidly psychologically incapacitated by minor wounds that are not immediately physiologically incapacitating. Psychological factors are also the reason people can receive severe, even non-survivable wounds and continue functioning for short periods of time. Up to fifty percent of those individuals rapidly incapacitated by bullet wounds are probably incapacitated for psychological rather than physiological reasons. Psychological incapacitation is an extremely erratic, highly variable, and completely unpredictable human response, independent of any inherent characteristics of a particular projectile.
The degree and rapidity of any physiological incapacitation is determined by the anatomic structures the projectile disrupts and the severity of the tissue damage caused by the bullet. Physiologically, immediate incapacitation or death can only occur when the brain or upper spinal cord is damaged or destroyed. The tactical reality is that in combat, opportunities for military personnel to take precisely aimed shots at the CNS of enemy combatants is rare due to high stress unexpected contact marked by rapid fleeting movements, along with frequent poor visibility on the battlefield including use of cover and concealment. Thus the reduced likelihood of frequent planned CNS targeting in combat conditions. Absent CNS damage, circulatory system collapse from severe disruption of the vital organs and blood vessels in the torso is the only other reliable method of physiological incapacitation from small arms. If the CNS is uninjured, physiological incapacitation is delayed until blood loss is sufficient to deprive the brain of oxygen. Multiple hits may be needed before an individual is physiologically incapacitated. An individual wounded in any area of the body other than the CNS may physiologically be able to continue their actions for a short period of time, even with non-survivable injuries. In a 1992 IWBA Journal paper, Dr. Ken Newgard wrote the following about how blood loss effects incapacitation:
“A 70 kg male has a cardiac output of around 5.5 liters per minute. His blood volume is about 4200 cc. Assuming that his cardiac output can double under stress, his aortic blood flow can reach 11 Liters per minute. If this male had his thoracic aorta totally severed, it would take him 4.6 seconds to lose 20% of his total blood volume. This is the minimum amount of time in which a person could lose 20% of his blood volume from one point of injury. A marginally trained person can fire at a rate of two shots per second. In 4.6 seconds there could easily be 9 shots of return fire before the assailant’s activity is neutralized. Note this analysis does not account for oxygen contained in the blood already perusing the brain that will keep the brain functioning for an even longer period of time.”
Military and LE (law enforcement) personnel are generally trained to shoot at the center of mass, usually the torso, of an aggressive opponent who must be stopped through the use of lethal force. Physiological incapacitation with wounds to the torso is usually the result of circulatory system collapse. More rapid incapacitation may occur with greater tissue disruption. Tissue is damaged through two wounding mechanisms: the tissue in the projectile’s path is permanently crushed and the tissue surrounding the projectile’s path is temporarily stretched. A penetrating projectile physically crushes and destroys tissue as it cuts its path through the body. The space occupied by this pulped and disintegrated tissue is referred to as the permanent cavity. The permanent cavity, or wound track, is quite simply the hole bored by the projectile’s passage. Obviously, bullets of greater diameter crush more tissue, forming a larger permanent cavity. The formation of this permanent cavity is consistent and reliable.
The tissue surrounding the permanent cavity is briefly pushed laterally aside as it is centrifugally driven radially outward by the projectile’s passage. The empty space normally occupied by the momentarily displaced tissue surrounding the wound track, is called the temporary cavity. The temporary cavity quickly subsides as the elastic recoil of the stretched tissue returns it towards the wound track. The tissue that was stretched by the temporary cavity may be injured and is analogous to an area of blunt trauma surrounding the permanent crush cavity. The degree of injury produced by temporary cavitation is quite variable, erratic, and highly dependent on anatomic and physiologic considerations. Many flexible, elastic soft tissues such as muscle, bowel wall, skin, blood vessels, and empty hollow organs are good energy absorbers and are highly resistant to the blunt trauma and contusion caused by the stretch of temporary cavitation. Inelastic tissues such as the liver, kidney, spleen, pancreas, brain, and completely full fluid or gas filled hollow organs, such as the bladder, are highly susceptible to severe permanent splitting, tearing, and rupture due to temporary cavitation insults. Projectiles are traveling at their maximum velocity when they initially strike and then slow as they travel through tissue. In spite of this, the maximum temporary cavity is not always found at the surface where the projectile is at its highest velocity, but often deeper in the tissue after it has slowed considerably. The maximum temporary cavitation is usually coincidental with that of maximum bullet yaw, deformation, or fragmentation, but not necessarily maximum projectile velocity.
All projectiles that penetrate the body can only disrupt tissue by these two wounding mechanisms: the localized crushing of tissue in the bullet’s path and the transient stretching of tissue adjacent to the wound track. Projectile wounds differ in the amount and location of crushed and stretched tissue. The relative contribution by each of these mechanisms to any wound depends on the physical characteristics of the projectile, its size, weight, shape, construction, and velocity, penetration depth and the type of tissue with which the projectile interacts. Unlike rifle bullets, handgun bullets, regardless of whether they are fired from pistols or SMG’s, generally only disrupt tissue by the crush mechanism. In addition, temporary cavitation from most handgun bullets does not reliably damage tissue and is not usually a significant mechanism of wounding.
Bullets that may be required to incapacitate aggressors must reliably penetrate a minimum of approximately 10 to 12 inches of tissue in order to ensure disruption of the major organs and blood vessels in the torso from any angle and through excessive adipose tissue, hypertrophied muscle, or intervening anatomic structures, such as a raised arm.
Tissue is a denser medium than air; as the bullets strikes tissue, the increased drag on the projectile overcomes its rotational stabilization and the bullet can yaw. If the bullet yaws, more surface area is in contact with tissue, so it crushes more tissue, creating a larger permanent cavity. When a bullet yaws, it also displaces more of the surrounding tissue, increasing the temporary cavity size. Both the largest permanent and temporary cavities are produced when the bullet is traveling sideways at 90 degrees of yaw, allowing the maximum lateral cross sectional area of the bullet to strike tissue and displace the greatest amount of tissue. Longer and wider bullets have a greater lateral cross sectional area and thus create a larger permanent cavity when they yaw.
Aerodynamic projectiles, such as bullets, cause minimal tissue disturbance when passing point forward through tissue. Deformation destroys the aerodynamic shape of the bullet, shortening its length and increasing its diameter by expanding and flattening the bullet tip in the classic “mushroom” pattern exhibited by deforming jacketed hollow point and jacketed soft point bullets. The larger frontal area of deformed bullets can crush more tissue to increase permanent cavity size and also displace more tissue to increase temporary cavity size. (Note: The Hague Declaration of 1899 prohibits the use of bullets that expand or flatten easily in the human body against combatants in international armed conflict; the Hague Declaration does not prohibit the military use of bullets that fragment or because of their design, yaw upon entry into tissue.)
Projectile fragmentation in tissue can also greatly increase the permanent cavity size. When a rifle bullet fragments in tissue, each of the multiple fragments spreads out radially from the main wound track, cutting its own path through tissue. This fragmentation acts synergistically with the stretch of temporary cavitation. The multiply perforated tissue loses its elasticity and is unable to absorb stretching that would ordinarily be tolerated by intact tissue. The temporary cavitation displacement of tissue, which occurs following the passage of the projectile, stretches this weakened tissue and can grossly disrupt its integrity, tearing and detaching pieces of tissue. Note that handgun bullets, regardless of whether they are fired from pistols or SMG’s, do not generally exhibit the fragmentation effects produced by rifle bullets. If handgun bullets do fragment, the bullet fragments are usually found within 1 cm of the permanent cavity; wound severity is usually decreased by the fragmentation since the bullet mass is reduced, causing a smaller permanent crush cavity.