Bean Bag Projectile Causing Ocular Compartment Syndrome, Intracranial Hemorrhage, and Facial Fractures

Bean bag rounds are a commonly used nonlethal projectile. Although they are generally reported to cause mild to moderate soft tissue injury, the potential for more serious injuries is only partially explored and may even be underappreciated. Injuries to the face, eyes, and head and their potential to inflict serious consequences, or even fatalities, are not well established.

We present a case of severe head trauma caused by a bean bag round. Injuries included ocular compartment syndrome, intracranial hemorrhage, depressed skull fracture, and multiple facial fractures. Emergency department management of this patient required lateral canthotomy, intubation for airway protection, and management of suspected elevated intracranial pressure. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although typically not regarded as serious, injuries caused by bean bag rounds have the potential to threaten life, limb, and vision. Emergency physicians should be aware of these possibilities, especially when the head is impacted, and should be prepared to perform critical actions and emergent procedures as needed. In addition, if not at a major trauma center, the emergency physician needs to be aware of the time-sensitive interventions required prior to transfer.