A global perspective on gun violence injuries.

Area of Science:

• Trauma Surgery
• Public Health
• Emergency Medicine

Background:

• Civilian gunshot violence is a significant global public health concern.
• Current treatment algorithms are primarily based on military studies, creating a knowledge gap due to differences in civilian contexts.
• There's a need to address non-accidental gunshot trauma, excluding suicide, to develop specific best practices.

Purpose of the Study:

• To establish a collaborative research group focused on gunshot injury.
• To address critical questions regarding best practices for treating civilian gunshot victims.
• To bridge the knowledge gap between military and civilian trauma care protocols.

Main Methods:

• Reviewing and synthesizing existing military and civilian trauma care protocols.
• Identifying key differences in civilian gunshot injuries (weaponry, energy, care environment).
• Proposing a collaborative research framework to address identified knowledge gaps.

Main Results:

• Exsanguinating hemorrhage control (using protocols like X-ABC) is a priority in acute treatment.
• Pre-hospital interventions (tourniquets, tranexamic acid, whole blood) and in-hospital definitive care strategies are crucial.
• Mental health support and resource management for mass-casualty events are vital components of comprehensive care.

Conclusions:

• Developing evidence-based, civilian-specific guidelines for gunshot injury management is essential.
• Optimizing pre-hospital, acute, and definitive care, alongside mental health support, can improve survival and long-term outcomes.
• Effective resource allocation and ethical considerations are paramount, especially during mass-casualty incidents.