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Mon Sep 1 21:38:33 BST 2008

Hello all,

I am a bit perplexed!!

I began Med School in 1972.  Served as a Medic (1973) and Doctor
(1982,1991,2006) in four wars. Seen thousands of war casualties and
personally treated hundreds of shrapnel/projectile victims of explosives and
firearms.  Treated hundreds of suicide bombing victims (and have data on
some 8000 others from other med. centers around the country) from all sorts
of stuff that the terrorists' twisted minds try to add to the explosives.

In all these years (1973-2008) I have never never never seen a metal
substance poisoning from these projectiles.  Oh, we did see these particles
to cause severe problems.  However, all were mechanical or infectious
complications.  Those (infectious complications) were seen more commonly
with the non-metalic projectiles or if traversed through contaminated organs
(i.e. hollow viscus etc.).  More so, I have never heard of anyone who saw
these types of complications (including the 2 years I spent at STC in
Baltimore MD 1993-5).

Personal experience is Level 6 :-) or less evidence but.

Am I blind?

Am I deaf?

Is it such a scarce issue?

Are my patients just LUCKY?

Do they use different "Metals" in the Middle East?

Are we divinely protected from this type of complication in the "Holy-Land"?

Is the King Naked?

All or some of the above?

Your humble devils advocate.

Mickey

*******************************************************************

Michael Stein MD

Chairman, Israel Trauma Society

Director of Trauma, Attending Surgeon

Department of Surgery,

Rabin Medical Center - Beilinson Hospital,

Petach-Tikva, 49100

ISRAEL

******************************************************************

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of listasmsd
Sent: Monday, September 01, 2008 1:28 PM
To: Trauma &amp; Critical Care mailing list
Subject: Re: question about projectile composition

old data

Am J Forensic Med Pathol. 1983 Jun;4(2):165-9. Links

A fatal case of lead poisoning due to a retained bullet.

DiMaio VJ, DiMaio SM, Garriott JC, Simpson P.

Lead poisoning from a retained bullet or missile is rare and is usually 

dependent on the location of the missile in a bone or immediately adjacent 

to a joint. A review of the literature revealed only 14 cases in which there

was adequate laboratory documentation of plumbism caused by a retained 

bullet or missile. Only one of these previously reported cases resulted in 

death. We report a second death due to lead poisoning from a retained bullet

with elevated blood lead levels documented by toxicologic analysis.>

> 

> 

> Hello again all, In the news today I saw that the army is studying the

> longterm effects of shrapnel left in the bodies of soldiers. It made me

> think of all the GSW fragments I have seen left in patients over the

> years. The standard missile composition I understand to be copper jacketed

> lead. Also common hollow point and softpoint projectiles have no covering

> at all. Does anyone know of the longterm health effects of tihs either in

> civillian studies or anecdotes? What about projectiles with tungsten? Does

> location in the body have an effect on outcome? Look forward to the input

> from the list. thanks again,Mike

> 

> 

> 

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question about projectile composition