The following case study is of an Afghan civilian woman who was medically evacuated to a Forward Surgical Team in regional Afghanistan having sustained a through-and-through gunshot wound to her right upper chest. The exact circumstance of the wounding was never made completely clear, but it was understood that the women was injured in crossfire during a firefight between two feuding Afghan tribes. The likely weapon that the bullet came from was an AK-47, and history from the woman suggested that the range she was shot from was likely between 300-400 metres, meaning that the bullet would have lost a significant amount of velocity before it struck her.
The casualty had been taken to a regional military base where her wounds were covered with occlusive dressings by the treating medic and an AME was organised to the FST that I was working at on the day. The following image shows the primary survey of the casualty in the resuscitation bay of the FST with myself assessing her wounds and one of the trauma surgeons listening to her chest to assess for breath sounds.

Gunshot wound chest initial resus

The images below are of the wounds being assessed once the occlusive dressings had been removed.

Gunshot wound chest entrance woundGunshot wound chest 4Gunshot wound chest exit wound