Gunshot wound to thigh... need your insights.

Hey Jan.

I'm a former police officer and have more experience with gun shot wounds than I'd like.

Your scenario is totally plausible. What is most plausible about your scenario is "face a protracted recovery where he requires physical therapy and an effort to get back to normal." We see all too often characters in movies, TV shows and books getting shot, with a very short recovery time, and little or no lingering disabilities.

The reality is, getting shot is a big deal. Every one I've know that has been shot has some lingering disability, even ones that were shot with small caliber handguns with non-expanding projectiles.

A bullet wound that nicks, but doesn't sever his femoral artery and breaks, but doesn't shatter his femur is plausible. Somebody who received such a wound literally cheated death by a matter of millimeters. I'm not medically savvy enough to tell you exactly the number of surgeries that somebody would need after that, but three certainly sounds plausible, and in line with what I've seen happen in real life.

I'd expect such a wound to come from a "service caliber" type handgun like a 9mm, .40 S&W, or .45 ACP, or potentially a intermediate power rifle round like the 7.62x39mm that is commonly fired from an AK-47 or SKS (both of which happen to be popular among drug dealers). If you want to really get into the weeds I'd make it a full metal jacket round instead of a hollowpoint or soft point, as that makes a narrower wound track more plausible.

Based on our experiences in recent wars, it's become common practice for police officers to carry a tourniquet and gun shot wound bandage (click to see links) to self apply. Even a "nicked" femoral artery is a big deal, and I'd expect that to survive that, either the MC or one of his buddies on the entry team would apply a tq pretty quick.

As far as how that would affect the MC, cops tend to be athletic, alpha type people. Suddenly being disabled, unable to walk and needing the help of other people is a big switch and hard to take. Also, there's an unconscious feeling of invulnerability that comes with the job and training. You're tactically superior to the average scrote on the street, but all they have to do is get lucky once.

I actually touched on this in the book I'm about to publish: "The thought nobody wanted to talk about, the thing that kept us up at night, staring a hole in the ceiling, was that you could have all the right gear, be trained like a Delta Force ninja, make all the right moves, and still die from a bullet out of a $50 pistol fired by some street punk who shut his eyes when he jerked the trigger."

Another angle you might want to think about is that the pain from this sort of thing is incredible, and it's not uncommon for people to come out of needing to be weaned off of opiod pain killers.

Coming within a few millimeters of dying is a really strong predictor for developing PTSD. Here's an excellent article on police stress in general.

This can be devastating to a relationship. The life partner is dealing with almost loosing their loved one, having to suddenly become their nurse/helper, and all the associated secondary trauma.

You may really find the book "Deadly Force Encounters" by Loren Christensen and Alexis Artwohl. Loren is an acquaintance of mine and has been in more real fights than most people have seen on TV. Dr. Artwohl has saved dozens of careers, marriages and even lives.

Hope that helps!

Good luck on your project.

jarrellj said:

I had thought, and as a former officer you may know this... that an ambulance might be on 'stand-by' since they knew this would be a tricky arrest which posed specific dangers. Maybe you could tell me if that makes sense.

Click to expand...

Hey Jan,

I'm glad that helped.

Regarding your question about an ambulance on standby, the only time I've seen that done as a matter of course is during things like full blown SWAT operation like a barricaded suspect where shots have been fired, or a hostage rescue.

It sounds like your guy got shot doing a high risk search warrant entry. I don't recall having an ambulance on standby for those, but it's entirely possible that it might happen.

What kind of jurisdiction is this? If it's a large police department in a major metropolitan area, it's actually unlikely that the dope detectives would also be the entry team. They would develop the case and hand the intelligence off to a dedicated SWAT Team who would hit the house/structure, secure it, and then hand it off to detectives for the secondary search for evidence. It's possible they might have an ambulance staged for an entry like that.

In a more rural setting, the dope investigators might also double as the entry team, and in fact it might be more likely they would coordinate with the local fire and EMS services to have an ambulance close. I worked in a major metro area and we could have fire and EMS on scene within a few minutes. In someplace like Montana or Wyoming, that response time might be much, much longer, so they might make sure and have medical staged nearby.

jarrellj said:

The research I've done suggests that he would require at least three surgeries, one to repair the artery, one to set the femur, and possibly a third to repair any muscle damage.

Jan

Click to expand...

There's a few things from the surgical standpoint.

1. The femoral artery isn't just hanging out there on it's own. It's in a fascial sheath along with the femoral nerve, femoral vein and lymphatics. If the artery is nicked, there's a good chance the others are.

2. Femur broken but not shattered...easily explainable with a low velocity round (most handguns excluding most magnums)

3. Muscle damage is normally not a major player in low velocity firearm projectiles. If you want significant muscle damage from a firearm projectile it sort of has to be high velocity because it's the shockwave moreso than direct injury that damages the soft tissues. A high velocity round is much more likely to shatter the bone. A low velocity round is not likely to cause much in the way of muscle damage. So you really should pick one. A low velocity round is your better choice if you want the character to walk again at some point.

The surgeries that you allude to would be done at the same setting most likely. First would be the vascular surgery and if necessary doing something about the femoral nerve and then if the patient is stable, then the ortho people would come in and probably pin the bone. If there are concerns about the vascular repair it is conceivable that they might immobilize the leg with traction and wait a day or two for ortho surgery

Recovery will depend on the bone healing and how damaged the femoral nerve was when the femoral artery was nicked. That very well may be a couple months on the rehab floor of a hospital or transfer to a rehab facility or depending upon locale and insurance possibly extended out patient rehab. In a good scenario your character might believably be back to desk duty in 6 months on on the beat in 9.

Hey Jan,

Let me make sure I understand: Your MC and his buddy from the city PD are monitoring a drug buy from their confidential informant. Something happens that places the CI in jeopardy, and your MC and his bud decide to pull a John Wayne and charge in to save the informant before any kind of back up arises. The MC gets shot for his trouble.

Do I have that right? Because if I do, that works. Essentially your MC and his bud are conducting an ad hoc hostage rescue on the fly, which explains why they'd be making an entry with out the benefit of a SWAT team and such.

There wouldn't be an ambulance standing by for that. Just two cops sitting in a car, listening to the CI's wire and drinking cold coffee.

Hi Jarellj

You could maybe try these books - They are from the writers digest books - Writers guides covering weapons and ballistics and effects and treatment of trauma written by experts aimed at authors.
https://www.goodreads.com/book/show/725719.Armed_and_Dangerous
https://www.goodreads.com/book/show/1106540.Body_Trauma

Hope this helps - Have fun being mean to your characters

Also, while in the movies and tv frequently show the CI wearing some kind of electronic wire, that isn't necessarily how it will go. They could send the CI go in with some money, buy the dope and come back. They then take his statement that he bought dope from so and so, use that to get a search warrant, then hit the house. They photocopy the money before the buy, so they have the serial numbers.

So their first clue that something is wrong might be that the CI has been in the house for much longer than it should take, and decide to sneak up and investigate.

Again, you're welcome. Would very much like to read this when it comes out. Good on you for trying to inject some verisimilitude in your story. I read quite a bit of crime fiction that makes me cringe.

Sounds like GeorgeK has his medical info dialed in. His point about a low velocity "service pistol" type handgun round being least likely to shatter the femur is spot on. My 7.62x39mm example above would much more likely splinter the femur, so I'd go with the handgun option.

Even "nicking" the femoral artery would be very problematical. That's a bad thing to damage, even in a seemingly small way. Breaking the femur, with all the attendant muscle damage, would be very serious, and require a long recovery, without involving the femoral artery.

caw

Might switch to a knee being shot. Have your officer need a knee replacement, plenty of off-duty time and physical therapy. A shattered hip works too, or pelvis break. It is really hard to nick a femoral artery and not have sever blood loss.

As for your ambulance, it would normally be only a few minutes out if it's available, so one on standby isn't really needed. They tend to roll faster for officers in need anyway.

For the life-threatening part, give him a serious infection or sepsis.

Jeff