Vaughn Bell pointed out this case study of a patient who tried to commit suicide via nail gun, and how medical personnel decided to treat the injury. The case study is impressive, but so is the addendum: Nail gun wounds—specifically, intentionally self-inflicted nail gun wounds—are a lot more common than you might expect.
As with any tool, some people will use a power tool for something other than its intended use, causing unusual injuries. And with the advent of the ˙weekend warrior,Ó more injuries have been caused by power tools. Specifically, the Centers for Disease Control and Prevention reports a dramaticincrease in nail gun injuries. From 2001Ï2005,there were 37,000 injuries caused by nail guns. Of those, 40% were to non-construction workers.
Care for these injuries is usually the same as for any patient with an impaled object. If possible, and if the object is still visible, secure the object. If the projectile isn_t visible and is lodged in the skull, there_s no way to secure the object, and the injury is likely more severe. In this case, because of the unknown location of the projectile, preventing head movement was the primary goal.
Multiple reports of self-inflicted intracranial foreign bodies are documented in the literature. The majority of these are reportedly from suicide attempts. Because the entrance wound may be extremely difficult to see, prehospital providers and ED personnel need to be suspicious of a suicide attempt or psychiatric illness when a patient presents with any blood on the head.
Fatality is reported in up to 40% of cases involving penetrating head trauma. Compressed air nail guns, specifically, are reported to fire at up to 425 meters per second and can cause significant brain injury.
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