Effects of police body armour on overmatching ballistic injury.

Overmatching occurs when body armour that has been designed to resist perforation by a specified projectile is perforated by a greater threat. This may result in wounding to the body armour wearer. In this work, overmatching of two types of police body armour was studied using two types of ammunition. The use of a 250-mm-long gelatine block to represent the depth of the human torso combined with armour panels mounted on the anterior and posterior of the block allowed for a more realistic simulation to be completed. There was some evidence to suggest that overmatching events could lead to increased levels of damage during a survivable incident compared with no body armour being present. This information is of interest to armour designers and medical personnel that might treat such wounds.

Preliminary effect of projectile yaw on extremity gunshot wounding in a cadaveric animal model: a serendipitous study.

Gunshot wounding (GSW) is capable of causing devastating tissue injuries by delivering kinetic energy (KE) through the contact surface area of a projectile. The contact surface area can be increased by yaw, deformation and fragmentation, all of which may be caused by any intermediate layers struck by the projectile prior to entering its target. This study aims to describe whether projectile yaw occurring before penetration of a cadaveric animal limb model causes greater damage with or without clothing layers present using 5.45 × 39 mm projectiles. In total, 12 fallow deer hind limbs were shot, further divided into 4 with no clothing layers (Cnil), 4 with a single clothing layer (Cmin) and 4 with maximum clothing layers (Cmax) as worn on active duty by UK military personnel. Contrast computed tomography (CT) of limbs was used to measure permanent cavity size and the results were compared using analysis of variance (ANOVA). No significant differences were found among clothing states for each series of measurements taken, with greater cavity sizes noted in all clothing states. This is in contrast to previous work looking at symmetrically flying projectiles in the same model, where a larger permanent cavity was found only with Cmax present. Projectile yaw is therefore likely to be a key variable with regard to causation of damage within this extremity wound model.

Ballistic protective properties of material representative of English civil war buff-coats and clothing.

One type of clothing system used in the English Civil War, more common amongst cavalrymen than infantrymen, was the linen shirt, wool waistcoat and buff-coat. Ballistic testing was conducted to estimate the velocity at which 50% of 12-bore lead spherical projectiles (V50) would be expected to perforate this clothing system when mounted on gelatine (a tissue simulant used in wound ballistic studies). An estimated six-shot V50 for the clothing system was calculated as 102 m/s. The distance at which the projectile would have decelerated from the muzzle of the weapon to this velocity in free flight was triple the recognised effective range of weapons of the era suggesting that the clothing system would provide limited protection for the wearer. The estimated V50 was also compared with recorded bounce-and-roll data; this suggested that the clothing system could provide some protection to the wearer from ricochets. Finally, potential wounding behind the clothing system was investigated; the results compared favourably with seventeenth century medical writings.

Shooting through windscreens: ballistic injury assessment using a surrogate head model-two case reports.

A synthetic head model developed to reproduce military injuries was assessed in two different scenarios involving shooting through intermediate targets (a laminated vehicle windscreen in scenario 1 and a military helicopter windscreen in scenario 2) with 7.62 × 39-mm mild steel core (MSC) ammunition. The injury patterns resulting from the two scenarios were assessed by a military radiologist and a forensic pathologist with combat injury experience and found to be clinically realistic.

Ballistic research techniques: visualizing gunshot wounding patterns.

There are difficulties associated with mapping gunshot wound (GSW) patterns within opaque models. Depending on the damage measurement parameters required, there are multiple techniques that can provide methods of "seeing" the GSW pattern within an opaque model. The aim of this paper was to test several of these techniques within a cadaveric animal limb model to determine the most effective. The techniques of interest were flash X-ray, ultrasound, physical dissection, and computed-tomography (CT). Fallow deer hind limbs were chosen for the model with four limbs used for each technique tested. Quarantined 7.62 × 39 mm ammunition was used for each shot, and each limb was only shot once, on an outdoor range with shots impacting at muzzle velocity. Flash X-ray provided evidence of yaw within the limb during the projectile's flight; ultrasound though able to visualise the GSW track, was too subjective and was abandoned; dissection proved too unreliable due to the tissue being cadaveric so also too subjective; and lastly, CT with contrast provided excellent imaging in multiple viewing planes and 3D image reconstruction; this allowed versatile measurement of the GSW pattern to collect dimensions of damage as required. Of the different techniques examined in this study, CT with contrast proved the most effective to allow precise GSW pattern analysis within a cadaveric animal limb model. These findings may be beneficial to others wishing to undertake further ballistic study both within clinical and forensic fields.

The effect of military clothing on gunshot wound patterns in a cadaveric animal limb model.

The majority of injuries in survivors of gunshot wounds (GSW) are typically to the extremities. Novel wound ballistic research is encouraged to try and capture corporate knowledge on the management of these injuries gained during recent conflicts and understand the wounding patterns seen. With recent work examining the effect of UK military clothing on extremity GSW patterns in a synthetic model, a model with greater biofidelity is needed for ballistic testing. The aim of this study was to assess the effect of UK military clothing on GSW patterns within a cadaveric animal limb model using two types of ammunition commonly used in recent conflicts-7.62 × 39 mm and 5.45 × 39 mm. In total, 24 fallow deer hind limbs were shot, 12 by 7.62 mm projectiles and the remaining 12 shot by 5.45 mm projectiles, further divided into four with no clothing layers (Cnil), four with a single clothing layer (Cmin) and four with maximum clothing layers (Cmax) as worn on active duty by UK military personnel. Limbs were analysed after ballistic impact using contrast CT scanning to obtain measurements of permanent cavity damage, and results were compared using analysis of variance (ANOVA). Results showed significantly different damage measurements within limbs with Cmax for both ammunition types compared with the other clothing states. This may result in GSWs that require more extensive surgical management, and invites further study.

The effect of military clothing on gunshot wounding patterns in gelatine.

With no two gunshot wounds (GSW) being the same, novel research into wound ballistics is challenging. It is evident that the majority of previous wound ballistic research has been conducted without the presence of clothing. Whilst the effect of clothing on wound contamination has been explored, there is a paucity of literature examining the effect of clothing on GSW patterns. The aim of this study was to test the effect of Multi-Terrain Pattern (MTP) UK military clothing on GSW patterns within calibrated blocks of 10% by mass gelatine, using two types of ammunition commonly used in recent conflicts-7.62 × 39 mm and 5.45 × 39 mm. In total, 36 blocks were shot, 18 by each projectile type, further divided into 6 with no clothing layers (Cnil), 6 with a single clothing layer (Cmin) and 6 with maximum clothing layers (Cmax) worn on active duty. Blocks were analysed with high-speed video and dissection to capture measurements of damage, and results compared using analysis of variance (ANOVA). Results showed significantly different damage measurements within blocks with Cmax for both ammunition types compared to the other clothing states. This may result in GSWs that require more extensive surgical management, inviting further study.

Assessment of polyurethane spheres as surrogates for military ballistic head injury.

SYNBONE® spheres were impacted with 7.62 × 39 mm mild steel core ammunition at a mean impact velocity of 654 m/s, SD 7 m/s, to simulate engagement distances of around 50-100 m. The wounds and fracture patterns were assessed by two forensic pathologists familiar with military cranial injury. The overall fracture pattern was assessed as being too comminuted when compared with actual injury. This suggests the SYNBONE® spheres have less utility for simulating military injury than other purposes described in the literature.

Forensic reconstruction of two military combat related shooting incidents using an anatomically correct synthetic skull with a surrogate skin/soft tissue layer.

Six synthetic head models wearing ballistic protective helmets were used to recreate two military combat-related shooting incidents (three per incident, designated 'Incident 1' and 'Incident 2'). Data on the events including engagement distances, weapon and ammunition types was collated by the Defence Science and Technology Laboratory. The models were shot with 7.62 × 39 mm ammunition downloaded to mean impact velocities of 581 m/s (SD 3.5 m/s) and 418 m/s (SD 8 m/s), respectively, to simulate the engagement distances. The damage to the models was assessed using CT imaging and dissection by a forensic pathologist experienced in reviewing military gunshot wounds. The helmets were examined by an MoD engineer experienced in ballistic incident analysis. Damage to the helmets was consistent with that seen in real incidents. Fracture patterns and CT imaging on two of the models for Incident 1 (a frontal impact) were congruent with the actual incident being modelled. The results for Incident 2 (a temporoparietal impact) produced realistic simulations of tangential gunshot injury but were less representative of the scenario being modelled. Other aspects of the wounds produced also exhibited differences. Further work is ongoing to develop the models for greater ballistic injury fidelity.

Ballistic impacts on an anatomically correct synthetic skull with a surrogate skin/soft tissue layer.

The aim of this work was to further develop a synthetic model of ballistic head injury by the addition of skin and soft tissue layers to an anatomically correct polyurethane skull filled with gelatine 10% by mass. Six head models were impacted with 7.62 x 39 mm full metal jacket mild steel core (FMJ MSC) bullets with a mean velocity of 652 m/s. The impact events were filmed with high-speed cameras. The models were imaged pre- and post-impact using computed tomography. The models were assessed post impact by two experienced Home Office pathologists and the images assessed by an experienced military radiologist. The findings were scored against real injuries. The entry wounds, exit wounds and fracture patterns were scored positively, but the synthetic skin and soft tissue layer was felt to be too extendable. Further work is ongoing to address this.

The effect of helmet materials and simulated bone and tissue layers on bullet behaviour in a gelatine model of overmatch penetrating head injury.

The aim of this work was to simulate an overmatch ballistic event against a head wearing a helmet. The experiments were designed to understand how layers of bone (or synthetic bone), synthetic skin and currently used helmet materials influence the behaviour of full metal jacket mild steel core (FMJ MSC) 7.62 × 39 mm bullets, impacting on targets with a mean velocity of 650 m/s. Bullet behaviour within 10% (by mass) gelatine blocks was assessed by measurements made of the temporary cavity within the blocks using high-speed video and of the permanent cavity by dissecting blocks post firing. While ANOVA did not find significant difference at the 0.05 level in the mean values of most of the measurements, there was a significant difference in neck length within the gelatine blocks. The addition of material layers did produce greater variability in the temporary cavity measurements under some of the conditions. One of the synthetic bone polymers with a synthetic skin layer produced similar results within the gelatine blocks to the horse scapulae (with residual tissue) and may be suitable for future ballistic experiments.

A systematic review of military head injuries.

INTRODUCTION: This commissioned review discusses military head injuries caused by non-ballistic impacts, penetrating fragments and bullets (including parts of bullets) and behind helmet blunt trauma (BHBT). METHOD: A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. The openly accessible literature was reviewed to investigate military head injuries and their severity. RESULTS: Fifty-four sources were identified that included pertinent openly accessible information relevant to this topic. Limited injury data exist for non-ballistic head injuries for UK forces, although some international data exist for parachutists. The majority of fatal head injuries are due to projectiles penetrating through the face rather than through the area of the head covered by the helmet. Penetrating head injuries are primarily caused by fragments, but helmets are more commonly perforated by high-energy rifle bullets than by fragments. No reports of a BHBT injury have been located in the literature. CONCLUSIONS: The description of body segment varies among articles and this makes comparisons among datasets difficult. There is a lack of detail regarding the precise position and severity of injuries, and long-term outcome for casualties. It is demonstrated that wearing military helmets reduces fatalities on and off the battlefield. The risk of BHBT injuries is widely referred to, but evidence of their occurrence is not provided by the authors that describe the risk of BHBT occurring. Further research into the causes and severity of head injuries would be useful for designers of military helmets and other associated personal protective equipment, particularly as advances in materials technology means lighter, thinner and more protective helmets are achievable.

Is behind armour blunt trauma a real threat to users of body armour? A systematic review.

INTRODUCTION: Behind armour blunt trauma (BABT) has been defined as a non-penetrating injury caused by the rapid deformation of body armour. There has been an increasing awareness of BABT as an injury mechanism in both the military and civilian worlds; whether BABT results in serious injuries is debatable. METHOD: A systematic review of the openly accessible literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method to investigate those injuries classified as BABT and their severity. RESULTS: 50 sources were identified that included pertinent information relevant to this systematic review on BABT injuries. Typical injuries reported included skin contusion, laceration and penetration, rib fracture and contusions to lungs, kidneys, spleen and (rarely) the heart. No evidence of fatal injuries due to BABT was identified. CONCLUSIONS: Whether BABT can lead to life-threatening injuries when small-arms ammunition impacts body armour components designed to stop that ammunition is debatable. It should be emphasised that other data may be available in government reports that are not openly available. Further research should be considered that investigates developments in body armour, including initiatives that involve reducing burden, and how they affect BABT.

Development of a skull/brain model for military wound ballistics studies.

Reports on penetrating ballistic head injuries in the literature are dominated by case studies of suicides; the penetrating ammunition usually being .22 rimfire or shotgun. The dominating cause of injuries in modern warfare is fragmentation and hence, this is the primary threat that military helmets protect the brain from. When helmets are perforated, this is usually by bullets. In combat, 20% of penetrating injuries occur to the head and its wounding accounts for 50% of combat deaths. A number of head simulants are described in the academic literature, in ballistic test methods for helmets (including measurement of behind helmet blunt trauma, BHBT) and in the 'open' and 'closed' government literature of several nations. The majority of these models are not anatomically correct and are not assessed with high-velocity rifle ammunition. In this article, an anatomically correct 'skull' (manufactured from polyurethane) and 'brain' (manufactured from 10%, by mass, gelatine) model for use in military wound ballistic studies is described. Filling the cranium completely with gelatine resulted in a similar 'skull' fracture pattern as an anatomically correct 'brain' combined with a representation of cerebrospinal fluid. In particular, posterior cranial fossa and occipital fractures and brain ejection were observed. This pattern of injury compared favourably to reported case studies of actual incidents in the literature.

Damage to apparel layers and underlying tissue due to hand-gun bullets.

Ballistic damage to the clothing of victims of gunshot wounds to the chest can provide useful forensic evidence. Anyone shot in the torso will usually be wearing clothing which will be damaged by the penetrating impact event and can reportedly be the source of some of the debris in the wound. Minimal research has previously been reported regarding the effect of bullets on apparel fabrics and underlying tissue. This paper examines the effect of ammunition (9 mm full metal jacket [FMJ] DM11 A1B2, 8.0 g; and soft point flat nose Remington R357M3, 10.2 g) on clothing layers that cover the torso (T-shirt, T-shirt plus hoodie, T-shirt plus denim jacket) and underlying structures represented by porcine thoracic wall (skin, underlying tissue, ribs). Impacts were recorded using a Phantom V12 high speed camera. Ejected bone debris was collected before wound tracts were dissected and measured; any debris found was recovered for further analysis. Size and mass of bony debris was recorded; fibre debris recovered from the wound and impact damage to fabrics were imaged using scanning electron microscopy (SEM). Remington R357M3 ammunition was characteristically associated with stellate fabric damage; individual fibres were less likely to show mushrooming. In contrast, 9 mm FMJ ammunition resulted in punch-out damage to fabric layers, with mushrooming of individual fibres being more common. Entry wound sizes were similar for both types of ammunition and smaller than the diameter of the bullet that caused them. In this work, the Remington R357M3 ammunition resulted in larger exit wounds due to the bullet construction which mushroomed. That fabric coverings did not affect the amount of bony debris produced is interesting, particularly given there was some evidence that apparel layers affected the size of the wound. Recent work has suggested that denim (representative of jeans) can exacerbate wounding caused by high-velocity bullet impacts to the thigh when the bullet does not impact the femur. That more bony debris was caused by Remington R357M3 rather than 9 mm FMJ ammunition was not surprising given the relative constructions of these two bullets, and is of interest to medical practitioners.

Interpreting the formation of bloodstains on selected apparel fabrics.

Bloodstain pattern analysis (BPA) is the investigation and interpretation of blood deposited at crime scenes. However, the interaction of blood and apparel fabrics has not been widely studied. In this work, the development of bloodstains (passive, absorbed and transferred) dropped from three different heights (500, 1,000, 1,500 mm) on two cotton apparel fabrics (1 × 1 rib knit, drill) was investigated. High-speed video was used to investigate the interaction of the blood and fabric at impact. The effect of drop height on the development of passive, absorbed and transferred bloodstains was investigated using image analysis and statistical tools. Visually, the passive bloodstain patterns produced on the technical face of fabrics from the different drop heights were similar. The blood soaked unequally through to the technical rear of both fabrics. Very little blood was transferred between a bloody fabric and a second piece of fabric. Statistically, drop height did not affect the size of the parent bloodstain (wet or dry), but did affect the number of satellite bloodstains formed. Some differences between the two fabrics were noted, therefore fabric structure and properties must be considered when conducting BPA on apparel fabrics.

UK military helmet design and test methods.

The aim of this paper was to provide the military medical community with an expert summary of military helmets used by HM Armed Forces. The design of military helmets and test methods used to determine the fragmentation and non-ballistic impact protection are discussed. The helmets considered are Parachutist, Combat Vehicle Crewman, Mk6, Mk6A, Mk7 and VIRTUS. The helmets considered provide different levels of fragmentation and non-ballistic impact protection dictated by the materials available at the time of the helmet design and the end-user requirement. The UK Ministry of Defence defines the area of coverage of military helmets by considering external anatomical features to provide protection to the brain and the majority of the brainstem. Established test methods exist to assess the performance of the helmet with respect to the threats; however, these test methods do not typically consider anatomical vulnerability.

A preliminary study into injuries due to non-perforating ballistic impacts into soft body armour over the spine.

The UK Home Office test method for ballistic protective police body armours considers anterior torso impacts to be the worst-case scenario and tests rear armour panels to the same standards as front panels. The aim of this paper was to examine the injuries from spinal behind armour blunt trauma (BABT) impacts. This study used a cadaveric 65 kg, female pig barrel and 9 mm Luger ammunition (9 × 19 mm, FMJ Nammo Lapur Oy) into HG1/A + KR1 soft armour panels over the spine. Injuries were inspected and sections removed for x-radiography and micro-CT assessment. All shots over the spine resulted in deep soft tissue injuries from pencilling of the armour and the shirt worn under the armour. The wounds had embedded fabric debris which would require surgery to remove resulting in increased recovery time over injuries usually seen in anterior torso BABT impacts, which are typically haematoma and fractured ribs. The shot with the deepest soft tissue wound (41 mm) also resulted in a fractured spinous process. Shots were also fired at the posterior and anterior rib area of the pig barrel, for comparison to the spine. Similar wounds were seen on the shots to the posterior rib area while shallower, smaller wounds were seen on the anterior and one anterior rib shot resulted in a single, un-displaced rib fracture. The anatomical differences between pigs and humans would most likely mean that injury to a human from these impacts would be more serious.

Drip bloodstain appearance on inclined apparel fabrics: Effect of prior-laundering, fibre content and fabric structure.

The interaction of blood and fabrics is currently a 'hot topic', since the understanding and interpretation of these stains is still in its infancy. A recent simplified perpendicular impact experimental programme considering bloodstains generated on fabrics laid the foundations for understanding more complex scenarios. Blood rarely impacts apparel fabrics perpendicular; therefore a systematic study was conducted to characterise the appearance of drip stains on inclined fabrics. The final drip stain appearance for 45° and 15° impact angles on torso apparel fabrics (100% cotton plain woven, 100% polyester plain woven, a blend of polyester and cotton plain woven and 100% cotton single jersey knit) that had been laundered for six, 26 and 52 cycles prior to testing was investigated. The relationship between drop parameters (height and volume), angle and the stain characteristics (parent stain area, axis 1 and 2 and number of satellite stains) for each fabric was examined using analysis of variance. The appearance of the drip stains on these fabrics was distorted, in comparison to drip stains on hard-smooth surface. Examining the parent stain allowed for classification of stains occurring at an angle, however the same could not be said for the satellite stains produced. All of the dried stains visible on the surface of the fabric were larger than just after the impacting event, indicating within fabric spreading of blood due to capillary force (wicking). The cotton-containing fabrics spread the blood within the fabrics in all directions along the stain's circumference, while spreading within the polyester plain woven fabric occurred in only the weft (width of the fabric) and warp (length) directions. Laundering affected the formation of bloodstain on the blend plain woven fabric at both impact angles, although not all characteristics were significantly affected for the three impact conditions considered. The bloodstain characteristics varied due to the fibre content and fabric structure for both impact angles investigated. It is therefore necessary to consider the age of the fabric (which is fabric specific), the fibre type (including blends) and the fabric structure, before interpreting bloodstain patterns. An understanding of this simplified inclined drip stain interaction has been investigated to generate a basis for more complex interactions, such as spatter bloodstains.

Methods for characterizing plant fibers.

The effectiveness of different microscopy techniques for measuring the dimensions of ultimate fibers from harakeke (Phormium tenax, New Zealand flax) was investigated using a factorial experimental design. Constant variables were geographical location, location of specimens along the leaf, season (winter), individual plant, a fourth leaf from a north-facing fan, age of plant, and cultivars (two). Experimental variables were microscopy techniques and measurement axis. Measurements of width and length of harakeke ultimate fibers depended on the microscopic preparation/technique used as well as the cultivar examined. The best methods were (i) transverse sections of leaf specimens 4 microm thick, embedded in Paraplast and observed using light microscopy, and (ii) nonfixed ultimate fibers observed using scanning electron microscopy.