How to stop a threat.....or when bullets really matter
By Brian Brzowski, MD, FACS. Suarez International Tactical Medicine Instructor
Guys (and gals), with
all the discussion on magazine capacity and the lethality of assault rifles, we
need to revisit the fact that shot placement is one of the most critical
elements of ending a violent encounter. While
a firm believer that all American citizens have a Constitutional Right to
magazines of whatever capacity they choose and to calibers and firearm
construction of their liking, we may soon see a time when we are permitted
fewer rounds of a lower ballistic effect.
It becomes paramount that we understand where our bullets need to go in
order to have their intended effect.
First, we need to recall that it is well-established that the body has enormous capacity (albeit with great individual variability) to function after sustaining tremendous damage. Reference my comments in these WT forums and previous documentation on the Miami FBI Firefight involving determined criminals and how long one can continue to fight despite receiving lethal, center of mass hits. Likewise, it is understood that there are fight-ending anatomic areas in the body that we can target with our shots. Our techniques need to be designed to direct fire into these regions, especially if we find ourselves forced to use smaller capacity magazines.
I am intentionally
excluding the harder to hit areas such as the hands/forearms/etc that can
render an adversary functionally incapable of operating a weapon, and the
less-motivated attacker who may voluntarily call off the fight from a painful
or frightening injury to the genitals/face/etc.
For our purposes, we're only going to consider the body parts that shut
off the electrical control of the body (nervous system) or rapidly and nearly
instantly deprive the muscular and nervous systems of sufficient oxygen to
operate (major blood vessels and heart).
Most are familiar with Central Nervous System shots that are popular with snipers. The area targeted is the brainstem:
Relatively speaking, this a small target, but it is literally the “light switch” of the body. Significant damage to the brainstem will most reliably immediately end all purposeful actions on the part of the bad guy. This area does meet our criteria to target.
Injury to other areas of the central nervous system such as the larger cerebrum does not consistently end the attack and shouldn’t be one of our primary targets. The thicker skull in this area does a good job of protecting the brain, and there are many reports of bullets simply bouncing off the bone and causing no significant injury.
Interestingly, I personally cared for a gentleman who was stabbed in the head with a large fixed blade knife. We removed the knife in the OR and discharged him home the following day with no permanent deficit whatsoever. His xray closely resembled this one:
The spinal column outside the skull is vulnerable to injury from gunshots but represents a narrow target that does receive some protection from a boney cage. Furthermore, disruption of the spinal cord will only affect the function of body parts at and below the level of injury making targeting this region ineffective as an immediate fight-stopper.
Pelvic shots as man-stoppers are controversial in many circles, and understandably the pelvis does not qualify as an area we should primarily target for reasons discussed elsewhere. A BG wearing body armor is the exception.
This leaves us with the anatomic area that presents the largest target and has a high degree of immediate impact on our adversary to target with our shots: the heart and great vessels.
The heart is a pump that circulates blood through the great vessels. The great vessels are those large conduits carrying blood to and away from the heart and are comprised of the aorta, the vena cava, and the pulmonary artery and veins (see the blue and red structures in the illustration). Oxygenated blood flows from the heart through the great vessels and supplies the body with the circulation needed to maintain function. Our central nervous system is exceedingly dependent on this oxygen-rich blood and can only work for precious seconds without it. Interruption of this process by damaging the pump (heart) or disconnecting the pipes (great vessels) is a fight-ender and worthy of making our primary target.
However, it is important to recognize where these important structures are, so let’s look at the surface anatomy.
As one can see, the heart and great vessels are located rather high in the chest. In fact, contrary to popular understanding, the traditionally taught “center of mass” does NOT include the heart and great vessels.
If one compares the surface anatomy image above to the traditional target below, you can see that the center 10x ring only includes the lower portion of the heart at the very apex of the ring.
For these reasons mentioned, I have transitioned to more anatomically-appropriate targets in my Tactical Medicine classes. If you come train with me, you will see targets such as these sold by LE Targets:
Lastly, presently I use high-capacity magazines. From point shooting distances, I will continue to “zipper” the BG. From greater distances, the RMR sitting atop the slide will help me direct my shots into the high chest and cranio-ocular region, leaving the pelvis available as another option if the situation dictates such a tactic.
As always, we must remember that shots on the BG are bad for him and good for you. However, when we have precious few rounds to expend, as with a pocket pistol or with future legislation possibly limiting the capacity of our magazines, keep in mind the priorities for targeting.