This case includes both English and Spanish versions.

The “Magic Bullet”

A 25-year-old man sustains multiple gunshot wounds from a .38-caliber revolver during an assault. Thirty minutes later, he arrives at the trauma center conscious, with a blood pressure of 106/65 mmHg, but with gunshot wounds involving both hemithoraces and the left arm, subcutaneous emphysema, and tenderness of the upper abdomen.

There is no obvious external bleeding. Peripheral pulses are present. At first glance, he appears relatively stable.

But the visible wounds do not tell the whole story. A projectile can traverse multiple structures and follow a trajectory that defies expectations.

The question is not simply: Where did the bullet enter?

The question is: What structures did it traverse, and what should your next decision be?

Estimated duration: 90–120 minutes
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