BIG T Trauma Ep. 28: Retained Ballistic Fragments: What We Were Never Taught
Share
Subscribe
The majority of non-fatal gunshot wound survivors walk away with a bullet still inside them. Most are discharged without a removal attempt, without a surveillance plan, and without a conversation about what comes next. This episode fills that gap.
Dr. Patrick Georgoff is joined by BIG T co-host Dr. Teddy Puzio (UT Houston), gun violence survivor and trauma surgeon Dr. Madhu Subramanian (Duke), and Dr. Tyler Simpson (Duke ACS Fellow) for a practical, honest conversation about one of trauma's most overlooked topics.
What we cover:
- Epidemiology: how common retained fragments really are, and why the downstream burden is underappreciated
- When to remove (and when not to): a framework for both index hospitalization and delayed removal
- Forensic evidence: how to handle bullets in the OR without destroying their evidentiary value — and who to call when you don't know
- Lead toxicity: the rare but real complication that can surface a decade later, which blood lead levels should prompt action, and when to call hematology or toxicology
- The psychology: retained bullets are independently associated with depression and reduced return to work — and that belongs in the risk-benefit conversation
DOMINATE THE DAY
BIG T Trauma Full Series: https://behindtheknife.org/podcast-series/big-t-trauma
This episode of Big T Trauma was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page.
Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen
Behind the Knife Premium: https://behindtheknife.org/premium
Oral Board Review: https://behindtheknife.org/oral-board
Oral Board Simulator: https://behindtheknife.org/oral-board/simulator
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US