Penetrating thoracic injury from a bean bag round complicated by development of post-operative empyema

Shotgun Bean Bag Projectiles Causing Open Fractures and Retained Radiolucent Foreign Bodies: A Report of 2 Cases

CASE

Bean bag projectiles (BBPs) are less lethal munition composed of a cloth bag filled with lead pellets and marking powder housed in a plastic casing fired from a 12-gauge shot gun. Two patients sustained penetrating BBP injuries that resulted in open fractures and retained BBP. Patient clothing and all BBP components were found deep in the wounds with marking powder surrounding fracture edges. Both patients healed without infection.

CONCLUSION

Surgical exploration of penetrating BBP injuries is recommended to remove marking powder, fabric, plastic, and potentially other forms of contamination. Fracture stabilization should adhere to existing guidelines pertaining to open contaminated wound conditions.

Spectrum of injuries with "less-lethal" beanbag weapons: pictorial essay

Beanbag weapons are gaining popularity with increasing daily use as a non-lethal or less-lethal alternative to traditional firearms. While these are considered "less-lethal," these are associated with a spectrum of serious injuries. We present a pictorial essay of these injuries ranging from mild skin contusions to more severe solid organ injuries.

Bean Bag Projectile Causing Ocular Compartment Syndrome, Intracranial Hemorrhage, and Facial Fractures

BACKGROUND

Bean bag rounds are a commonly used nonlethal projectile. Although they are generally reported to cause mild to moderate soft tissue injury, the potential for more serious injuries is only partially explored and may even be underappreciated. Injuries to the face, eyes, and head and their potential to inflict serious consequences, or even fatalities, are not well established.

CASE REPORT

We present a case of severe head trauma caused by a bean bag round. Injuries included ocular compartment syndrome, intracranial hemorrhage, depressed skull fracture, and multiple facial fractures. Emergency department management of this patient required lateral canthotomy, intubation for airway protection, and management of suspected elevated intracranial pressure. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although typically not regarded as serious, injuries caused by bean bag rounds have the potential to threaten life, limb, and vision. Emergency physicians should be aware of these possibilities, especially when the head is impacted, and should be prepared to perform critical actions and emergent procedures as needed. In addition, if not at a major trauma center, the emergency physician needs to be aware of the time-sensitive interventions required prior to transfer.

Severe Craniofacial Morbidity from a Bean Bag Projectile

Bean bag munitions, less-lethal weapons primarily used by law enforcement, can cause severe morbidity. Although bean bag munitions are less likely to cause severe injury when compared with regular gunshot rounds, it is crucial to understand that bean bag munitions may be life-threatening. In this case, we describe our experience with a patient who suffered a zygomaticomaxillary complex fracture, facial nerve injury, and retained munition round in his maxillary sinus from a bean bag projectile shot during an altercation with the police. The patient was urgently transferred to the operating room for extraction of the bean bag munition, and although fracture repair was successful, the patient sustained significant damage to facial nerves, leading to lagophthalmos. To our knowledge, this is the first case report describing a penetrating injury from a bean bag munition that was retained within a facial structure. We will discuss the surgical intervention used for this patient and the review of the current literature on these less-lethal munitions.