Bloody Bodies and Bloody Scenes

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Violence as portrayed in the movies and television has traditionally been relatively bloodless. In real life, most gunshot scenes are quite bloody. As in many aspects of forensic pathology, this observation is not immutable. Some scenes show evidence of considerable bleeding; some essentially none. In the latter case, hemorrhaging is internal (into the chest or abdominal cavities)or is prevented by clothing. The only observable blood may be a dime-shaped area of bleeding on the clothing overlying the entrance site.

Minimal bleeding around an entrance site usually involves small-caliber weapons and locations on the body that are clothed and/or elevated, i.e., not in dependent areas where bleeding or leakage of blood would occur secondary to gravity. Clothing may act as a pressure bandage. When the deceased is wearing multiple layers of clothing, blood from the wound may be absorbed by the internal layers of clothing so that there is no evidence of bleeding on the outer clothing.

Gunshot wounds of the head usually bleed freely. This is not invariable, however. The author had a case in which there was a contact gunshot wound of the back of the head from a .22-caliber rimfire weapon whose entrance was sealed by the hot gases. There was no blood at the scene or visible on the body. The entrance was concealed by a bushy haircut and was found only when the head was opened as part of a routine autopsy on an apparent natural death.

In scenes where the deceased has walked or run from the scene of the shooting, there is usually a trail of blood. The quantity of bleeding, however, is very variable. In some cases there may be no blood because the bleeding was internal or the victim pressed their hand or a cloth against the wound, thus acting as a pressure bandage to prevent external hemorrhaging onto the floor or ground.

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