Pattern Of Injuries Due To Rubber Bullets In A Conflict Zone

Background: The low velocity rubber bullets were used in Indian Administered Kashmir by Indian police since May 2008 to control anti India protests. Our hospital received all kinds of injuries be they due to conventional bullets or tear gas shells or rubber bullets. We included injuries only due to rubber bullets and specifically studied pattern of injuries caused by them.Methods: We analysed 100 patients who had sustained rubber bullets from May 2008 -july2010 and were received by our hospital. We assessed severity of injury in relation to range from which the bullet was hit, anatomical region of the injury and final outcome. Severity of injury was established by injury severity score (ISS). Findings: 100 patients 95 males and 5 females were included in the study who were proven to have sustained rubber bullet injuries. Average age ranged 12-60 years. Injuries were distributed randomly all along the body , the majority 80 patients (80%) had injuries in the limbs but those to head and neck 5 patients (5%), chest 8 patients (8%), abdomen 4 patients (4%) , back 3 patients (3%). 7 patients sustained injuries in multiple anatomic regions. 65 Patients (65%) had blunt injuries and 35 patients(35%) had penetration. Severity of injury was defined by the ballistic features of bullet, firing range and anatomic site of impact.Interpretation: The severity of injury whether blunt or penetrating caused by these rubber bullets is determined by resistance of body at the anatomic site of impact. Improper ranging with inaccuracy of rubber bullets with improper aiming can result in severe injuries sometimes ending in death. So this type of ammunition should never be considered safe in mob control.