Accidental nail gun injuries to the heart: diagnostic, treatment, and epidemiological considerations
Nölke, L.; Naughton, P.; Shaw, C.; Hurley, J.; Wood, A.E.
Journal of Trauma 58(1): 172-174
2005
ISSN/ISBN: 0022-5282 PMID: 15674169 Document Number: 586979
Nail guns are frequently used in industry to allow rapid insertion of nails into timber, concrete, or light metal work. The nails vary in length from a few millimeters to several centimeters. They may be smooth in their entire length or have barbs on their outer end to give a better hold. The nails usually are propelled by compressed air or a small explosive charge. The trigger mechanism in most modern nail guns involves a trigger activated by the index finger of the hand holding the gun with a contact plate switch at the end of the gun from which the nail is propelled, acting as a safety switch. These devices appear to be used with minimal training, and the general public can easily obtain them without any training. We report a series of penetrating cardiac injuries caused by nail guns. The nail guns were reportedly fired from a distance of 1 to 4 feet from the victims. The nails had penetrated through the chest wall into the myocardium. The nails were 30-70 mm in length. The pattern of these injuries and the mechanism of their production suggest that the safety mechanisms on the guns and the protective clothing worn by operators of the guns do not prevent injuries.