title: Belfast Limb Arterial and Skeletal Trauma (BLAST): the evolution of punishment shooting in Northern Ireland.
abstract: BACKGROUND
  Northern Ireland has developed significant experience in specific punishment injuries due to its unique civil unrest. Simple gunshot wound (GSW) injuries have begun to evolve into more complex injuries.
  
  
  METHODS
  We describe three cases of young male victims who suffered from GSW injuries-from a single GSW injury to multiple GSW injuries involving all four limbs; the phenomenon of Belfast Limb Arterial and Skeletal Trauma. We describe the management of these injuries, with a review of current literature.
  
  
  CONCLUSIONS
  Due to the unique political situation of Northern Ireland, there has been significant development of surgical experience in GSW management. Historically, single knee-capping injuries were prevalent. However, these shootings have evolved into targeted injuries resulting in significant trauma as demonstrated by this case series.
authors.affiliation: Belfast Vascular Centre, Royal Victoria Hospital, Belfast, Northern Ireland. mlau01@qub.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Lau
authors.affiliation: Belfast Vascular Centre, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: S
authors.initials: S
authors.lastname: McCain
authors.affiliation: Belfast Vascular Centre, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Baker
authors.affiliation: Belfast Vascular Centre, Royal Victoria Hospital, Belfast, Northern Ireland.
authors.forename: D W
authors.initials: DW
authors.lastname: Harkin
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D009660:Northern Ireland; D011678:Punishment / Q000523:psychology*; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000209:etiology*; D014948:Wounds, Gunshot / Q000523:psychology*; D055815:Young Adult
keywords: BLAST; Belfast; Civilian; Gunshot injury; Intraluminal shunt; Popliteal fossa; Punishment shootings; Tourniquet