Cardiac injury due to accidental discharge of nail gun.

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Since 1991, the incidence of injuries associated with pneumatic and explosive powered nail guns has steadily been rising due to increasing use of these devices by the untrained consumer. The vast majority of injuries involve the extremities, but injuries have been reported to occur in virtually every area of the body.


Discuss the epidemiology, pathophysiology, and management of penetrating cardiac nail gun injuries.

Case report

A 33-year-old man sustained a penetrating cardiac injury from accidental discharge of a nail gun. The patient had successful repair of a laceration to his right ventricle.


Penetrating cardiac injuries from pneumatic nail guns are rare and have mortality similar to stab wounds. Improved safety mechanisms and training are the keys to prevention. Consideration also should be given to implementing legislation restricting the sale of nail guns.





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Publication Info

Temple, Alton D, Francis M Fesmire, David C Seaberg and Harry W Severance (2013). Cardiac injury due to accidental discharge of nail gun. The Journal of emergency medicine, 44(2). pp. e161–e163. 10.1016/j.jemermed.2012.01.054 Retrieved from

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Harry Wells Severance

Adjunct Assistant Professor in the Department of Medicine

Site Principle Investigator: PROspective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) prospective, randomized, multi-center clinical trial:

Principle Investigator - Duke E.D. Site - "Speed" Study. Pilot phase of Gusto IV. Investigating Abciximab (a GP IIb-IIIa inhibitor) in combination with rapid access to cardiac cath. Funded through Duke Clinical Research Institute. Multi-center trial.

Principle Investigator - Project: proposed mechanisms for afferent pain transmission from myocardial cells to pain centers. Purpose is to identify potential biochemical markers for early anginal presentations. Funded: grants received from Merck & Co. and Roche-Boehringer-Mannheim. Pilot phase paper - in preparation.

Other Interest Areas:
Wounding and medical management of penetrating injuries derived from firearms and blast-related injuries.

Impact of Observation/short-stay strategies on clinical care and inpatient/outpatient systems.

Impact of Emerging Viral Threats on clinical management and social/economic/political systems,

Acute Cardiology - Chest Pain Presentations 
Evolving Technology and AI in improving clinical care/management

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