Harbor: Bullet Removal Guidelines

General Considerations

• The bullet may be used as evidence in an active investigation, so it is important to:
  • Document chain of custody
  • Minimize any damage to the bullet when removing it

During Removal

• Try to avoid having metal tools directly contact the bullet (this can mark the bullet and may make investigation by a firearms expert more challenging)
• If possible, bluntly dissect around the bullet and remove with your gloved hand
  • If you are unable to do so (doing so may cause too much new trauma, result in a large incision, etc), you can put gauze between the bullet and your metal tool to minimize marking the bullet

What To Do with the Bullet

• Place a request pathology order
• Get evidence envelopes from the OR front desk (there is a small one and a large one)
• Place bullet in small envelope, seal it, and then place this in the large envelope
• The large envelope has the chain of custody signature lines, fill these out as applicable
• Have someone walk envelope to pathology
• Notify Sheriff Liaison that you have removed a bullet from a patient and to ask them to help notify the appropriate agency (the one with jurisdiction where the investigation will take place)
  • Of note, the appropriate agency may already be present if they arrived with the patient to the trauma bay
  • In cases where the bullet has been in the patient for months or years, the Sheriff Liaison will need to talk with the patient to determine which is the applicable agency