It’s not all or nothing. Each case is individual. Sometimes the bullet is intact and sometimes it’s in pieces. Sometimes trauma repairs minor injuries to the intestine, pulls the bullet, and they go to a post surgical floor like any other GI surgery. Sometimes trauma pops the spleen and the bullet and the patient still goes to med/surg. It depends on what a bullet hits and how, and how it lands is ruled by chaos and statistics. Sometimes it doesn’t puncture an artery but lodges next to it creating a future potential aneurysm that is monitored in ICU for 24h and then they’re off to med/surg, and the potential aneurysm goes on “continue to monitor” mode outpatient.

In reality, a person ignoring diverticulitis (then perfing) can sometimes spend more time in ICU than a bullet wound. And sometimes the bullet kills outright. It’s so variable. But that’s adults. Tiny bodies have far worse odds on any hit.

I’m not making light. I’m emphasizing how chaotic it is.