A gun is the most effective and easily available weapon, so in a disaster scenario, it’s obvious that gunshot wounds pretty frequent.
Some types of gunshot wounds can even be healed with home resources, but most of them need to be treated by a medical professional and with hospital resources. But for all gunshot wounds, first aid is essential for survival and complete healing!
What Should Be Done First?
The first step is to make sure both you and the victim are safe. If you are going to be injured too, you won’t be much of a help!
Unless the victim is shot in the arms or legs, it’s preferable not to move her. All gunshout wounds in the head, neck, chest, or abdomen have a great potential of spinal injury, and moving the victim could cause additional damage to the spine. However, if your location is too exposed and it puts you both in danger, you can consider moving the victim to a safer place.
It’s always a great idea to use latex gloves when dealing with open wounds, for your protection. If emergency numbers are still available, call them! Most gunshot wounds require prompt interventions from a medical practitioner, preferably a surgeon.
Gunshot wounds always cause a great deal of tissue damage, so bleeding is usually heavy. You need to control the bleeding in order to give the victim a chance to survive. You can use any type of cloth to put pressure on the wound with your palm. Apply steady pressure for at least 10 minutes without moving too much. If the cloth becomes soaked, just add another one on top of it. Never remove the soaked bandage, because doing so would only make the bleeding start again.
If the victim was shot in an arm or leg, there is a great chance that a large artery was damaged. In an arterial hemorrhage, the blood is bright red and flows with pressure, following the rhythm of every heartbeat. An arterial hemorrhage is especially dangerous because it causes massive blood loss in a very short time, and it’s harder to stop than venous damage. The increased pressure of the arterial blood makes the clotting process more difficult. This is when you must consider applying a tourniquet.
A tourniquet can only be applied on the arms or legs. NEVER try applying one on the neck of the victim!
Write down the exact hour when the tourniquet was applied. Keeping it on for more than 30 minutes at a time could result in severe tissue damage and necrosis. An emergency tourniquet can be improvised from any kind of thin strap and is always placed proximal to the site of hemorrhage. For instance, if there’s a bleeding wound in the ankle, the tourniquet must be placed below the knee.
Applying a tourniquet in a correct, effective manner means more than just tying a piece of cloth around a man’s leg or arm, so you should learn how to make one.
A pressure bandage is also very important in controlling the bleeding, so you should be able to apply one of these as well.
Another extremely effective way of controlling the hemorrhage is by inserting XSTAT in the wound (see image). They absorb very well and increase volume, applying pressure on blood vessels and helping the hemorrhage to stop.
Most people with gunshot wounds go into shock. It’s important to be prepared for that. Heat loss should be minimized, so you should use any available resources to prevent the victim from getting cold. Normally, if a victim is in shock, her legs should be elevated in order to maintain blood flow to the brain and other vital organs situated in the upper body. But don’t elevate the legs of a gunshot victim who has a spinal or a thoracic injury!
If an emergency team is on its way, the hemorrhage is under the control, and you and the victim are in a safe place, you can just wait while reassuring the victim. However, if emergency care is not available, you should take additional steps in treating the wound.
You need to carefully look for an exit wound or for any other wounds on the victim’s body. The exit wound shows you the trajectory of the bullet and indicates what other organs might be damaged.
If you are dealing with an arm or leg wound, just control the bleeding, apply a pressure bandage, and rush the victim to a safe, warm place, where you can clean the wound (carefully, to prevent it from bleeding again) and give antibiotics to fight infection.
If you are dealing with a chest wound, there isn’t a lot you can do. A bullet chest wound is also called a sucking wound because air is coming in through the wound, causing lung collapse. A sucking wound is easy to recognize since there is a specific sound: The victim coughs up blood, and there’s a shortness of breath.
You need to find the wound and check if there’s an exit wound as well. If there is, they both need to be treated. You need to seal the wound using some airtight material and taping it around the wound. Plastic is the top choice, and it should be taped on all sides, except for the bottom corner—that’s where air will escape. While sealing the wound, ask the victim—if still conscious—to exhale and hold their breath so much of the air is forced out before the wound is sealed. Then apply steady pressure on the wound and monitor breathing.
An abdominal gunshot wound can be equally as dangerous as a chest wound. If the bullet damaged the liver or spleen, there isn’t much you can do to control the bleeding. Pressure on the wound can help, but sometimes it’s just not enough. If the intestines are damaged, a severe infection will occur and will probably not subside unless surgery is involved to fix the intestinal walls and prevent them from leaking. However, since it’s not over till it’s over, the best thing you can do is to prevent the victim from taking anything by mouth. They should not even drink a sip of water—this is crucial in order to give the victim a chance to survive! The next thing to do is find a doctor that can treat the abdominal damage.
Despite what you might have seen in movies, removing the bullet is almost never a good idea. It will just cause more bleeding, and you will most probably be unable to find it without an X-ray. There are hundreds, even thousands, of veterans that have metal projectiles or projectile fragments in their bodies, and they don’t cause any serious problems.
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