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How To Treat a Gunshot Wound
29 June 2012, 02:06, (This post was last modified: 29 June 2012, 02:19 by Nemesis.)
#1
How To Treat a Gunshot Wound
Gunshot wounds are one of the most serious forms of trauma that you can encounter.

Gunshots cause three types of trauma: penetration (destruction of flesh by the projective), cavitation (damage from the bullet's shock wave in the body), and fragmentation (caused by pieces of the projectile or bone).[1] If is very difficult to predict the degree of damage done by a gunshot wound, and many of the injuries caused by a gun far exceed what you can reasonably treat. For this reason, the best option for most gunshot wounds is to get the victim to a hospital as soon as possible. Read on to learn what you can do to help stabilize a gunshot victim.

If the victim was shot by accident (e.g., while hunting), make sure that everyone's firearm is secured and pointed away from any other people.

If the victim was shot in a crime, try to make sure that the gunman is no longer on the scene. Wear personal protective equipment if available.


Do not move the victim unless you must do so to keep him safe, or to access care i.e.: in a rural or off-road setting.

General principles of first aid for bullet wounds

Steps, warnings and tips are only for your consideration. Although the specifics of treating a gunshot wound will vary somewhat depending upon the part of the body where it occurs, these steps can be applied to all gunshot wounds.

Act quickly. Time is your enemy in treating the victim. Victims who reach medical facilities during the "Golden Hour" have a much better likelihood of surviving.

Check the A, B, C, D, E's. Assess these five critical factors:

A (Airway) - If the person is unconscious, check to make sure that his airway is not obstructed. The tongue can be a common cause of airway obstruction, and simply turning his head can solve the problem.

B (Breathing) - Is the victim taking regular breaths? Can you see his chest rising and falling? If the patient is not breathing, start rescue breathing immediately.

How to Perform Rescue Breathing

C (Circulation) - Does the victim have a discernible pulse? If the victims does not have a pulse, begin CPR.

How to Administer Adult CPR (Cardiopulmonary Resuscitation)

D (Disability) - This refers to damage to the spinal cord or neck. Check to see if the victim can move hands and feet. If not, there may be an injury to the spinal cord that can be worsened by moving him.

How to Treat a Spinal Injury Victim

E (Exposure) - Make sure that you fully expose the patient so that you do not miss wounds to the armpit, buttocks or other difficult-to-see areas.

Control bleeding. Controlling bleeding is most important thing you can do to save a gunshot victim's life.[1]

Applying direct pressure to most wounds is the best way to control most wounds. Use a pad over the wound and apply pressure directly to the wound. If you have nothing available, even your hand or fingers can be used to control bleeding.

Use pressure points in the arm (between the elbow and armpit), groin (along the bikini line), or behind the knee to control bleeding in the arm, thigh, or lower leg.

There is little that can be done in the field to control serious bleeding from the chest, abdomen, or pelvic region. Your best course of action with these sorts of injuries may be to get the person to an emergency room as soon as possible; however, bleeding of this sort frequently leads to death.

Be prepared to treat the victim for shock. Gunshot wounds frequently lead to shock, a condition caused by trauma or loss of blood that leads to reduced blood flow throughout the body. Expect that a gunshot victim will show signs of shock and treat him accordingly. However, do not elevate the legs if the gunshot wound is to the torso, as this will increase bleeding and make it more difficult for the victim to breathe.

Wait for help to arrive. Stay with the victim until help arrives. Avoid moving the victim unless you must.

Special instructions for regions of the body

Head – Gunshot wounds to the head are frequently fatal. Your best option is to keep the head elevated and get the victim to a trauma center as soon as possible.

Face and neck – These wounds typically bleed severely. Use direct pressure to control bleeding and keep the victim upright. Be careful not to obstruct breathing while controlling bleeding. With injuries to the neck, be careful that blood flow to the carotid arteries isn't disrupted, as this can reduce blood flow to the brain.

Chest and back – Apply direct pressure to control bleeding; understand that it may be difficult to control chest bleeding because the ribs make it difficult to compress the structures that are bleeding. Gunshots to the chest can cause what is known as a "sucking chest wound". These happen when air travels in and out of the wound with each breath. Treat these as follows:

Seal wound with hand or airtight material (e.g., plastic film).

Apply an airtight bandage on three sides of the wound (see image below). Do not close the bandage on the fourth side.



Lift the unsealed side of the bandage as the victim exhales to allow air to escape.

Abdomen – Use direct pressure to the injury site. As with the chest, controlling bleeding in these cases can be quite difficult.

Arm or leg – Use direct pressure to control bleeding. Arm and leg injuries from gunshots can be elevated above the heart to help control bleeding. Use pressure points in the arm, groin, or behind the knee if direct pressure does not control bleeding.

Never use a tourniquet except to:

save a life when excessive bleeding can not be stopped by pressure or to go to get help as when alone, then to
arm or leg only and above bleeding (never on any other part of the body.)!

Never use wire, string or similar narrow material that cause new cut or bursting injury and new bleeding injuries when tightened.

Tips - It is very difficult to accurately assess the severity of a gunshot wound based upon what is visible on the victim; internal damage may be severe even in circumstances where the entrance and exit wounds are small.

Gunshot wounds are a common cause of spinal cord injury. If the victim appears to have a spinal cord injury, do not move him unless you absolutely must. If you must move the victim, be sure to keep the head, neck and back aligned.

When applying bandages to stop bleeding, add new bandages over the old; do not remove bandages when they become soaked.
Tips to Remember

Arterial bleeding [from severed arteries] can be recognized by spurting and rapid outflow.

Veinous bleeding is considerably slower and more moderate.

- External bleeding can almost always be stopped using pressure

- Ice can help close damaged blood vessels and slow blood loss

- A 25-30% loss on blood volume may result in shock

- Using a tourniquet may result in amputation of the affected limb

- Do not try to remove a deeply embedded object -- doing so may cause further bleeding.

- Internal bleeding is very serious and often the only effective treatment is surgery

- Signs of internal bleeding include firmness in the abdomen after injury, vomiting blood, blood in urine or feces, large bruises over the flank or abdomen, pale skin, cool and clammy skin, rapid heart rate, weakness, thirst, dizziness, shortness of breath.

- If victim has bones or internal organs protruding do not attempt to push these back inside the body. Cover the exposed tissue with moist sterile cloth pr bandages. Seek immediate medical attention.


Do not look for a sanctuary in anyone except your self    ཨོཾ་མ་ཎི་པདྨེ་ཧཱུྃ
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22 August 2012, 20:21,
#2
RE: How To Treat a Gunshot Wound
Interesting stuff,could you do one about shock and treatment for shock?
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22 August 2012, 20:36,
#3
RE: How To Treat a Gunshot Wound
superb article mate, thanks alot for this!
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18 June 2013, 17:43,
#4
RE: How To Treat a Gunshot Wound
(29 June 2012, 02:06)Nemesis Wrote: If the victim was shot in a crime, try to make sure that the gunman is no longer on the scene. Wear personal protective equipment if available.

If the victim perpatrated the crime and my neighbors or I shot him, I doubt that any treatment would be forthcoming...

Quote:Never use a tourniquet except to:

save a life when excessive bleeding can not be stopped by pressure or to go to get help as when alone, then to
arm or leg only and above bleeding (never on any other part of the body.)!

Never use wire, string or similar narrow material that cause new cut or bursting injury and new bleeding injuries when tightened.

Use a triangular bandage as a tourniquet on an arm or leg if necessary. If you apply a tourniquet, mark the patient's forehead with "TK" and the time applied with a ballpoint pen or marker!

Don't buy the ready-made variety of triangular bandage however. Save your money. Go to your local fabric store, buy a square (36" X 36") or two of the cheapest unbleached muslin available, fold as a triangle, 1 fold corner to corner, and cut along the fold with "pinking" shears. Store each in a "Zip-Loc" freezer bag with 2 large safey pins. This can be used as a tourniquet, a sling, or a valpo bandage to immobilize an arm or shoulder, as well as a tourniquet.
If at first you don't secede, try, try again!
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18 June 2013, 17:48,
#5
RE: How To Treat a Gunshot Wound
if its any more than a flesh wound there probably dead already.if not from the actual gunshot, then from the shock and trauma or gangrene.
Some people that prefer to be alone arent anti-social they just have no time for drama, stupidity and false people.
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18 June 2013, 18:11,
#6
RE: How To Treat a Gunshot Wound
BP,

People get shot all the time. Surprises me how many survive.

Now after an event the stats will swop over and more will die than live, just like they did when guns first came out.

Doesn't negate the article though. Using the information you could make the difference.
Skean Dhude
-------------------------------
It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change. - Charles Darwin
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18 June 2013, 18:18,
#7
RE: How To Treat a Gunshot Wound
wish I hadn't answered this one, without our own high powered guns we're all sitting ducks, but this isn't America, and most of us don't live in Londonistan or Birmingabad, apart from a few old ancient shotguns its not something that's going to happen around here.
Some people that prefer to be alone arent anti-social they just have no time for drama, stupidity and false people.
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18 June 2013, 18:34,
#8
RE: How To Treat a Gunshot Wound
My, my BP, that is not what everyone has been telling me here!

Lots of certificates, lots of people in the country with guns, lots of shooting club members.

Then there are all those zip guns people will be assembling once SHTF and the laws are down.

Simple solution, if you don't want to be a duck, be a shooter.

And be aware that people survived GSW for centuries before modern antibiotics. Unless a primary organ or artery is hit you have a pretty good chance.

To this day knife wounds are more fatal than GSW.
DON'T LOOK AT THE FLASH!
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18 June 2013, 18:42,
#9
RE: How To Treat a Gunshot Wound
(18 June 2013, 18:34)Mortblanc Wrote: My, my BP, that is not what everyone has been telling me here!

Lots of certificates, lots of people in the country with guns, lots of shooting club members.

Then there are all those zip guns people will be assembling once SHTF and the laws are down.

Simple solution, if you don't want to be a duck, be a shooter.

And be aware that people survived GSW for centuries before modern antibiotics. Unless a primary organ or artery is hit you have a pretty good chance.

To this day knife wounds are more fatal than GSW.
lots of illegal guns in the cities, especially London where all the gangs keep popping off at each other, but then I don't live in a city, the worst we've got around here is a few old farmers with a shotgun or two. in any case I didn't say I was defenceless did I! I have ways of protecting myself and my family, none of which I intend to list here.but like a few other people on here I have been accumulating stuff quietly and stealthily.
Some people that prefer to be alone arent anti-social they just have no time for drama, stupidity and false people.
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18 June 2013, 18:45,
#10
RE: How To Treat a Gunshot Wound
That's good, solid info and thank you. It's a pity though, that the links to these didn't come through in the copy & paste:

(29 June 2012, 02:06)Nemesis Wrote: How to Perform Rescue Breathing

How to Administer Adult CPR (Cardiopulmonary Resuscitation)

How to Treat a Spinal Injury Victim

It's also a pity that such instructions always advise getting the patient to A&E or the emergency room or until qualified help arrives. After an 'event', these may not be available...



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