Gunshot trauma--what do you do?

L

LASur5r

Moderator
Okay, guys...you brought it up on another thread...
You or your significant other has been hit by a bullet...how do you handle it?

Let's say you and your wife are out driving just enjoying the day and you are driving a block away from the "projects"...all of a sudden your passenger side window makes a loud cracking sound and your wife grabs her arm...She says, "I've been hit..." and starts bleeding heavily.
What do you do?

This was a real situation...my friend's wife was hit this way...later investigation figures that it could only have come from the "project houses."

Meanwhile, your wife is bleeding profusely and going into shock...how many remember their first-aid?
 
My FIRST first aid is to drive like hell and get away before another round comes through the window. Priority one is stop the bleeding, so while driving, I probably would have advised her to wrap the seat belt around the wound and lean into it to provide direct pressure. As soon as we could stop safely, use escalating measures till the bleeding stops. Direct pressure, pressure point up under the armpit, tourniquet.

While doing this CHECK FOR TORSO ENTRY WOUND. The round may have passed through the arm.

Priority two is treat for shock. Get her to lay across the back seat, cover her to retain body heat. Loosen tight clothes.

At that point, the best I can do is haul butt to the hospital (quicker than waiting for 911) and report it to the cops once she has medical attention.
 
Main thing I remember from first-aid is ABC: airway, breathing, circulation. If she can talk, that means her airway is clear and she is breathing. Time to focus on circulation.

Most important question is whether the bleeding is arterial. If the blood is shooting out, rising and falling in time with the heart, then it is arterial and must be stopped immediately or she will likely bleed out within just a few minutes. In that case, you apply pressure to the artery upstream of the injury. IIRC, for a leg wound, you apply pressure into the crook between the pelvis and thigh. I'm not clear about the artery in the arm, but I think it may be in the underarm area. If you have a third hand, direct pressure on the wound area as well.

M1911
 
Also if the wound is in the arm and has not gone through to the torso, after doing all the afore mentioned, when lying victim in back seat, remember to elevate the legs, circulation must remain in area of body with vital organs, and raising the injured limb whether arterial or not. Always keep it elevated above heart level. Tourniquet should be the absolute last resort and avoided if at all posible. But if necessary, by all means, use it. Arterial wounds, I think all would agree are the most dangerous (that is what Tejano music star Selena died from, defensive wound to right arm) Also, you are right, transporting to hospital would probably be faster than waiting for an ambulance, unless you know one is nearby (i.e. an EMS starion).

Oh yeah, and depending on the caliber and entry site, possibility of a broken bone is always there.

Will probably think of something else when I send this, hope this helps.

MdP

------------------
My Colt .45... Better to have and not need, than to need and not have.
 
Most answers are dead on.

ABCs are what we teach everyone to do and certainly should have priority. Might I suggest that all tactically minded individuals could benefit from a good first aid course ala Red Cross or from one of the reputable schools.

As far as upstream pressure: this really refers to "pressure points". It is FAR more effective to maintain direct pressure over the wound and maintain it. Do not look at it from time to time, just keep the pressure on and get to competent aid. Tournequiets are really last ditch efforts and ought to be avoided as almost all bleeding can be controlled by direct pressure. That which can not is either not being properly firmly applied over the wound or the patient has an exsanguinating injury that in all likelyhood is not amenable to tournequeting either (with few exceptions). If bone is grossly broke AND you have something to splint with that's a good op, but I'd personally just haul to nearest ER asap with direct pressure as I stated before.

Regard,

Bob

I would second the not call 911 and haul a** to a nearby ER. If you have cell phone you could call 911 and let them know what hospital you're heading for so there are folks ready to help. Even 2 min heads up helps us get stuff ready.
 
FWIW, a good first aid kit-not the pretend one with the stuff for scratches and minor cuts, but one with the stuff for Major Injuries is a good idea for your vehicle. Good not only for g/s wounds, but also for car wrecks...
 
You can buy fairly extensive kits from EMT, Fire and Police supply stores. But I find that you tend to wind up with not enough of the important stuff, and too many things that really only have esoteric uses.

I just bought a fanny pack, visited some stores and slung together a fairly extensive customized first aid pack over a period of time that is now a standard part of my 'car kit', and was a bit cheaper than one of the standard ones.

If you have some spare time, and some spare cash, I reccomend that everyone take a Basic EMT course. In Texas, they're held at most of the junior and community colleges. The knowledge learned is invaluable, the look into how the Rescue and Emergency Room actually operates is truly eye-opening and you make contacts with some generally nice people.

LawDog

[This message has been edited by LawDog (edited November 01, 2000).]
 
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