Gun Shot Wounds

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I was a paramedic here in Florida for over a decade, and treated many gunshot wounds.

First, bare in mind that without a modern shock-trauma unit...you will lose some people, and the most you can do under austere conditions is make them as comfortable as you can and maybe prolong life a bit.

Bullet wounds are different from the way media portrays them, and there is a difference between a rifle wound and a pistol wound.

Rifle wounds are far more destructive than pistol wounds, and any rifle wound to the torso or neck (especially with a .223/5.56 round) can look deceptively benign, except that the bullet may bounce around inside the body as it richochets off bone, and turn a person's insides into raw hamburger.

Read Gray's Anatomy, and try to get a feel for what gunshot wounds actually do to a human body.

If we want to discuss prehospital measures to keep someone alive until you get them to a surgeon, we're on better ground.

Treat for shock, which means stopping the bleeding (by the way, don't jump to a tourniquet right away. Tourniquets are popular in the movies, but are actually rarely indicated and may result in the loss of a limb), keeping the patient warm, using oxygen (welder's oxygen is a very bad idea. If tanks are unavailable, try to get an oxygen concentrator. Check Craig's List), and starting an IV of saline or Ringer's Lactate. Protect the patient's airway (especially from vomiting). Transport the patient on a rigid, flat surface, and try not to jar or move the patient around too much. Try to find and remove any weapons that the patient may have, since physicians take a dim view of cocked and loaded guns falling out of a patient's clothes while they're trying to do an emergency procedure. Doctors and nurses have died from accidental discharges from this.

Be ready to disclose any and all info to the doctor upon arrival to a hospital.

1) Where and how many times the patient was shot.
2) Age and gender of patient.
3) Known medical conditions, including allergies if possible.
4) Drug and alcohol use of patient, if known.
5) Any medicines (including over-the-counter and herbal supplements).
6) What kind of weapon was used, and how far away the patient was from the weapon. Include caliber, if possible.
7) Name of patient's doctor, if possible.
8) What measures you've taken prior to arrival in the hospital.
9) Patient's vital signs and mental status.
10) Any information regarding patient's wishes, including advance decisions regarding organ donation. Some patients may not wish to receive blood transfusions because of religious priorities, other patients may desire to be exempt from CPR.

In gunshot events, there are often multiple victims, so it becomes important to prioritize patients and write off the ones you can't help.

Anyone who has large parts of their heads missing with exposed brain tissue should, in my mind, be written off (there are people who disagree with me on this). People with no pulse after a gunshot wound should be written off if there are multiple casualties.

Anyone who wants to help after such a thing should be protected with masks, goggles, and gloves. AIDS is very difficult to catch, but Hepatitis C and B are easier to catch. There is a vaccine for Hep B, and C can actually be cured, but it's better to avoid them to begin with.

Understand that there will often be irrational people after such an event, and measures (like delegating a roving safety officer) should be taken to keep frantic relatives from interfering in a well-intentioned, but destructive manner. This goes double for relatives of the people who were written off. It isn't unusual for a father to pull a gun and demand that someone treat his dead daughter or his dead, pregnant wife.

Hostages have even been taken under such circumstances, and this is something to be avoided.

And so on.

Learning the intricacies of this process will go much further in saving peoples' lives after gunshot wounds than any trauma kit.

Even better, take a First Responder course or an EMT course at your local community college. Such courses are surprisingly cheap, and will provide you with a sense of confidence that will be much more helpful than any stuff that you can amass.

I hope I was helpful.

P.S. During the Las Vegas shooting, there is a video of a man giving the sniper the finger. I admire the guy's balls (seemingly as big as pineapples), but not his intelligence. Never give a sniper the finger, and make sure--in your rush to help shooting victims--that the gunman has actually been neutralized.
 
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Hey guys! Anyone have any experience in "how to treat a gunshot wound?" What steps do i take and is there a med kit associated with gunshot wounds that i can buy? Thanks!
Don't know much about that but I did watch "Death Wish" over the weekend and thoroughly enjoyed it. Of course the hero was a surgeon and could fix himself up quite nicely with stuff he snuck out of the hospital and something that looked like superglue. In any case, It is kind of nice to day dream about cleaning up some crime. TCB and all that. Yes!
 
In the real world, after shtf and with no hospital/trauma center to take someone to, “you’re gonna die” comes to mind.
If the blood loss doesn’t get you, infection likely will. Remember the grey man philosophy and avoid confrontation as much as possible.
 
I agree, Brent.

Prevention takes priority over cure.

There are a lot of misinformed people (idiots) who have commando fantasies fueled by Scwartzeneggar, Chuck Norris, Stallone, VanDamme, Lee Marvin, and so on.

I really believe that these people will be the first ones to come apart at the seams when they're confronted with a major gunshot wound.

There's nothing romantic about guerrilla warfare.

Keeping a low profile, subtlety, staying inconspicuous, keeping your mouth shut, minding your own business, helping others quietly through convoluted channels...that's the way to go.
 
I agree, Brent.

Prevention takes priority over cure.

There are a lot of misinformed people (idiots) who have commando fantasies fueled by Scwartzeneggar, Chuck Norris, Stallone, VanDamme, Lee Marvin, and so on.

I really believe that these people will be the first ones to come apart at the seams when they're confronted with a major gunshot wound.

There's nothing romantic about guerrilla warfare.

Keeping a low profile, subtlety, staying inconspicuous, keeping your mouth shut, minding your own business, helping others quietly through convoluted channels...that's the way to go.
It can be fun to fantasize about getting even with some evil doers. Would I take action, nope. just day dreamin that's all.
 

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