Essential First Aid for Shooting Range

[Cosmoline]

I've asked some paramedics and docs about this over the years. 4x4 pads are the most recommended item. Lots of them. When the bleeding gets going in earnest, you go through them very quickly. Most bought kits have a lot of crud you either don't need or aren't really qualified to use. One thing you can do is basic elevation and direct pressure.

Folks need to remember that "shock" in a a medical sense DOES NOT MEAN psychological "shock" at seeing some wound or getting bruised. In the case of gun shots, it means the drop in blood pressure from massive blood loss. And it's a sure-fire killer if the blood loss isn't stopped. You don't die because you're upset. Not unless you have a really bad pre-existing heart condition. Covering someone up with a blanket is not going to do much to stop dying from hypovolemic shock after a bullet rips through them.

http://www.nlm.nih.gov/medlineplus/ency/article/000039.htm

http://en.wikipedia.org/wiki/Hypovolemia

Basic first aid hasn't changed in decades: A-B-C

Most of us are nowhere near qualified enough to open a breathing passage, so realistically beyond dislodging a stuck filbert in someone's throat it's going to require more training. Slowing down blood flow till the ambulance comes is something basic first aid can cover. Intubation after a GSW to the lungs or throat--not so much.

stopping the bleeding of a person who's not breathing or has no heartbeat is pointless.

True, but if they're in that condition after a GSW they're likely dead as doornail already. And trying CPR on someone with a hole and bullet in him is just not a good idea without advanced training. The idea is to move him as little as possible and staunch any immediate blood loss. That's about it. These are really complex injuries unfortunately and require expert treatment ASAP.

 

[wgaynor]

My apologies. I was blinded by the tampon.

 

[wgaynor]

Good one Cosmoline. There's a disconnect between many medical terms and general terms.

I tend to think in the sense of medical terms

 

[beatledog7]

Absolutely work within your skill set. But you don't need to know how or be equipped to intubate a victim in order to restore his airway. I can teach a ten-yr-old how to do it with no tools in about a minute.

I still don't see how we got from common range injuries to gunshot wounds.

 

[Cosmoline]

Just making sure the mouth is open and tongue in the right place is one thing, but that's usually not the reason for the failure to keep breathing. And actually restoring 02 flow requires some advanced training and equipment. It's also not too easy.

Range injuries are likely to be either minor cuts and such which require minimal aid if any, or they're going to be GSW's or Kaboom injuries that are among the most complex of traumas with many layers of tissue injured and possible organ damage.

I keep my kit jammed with pads and top it off with some pain pills and band-aids. Not much point to anything else for my limited skill level.

 

[HorseSoldier]

I still don't see how we got from common range injuries to gunshot wounds.

I've always differentiated between boo-boo and blow out kits. The boo-boo kit is band aids, stuff to clean up a minor wound, NSAIDs, and such. The blow out kit is your life saving stuff. Needless to say, the boo-boo kit is the stuff that tends to get used up -- but it's also stuff where if it wasn't there life would go on, whereas if the stuff in the blow out kit is getting used life may or may not be going on from there.

 

[Ragnar Danneskjold]

Anyone using Quik-Clot:

Get rid of it now. And get yourself some Combat Gauze instead. FAR better than quick clot. None of the cauterizing damage or risk of clots floating down the blood stream, but same hemostatic properties. It's basically your standard sterile cause that's impregnated with a hemostatic agent. It promotes quick clotting but with none of the dangers you find in actual Quik-Clot powder.


Again, if you really care about treating a GSW on yourself or someone else, do everyone a favor and immediately go online and buy Combat Gauze. The day it comes in the mail, take all of your Quik-Clot power and throw it in the trash. Combat Gauze has the additional benefit of not really needing any special technique to use. With the Quik-Clot powder, it's messy, hard to use, difficult to keep in the wound while bandaging, etc. Combat Gauze is much easier.

1: Observe bleeding wound.
2: Put combat gauze in and around the wound.
3: Apply standard dressings and bandage on top as you would normally.

Quick and easy. Just pack the Combat Gauze into the wound. That's it. Put your normal first aid stuff on top of it.


Also, as cold-hearted as it may seem, look up your local "Good Samaritan" laws or even better, try and find some actual legal advice pertaining to your area. There's a chance you might get legaly hemmed up if you try to use life-saving techniques you have not been certified on, or if they're beyond the scope of a non-medical professional. Someone previously mentioned clearing airways. A nasopharyngeal adjunct is a tube that can be used to open some airway injuries, and it's issued to all US military personal as part of the basic first aid kit. But using one as a civilian on another civilian might get you in trouble, especially if you cause more harm. Just be careful that you not only have the right training and materials, but the legal knowledge of when and how you can use them. We're a nation of laws, which means we're also a nation of lawyers. Keep that in mind.

 

[Shadow 7D]

Listen, here is a point
when you get up to certain extent
realize, a good samaritin law may keep you OK on criminal charges,
but it's entirely likely that they can come against you when you start with the advance procedures

stuff like quick clot, and the MASSIVE INTERNAL DAMAGE it can cause, yeah...
see that's not basic first aid, just agreeing that there is a line, not clearly defined where you go from A OK under a good samaritan law, to being infront of the judge arguing the merits of the case.

 

[Librarian]

Tampons and Sanitary type napkins are good for plugging wounds.

This dreadful piece of advice keeps being regurgitated. It is a bad idea to "plan to improvise" with something not intended for the purpose, especially when you're talking about an injury as catastrophic as a gunshot wound. Doubly so when good equipment is readily available from so many sources.

I'm going to be contrary here and suggest that one should not be dogmatic about that.

There are better things to control bleeding, it's true. Gauze is useful because it gives lots of places for coagulation to occur, while an external sanitary napkin is meant to absorb fluids (primarily blood). (ETA see Thrombin Production and Human Neutrophil Elastase Sequestration by Modified Cellulosic Dressings and Their Electrokinetic Analysis for more than you ever wanted to know.)

I'm not all that happy about plugging a tampon into a hole or laying it into a deep wound.

It took me a while to find a doctor who suggests those sanitary napkins are useful, but he was speaking in the context of the subject of his book: Iserson, Kenneth V, "Improvised Medicine, providing care in extreme environments" McGraw-Hill, 2012. Paperback edition, p 40

...
Any absorbent material may be used as a dressing. If a highly absorbent dressing is needed, such as for wounds with a lot of exudate, use a menstrual pad. Otherwise, use the more-absorbent cotton fabrics, rather than synthetics, which absorb less.

Some veterinarian 'first aid' sites DO suggest such pads for treatment of animals.

I'd tend to think a pad would be a good 'second layer'; one does not remove the first dressing, because that is likely to disturb clotting (if any is going on), but slapping a pad over the original dressing and wrapping for more pressure could be useful.

While retired now, out here in meat-space my name gets letters after it - BSN and RN.

 

[Odd Job]

Also, as cold-hearted as it may seem, look up your local "Good Samaritan" laws or even better, try and find some actual legal advice pertaining to your area. There's a chance you might get legaly hemmed up if you try to use life-saving techniques you have not been certified on, or if they're beyond the scope of a non-medical professional.

These are wise words indeed.

 

[Fred Fuller]

I keep saying it - MINDSET - SKILLSET - then last of all Toolset.

Your SKILLS matter more than your tools, and your mindset matters most of all.

What items you physically own are less important that what you KNOW and what you are capable and willing to DO. There are any number of excellent trainers out there teaching everything from Red Cross First Aid and CPR to field treatment of GSWs.

How many here have availed themselves of any level of this training? If not, WHY NOT?

This is NOT the "Gear" forum, folks.

 

[Double Naught Spy]

What items you physically own are less important that what you KNOW and what you are capable and willing to DO. There are any number of excellent trainers out there teaching everything from Red Cross First Aid and CPR to field treatment of GSWs.

How many here have availed themselves of any level of this training? If not, WHY NOT?

Your question was rhetorical, right?

 

[Fred Fuller]

Not rhetorical at all.

 

[Bix]

In that case, I've taken a couple GSW/Trauma specific classes, as well as several basic Red Cross classes.

On point: My range first aid kit is based on the specific things I was taught in those classes. Beyond the very basics - which seem obvious - I don't see how you can make recommendations without knowing the relevant level of training.

 

[Texan Scott]

Training. All the professional training you can get, especially for range officers. Nothing - NOTHING - in that bag is as important as knowing what to do with any of it. Much of what's in there (or not) can be improvised. That's less than ideal, yes. But someone with the TRAINING to use a proper trauma kit already has a good idea of what should be in it.

 

[evalero2]

A tourniquet and quick clot with a plunger are the only two things your going to be able to use for a gunshot wound. Carrying bandages/dressing and antisceptic is a good idea for less serious injuries. That would be it.

 

[Ramone]

Sticking a tampon in a wound always struck me as a kinda silly idea- you'd need a pretty standardized wound for it to work.

Sanitary napkins, OTOH are more durable and absorbent than gauze ( though gauze does better promote clotting), and when combined with duct tape will allow an impressive amount of direct pressure to be maintained on the wound.

Also, my GF objects to being handed a wad of gauze when she gets her period.

 

[Tim the student]

A tourniquet and quick clot with a plunger are the only two things your going to be able to use for a gunshot wound.

That has not been my experience.

 

[taliv]

so far, camping/hiking, shooting lots and lots of matches, and shooting probably 3-4 days/week for many years, i'd say the most common medical items used out of my kit are, in order:

sunburn:
sunscreen/lipbalm/salve

minor cuts/scraps:
ignored

headaches: (not me, fortunately)
aspirin/ibuprofen
water

blisters:
water
salve
moleskin

cuts:
water
antibiotic
coflex dressing

crap in eye:
water / eyewash


i keep the more serious stuff in my kit but have fortunately not had to use it. i started out a couple years ago with a pretty typical kit, then seriously upgraded it a little over a year ago, and have gradually refined the relative quantities of supplies based on the frequency of use.

 

[Double Naught Spy]

What items you physically own are less important that what you KNOW and what you are capable and willing to DO. There are any number of excellent trainers out there teaching everything from Red Cross First Aid and CPR to field treatment of GSWs.

How many here have availed themselves of any level of this training? If not, WHY NOT?

Your question was rhetorical, right?

Not rhetorical at all.

Oh, okay, then that is really simple to answer. It is for the same reason that folks typically don't get any defensive gun training beyond what is legally required by law for carry permits (assuming any of that counts as defensive gun training). It is the same reason people don't practice more. It is the same reason so many self proclaimed and well prepared folks are fully ready to defend themselves or their loved ones but will also declare themselves defenseless without a gun. It is for the same reason so many posters here claim near omnipotent situational awareness and readiness to react and yet in reality we see how many folks (many gun folks) start off by saying that they could not believe X was happening.

Of course, no need to stop there. Most of us that commute regularly in a metropolitan area will experience some form of road rage from another driver or will end up driving a friend or loved one to the hospital for a crisis, but how many of us take self defense or crisis driving courses? We all think we drive well, but how many of us take an winter/snow/ice driving class for those winter events that we are apt to encounter minimally a few times in our lives if not many times a year?

When was the last time we all went out and practiced with our fire extinguishers?

There is a significant disconnect between what most people think they can do, can handle, are likely to have to handle, what they need to be able to handle it, etc. and reality. It is a form of self delusion. Sure, we all have excuses for not being better prepared, better trained, etc. that sound really good, but really aren't very good excuses when considering that the purpose of such preparation and training are to save our lives. We don't have time for training despite having time to go boating, hunting, fishing, to the movies, to play golf, play softball, or go to the bar. We can't afford it despite having money for the new TV, new computer, new hunting rifle, new novelty gun, etc.

I see this disconnect every time there is a major looming crisis such as hurricanes and wild fires. Even knowing that the threats are bearing down, given ample warning, and often proclaiming to be prepared, they are the same folks on TV later stating how badly events got out of hand and that there was nothing they could do...and those are the people who have actual warnings are not surprised that they are about to have a crisis.

Along those lines, why aren't all of us in top notch physical condition? If we are working, getting combat training, getting medical training, getting other emergency training, and not immediately maintaining our gear, why aren't we all out on the jogging path and at the weight rooms?

For those of us with all that training, is it enough? So you had some classes. Great. How many have you had this year to update those perishable skills?

For some strange reason, we think we need to have a life outside of the gun experience, that getting all the training and making all the preparation we should make to be as safe as we often claim we are would be to a level that looks likes those paranoid weirdos we see on TV called preppers. Those folks make it a full time job or full time pre-occupation outside of their jobs to be preparing and don't seem to have much of a real life otherwise and most of us don't want to live that way. So the question becomes one of realism. Assuming no self delusion or ego about our amazing prowess, what is the amount of training that I need in what areas to be able to handle normal and realistic crises while at the same time not ruining the rest of my life at the same time? Here it is important to keep in mind that the next serious crisis any of us face likely will not be GSW at the local gun range.

 

[Ragnar Danneskjold]

FYI, the sensationalized version of preppers that you see on TV is about as accurate to real preppers as "Sons of Guns" is to regular gun owners.

On that note, if you're watching any TV show about any group and thing you're seeing an accurate depiction of that group, you need to turn the TV off and leave it off until you've relearned how to use your brain.

 

[Odd Job]

Once again, an excellent post from DNS, particularly this part:

Along those lines, why aren't all of us in top notch physical condition? If we are working, getting combat training, getting medical training, getting other emergency training, and not immediately maintaining our gear, why aren't we all out on the jogging path and at the weight rooms?

The greatest realistic threat to the well-being of the ordinary Joe is rooted in lifestyle choices. I hold my hand up here and admit I am one of these who should be doing more exercise instead of typing here at the PC.
I think Justin's signature is Round Count > Post Count.

Perhaps the new phrase should be Step Count > Round Count > Post Count

 

[wgaynor]

Double Naught, Go to the American Red Cross and take a first aid course/cpr course. That will be sufficient.

And yes, I'm a Prepper.

 

[Fred Fuller]

Once again, it's a question of stakes versus odds. The odds are that in a lifetime of normal range sessions any given one of us won't have to treat a GSW - blistered fingers, yes, but GSWs are far less likely. Doesn't mean they can't happen - note the thread I posted yesterday about the unfortunate event in Texas. But they don't happen to most of us most of the time.

How important is it to know basic first aid? I can't answer that. I spent six years as an EMT, and did the whole basic RC first aid and CPR class thing before I got the EMS training. It was important to me at the time to get the training and to use it serving my community as part of the local volunteer rescue squad. I let my certification lapse after six years, when I moved into a different area that had full time professional EMS. This was a long time ago and I haven't considered recertifying in EMS, and my CPR cert is out of date now too. But I'm not riding to the rescue any more either, my letter from the state authorizing red lights and siren in my POV is expired too.

Life is all about choices. It's not my business to tell anyone what choices they have to make. But by the same token, I don't think it's some self-designated hero's option to try and ride to the rescue in a situation that individual is not trained and prepared to handle, be it a gunfight or an automobile accident with injuries.

Wanna be a hero? Go get the level of training needed to meet basic standards for whatever it is you want to do. When I was a volunteer firefighter in the 1970s, we were trained to the same standards as full time paid firefighters, by the same people who trained the full timers. And our department's insurance rating reflected that, in part - our equipment, response times, the town's water system etc. all had a lot of bearing on the insurance rating as well. While I was an EMT in a volunteer unit, I had the same training and certification as any paid EMS worker in the state at my level.

And I haven't even mentioned potential legal implications of getting involved in situations beyond one's level of demonstrable training and ability.

But that too is a matter of choice. The best advice I can give is to choose carefully and prepare accordingly...

 

[Double Naught Spy]

Double Naught, Go to the American Red Cross and take a first aid course/cpr course. That will be sufficient.

I am not sure why you are suggesting I get some training in basic first aid. I was just answering Fred's query as to why people don't get such training.

FYI, I used to be an instructor for the ARC. I have had a bunch of their classes along with gun classes. I can say that there are a tremendous number of first timers that take the ARC classes and do so usually because of a job or other circumstance either requiring it or making it important for them to have...and often they may have a companion along for the ride. Most will never get a renewal unless it is required. Years later, most won't remember too much about the course either.

FYI, the sensationalized version of preppers that you see on TV is about as accurate to real preppers as "Sons of Guns" is to regular gun owners.

On that note, if you're watching any TV show about any group and thing you're seeing an accurate depiction of that group, you need to turn the TV off and leave it off until you've relearned how to use your brain.

Yep, and you will be shooting with a bunch of those guys at your local gun range who think tv is real, who have a disconnect between what they think their capabilities are and what they need to improve.