Gun shot wounds and first aid

[Soybomb]

There's always alot of posts on how to potentially have weapons in places that are supposed to be weapon free but I don't often see people talking about what to do to treat anyone that gets actually gets shot. I think many of us probably shoot at remote shooting ranges also. What should people who work in schools be wanting to keep in their desks other than a gun so they can treat their students, coworkers, or even themselves if they're one of the unfortunate few to be involved with something like that? What should I keep in a pouch on my range bag that might help save a life while waiting 10-15 minutes for paramedics to arrive?

I know there are some first aid classes centered around these things but they seem to be a leo/military type thing for the most part. What should your average person who knows basic first aid for bleeding like compression, elevation, and pressure points also know or have? I usually have about a dozen 4x4 sterile pads, a roll of stretchy gauze, an ace bandage, a couple pair of gloves, and some waterproof tape in my car just as handy things for patching up minor injuries that might happen during long commutes. What should I supplement this with? Does it need a training class to learn to use well?

 

[1911 guy]

Take a class.

Most classes are indeed mil/leo oriented, but there are some good ones available for us who are either out or nover were in. Look at the Red Cross (good training, questionable charity), the local hospital, fire department, etc.

Your biggest concerns are going to be bleeding, sucking chest wounds and shock. Treat those and the victim will likely make it to see the professionals.

Pressure is the number one way to stop serious bleeding. QuickClot is available now, but I believe you still have to take a class on it's use before you can use it. Knowing how to use a turniqete (sp?) can be handy in severe cases.

Sucking chest wounds mean the chest wall has been penetrated. A stiff airtight material like a library card, drivers license, laminated paper, etc will keep airflow from completely wrecking respiration. Again, classes cover much more than I can type here.

Shock is covered in almost all first aid classes, and the least treatable under a stressfull situation. Elevate their feet? What if there's a bullet hole in their chest? Wrap them up in a blanket? Now it's soaked in blood and cooling them.

My best advice is to get some rudimentary training. A degree in medicine won't enable you to do anything in these situations a well trained Boyscout can't do. Let your training and knowlege dictate what equipment you have on hand. Better to have an extra Ace bandage than a GeeGollyWhizBang you have no idea how to use.

FWIW, I keep two of these kits, one at home, one in the car trunk.
Painkiller (aspirin, advil, whatever.)
Benadryll lotion
StingKill (a topical anesthetic/drawing agent)
instant ice packs
instant heat packs
gauze and tape
gauze squares
scissors
assorted band-aids
CPR shield
splints
"survival" blanket (reflects bodyheat inward)
fever reducer
razor blades
laminated posterboard
alcohol
peroxide
cotton balls
matches
Steri-Strips (adhesive stitches)
iodine
gatorade (small bottles)

A few other things, but I'm too lazy before church to go get the bag.

 

[ShackleMeNot]

http://www.TacticalResponse.com/course.php?courseID=36

We designed a two day course for the average shooter to be able to deal with the first 15 minutes after a shooting.

It sounds like you have a good start for a trauma kit. There is some specialized medical equipment you might want to have and training in how to use it is always prudent. A book or website might give you some good info but an instructor will give you info AND constructive feedback.

Anyway, it's always good to see someone thinking about trauma medical issues. Not enough gun owners give it a second thought.

 

[joab]

The most basic FA kit I have carried and gotten the most use of was duct tape and gauze pads or white hand towels in a zip lock bag

Not fancy and many professionals cringe at it, but I have treated many bleeding wounds with that kit, super glued the tip of my finger back on once and duct tape a pad over it so I could finish my job

 

[Mtnvalley]

If your range bag is as crowded as many are, sometimes it's easy to cut corners on FA gear. It may be an idea to have a more comprehensive kit/bag in the car, and just keep gloves (vac-packed) a few 4x4's, an Israeli compression bandage, and some tape in the range bag. An Asherman chest seal for sucking chest wounds would be a nice addition, but if you don't have a separate compartment away from your gear, I could see it getting chewed up.

 

[AndyC]

I keep tampons, battle bandages (whatever they're called in the US) and duct-tape both in my car's medkit and range-bag.

 

[jkingrph]

--------------------------------------------------------------------------------

Most classes are indeed mil/leo oriented, but there are some good ones available for us who are either out or nover were in. Look at the Red Cross (good training, questionable charity), the local hospital, fire department, etc.

Your biggest concerns are going to be bleeding, sucking chest wounds and shock. Treat those and the victim will likely make it to see the professionals.

Pressure is the number one way to stop serious bleeding. QuickClot is available now, but I believe you still have to take a class on it's use before you can use it. Knowing how to use a turniqete (sp?) can be handy in severe cases.

Sucking chest wounds mean the chest wall has been penetrated. A stiff airtight material like a library card, drivers license, laminated paper, etc will keep airflow from completely wrecking respiration. Again, classes cover much more than I can type here.

Shock is covered in almost all first aid classes, and the least treatable under a stressfull situation. Elevate their feet? What if there's a bullet hole in their chest? Wrap them up in a blanket? Now it's soaked in blood and cooling them.

My best advice is to get some rudimentary training. A degree in medicine won't enable you to do anything in these situations a well trained Boyscout can't do. Let your training and knowlege dictate what equipment you have on hand. Better to have an extra Ace bandage than a GeeGollyWhizBang you have no idea how to use.

FWIW, I keep two of these kits, one at home, one in the car trunk.
Painkiller (aspirin, advil, whatever.)
Benadryll lotion
StingKill (a topical anesthetic/drawing agent)
instant ice packs
instant heat packs
gauze and tape
gauze squares
scissors
assorted band-aids
CPR shield
splints
"survival" blanket (reflects bodyheat inward)
fever reducer
razor blades
laminated posterboard
alcohol
peroxide
cotton balls
matches
Steri-Strips (adhesive stitches)
iodine
gatorade (small bottles)

A few other things, but I'm too lazy before church to go get the bag.
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Most items are good. Do not give aspirin, advil or any other non steroidal antiinflammatory drug as they all will prolong clotting time. That may not be of signifiance at the time of the injury but could be a factor if surgery is required soon thereafter.

Any flexible, non porous material such as saran wrap, aluminum foil, thin cardboard, surrounded by tape will help a sucking wound, Wide enough strips of tape are probably the best.

Phone to call 911

 

[swatmedic]

Spend the money and get a decent kit. The VOK from tactical response gear is good. More importantly get some training in its use. No one here would advocate a person go to the local gun store, buy a handgun, and with no additional training carry it around, with the mindset that it's better then nothing. If you are going to carry gear with the intention of possibly using it on another person, you had better have some training on how to use it. That goes for both guns and bandages.

 

[skidmark]

If you are not at a street address in a major urban/suburban setting, you would do well to have your GPS latitude/longitude coordinates written down. Makes medflights much easier to arrange for, and cuts down the time they need to spend looking for you.

I have only run into one range that includes a FA kit and emergency contact procedure briefing as part of the introductory activities. Needless to say, I was quite impressed.

Seems lots of hunters & plinkers these days use GPS to get to & from the starting point to where they are going to be spending quality time.

You may be in cellphone range even when at Uncle Johnny's farm, but I'll bet you wioll not remember the street address for that field or woods you are in while somebody is bleeding. Even if you have moved from where you took you position reading you have cut down the area to be searched. If you can work the GPS you can figure out how far & in which direction you are from your initial reading.

stay safe.

skidmark

 

[Trope]

I took the Heartsaver First Aid (First Aid + CPR + AED)from the American Heart Assn. and it didn't cover much in the way of gunshot wounds. Basic stuff like clearing the area, applying pressure, and how to deal with shock. But mostly, it was "call 911".

This thread reminds me that it's time to look into the next step of training.

 

[mljdeckard]

I'm in the process of getting CLS (Combat Lifesaver) trained, when I deploy, I plan on acquiring a bag with items like IV's, bandages with quickclot, chest tubes, tourniquets, etc. I'll keep the bag in my vehicle when I'm home.

 

[nlax2011]

Not sure if it's been mentioned, but do not give aspirin or similar painkillers, can prevent proper clotting.

Beyond that I'd highly recommend a First Aid & CPR course. Really something most people should do as you may come across situations where you'd need to use CPR more often than a gun.

Beyond that I'm not sure what other sort of training you could take, save for First Responder/EMT courses or other training geared towards military. Unless you are stuck out in the woods or on the battlefield there's not going to be much to do besides keep them down and still and try and control the bleeding (taught in first aid) without further medical training.

 

[DWARREN123]

Best deal is take a First Aid Class. The first thing to do , taught by the military, is do not get shot yourself and remove the victim from the danger area.

 

[alucard0822]

At my local range our first aid kit is quite simple, it contains band-aids and a shovel

A good class and kit are the way to go, one is useless without the other. some 4x4 bandages, gloves, scissors, some clean small towels, tape, a canvas belt and playing cards are what we actually have. Direct pressure is the best way to stop most bleeding, where the 4x4s are placed over the wound, and the towels to help apply pressure. For a punctured lung, tape a playing card(stiff and plastic coated) over the wound, leaving a corner untaped to vent. The belt to tie off an arm or leg, scissors to remove clothing to access. Basically enough stuff to buy someone a few extra minutes waiting for an ambulance.

 

[mad hungarian]

Great thread - I will add duct tape and playing cards to the FA kit in my vehicle and home.

alucard0822 - are the band aids for the blisters one gets when using the shovel ?

 

[wideym]

Unless you are a doctor with a sugical kit, keeping someone or yourself alive is the priority. Tourniqests are best to stop excessive extremity bleeding. Just don't loosen it and forget about amputation stories. You have up to four hours before necrotization of the flesh, plenty of time for evac. Quickclot is another great life saver no matter that some doctors complain about removing it(you are bleeding not him). Most of all know how to treat for shock. Even minor wounds have proven to be fatal if the person dies from shock. The best advice is to take a first aid course and refresh at least once a year.

 

[KC&97TA]

I keep tampons, battle bandages (whatever they're called in the US) and duct-tape both in my car's medkit and range-bag.

+1

Few know this, but an uncented tampon, that has a plastic aplicator is great for a gun shot wound and steral, works better on .30 cal sized holes, don't try to plug a 5.56mm with a tampon it's too small of a hole. Place the tampon, remove the aplicator, cover with a compression bandage and then duct tape for pressure and to also keep the dust out of the wound... and keep on fighting like a warrior.

 

[sniper5]

OK, I'll weigh in on this one. I'm still licensed as a paramedic with 18 years experience in a busy downtown urban EMS system. Currently a respiratory therapist in a busy trauma center, and a former paramedic instructor.

I'll echo the advice of others: Get a class. First aid or EMT or any specialized classes dealing with trauma that you can qualify for.

If you get stuck in a situation and you have to DO SOMETHING:

CALL FOR HELP!!!!!

1st do no harm: If you can't make it better don't screw it up and make it worse.

Airway: Got one? GREAT. If not turn them on their side. Takes care of the tongue, blood, vomit, etc. Try to keep their body in line in case of a spine injury. They will die without an airway. Yeah, I know. Lots of better ways. But they take classes and training. This is one that does the most good for the most people when TSHTF.

Breathing: If they can't breathe, someone's got to breathe for them. Take CPR classes. If they have a hole in their chest take the most airtight thing you can find and put it on the hole. If you can tape it down, tape 3 sides and leave one open. Otherwise just hold it.

Circulation: CPR if they don't have a pulse. You can't do ANYTHING about internal bleeding. Don't try. Just wastes time. That's why surgeons make so much money. Think gravity-legs up, head down. PHD--Press Hard Dummy. Control bleeding through DIRECT pressure. Find where it's coming from and push ON THAT SPOT-HARD using the cleanest thing you have READILY available-don't go shopping. If the cleanest thing you have is your hand, well OK. Look for shirts, towels, rags, etc. If it doesn't at least slow to a trickle you are either not pushing hard enough or don't have the right spot.

Take a class, I can't emphasize that enough. But if the stuff above won't keep them alive until help arrives, they probably were beyond saving. Not much comfort, but a reality check.

Hopefully none of you will ever need any of this, but if you do, hopefully it will help.

Mike Stacey EMT/P RRT-NPS

 

[Pat McCoy]

1969 in RVN our battalion surgeon taught us "Stop the bleeding, make sure theyr'e breathing, get help". Any more than that could casue more problems than it solved.

 

[Groucho_]

I learned to treat puncture wounds and tie tourniquets, etc. from basic first aid classes. The military field manual on combat first aid is a great reference read once you've gotten some actual instruction. Specifically, I own a copy of US ARMY IS0825 - Combat Lifesaver Course, among others, which I keep with my first aid kit. A good military grade first aid kit can be had at basically any surplus or outdoors/camping shop. Online, you could buy a kit such as this one. They can be a little expensive but if they are to ever come in handy you'll be glad you spent the money.

 

[evan price]

ABC of trauma:
Airway
Breathing
Circulation


In that order.

Deep penetrating wounds such as a gunshot are rarely instantly fatal.
If so, nothing you are going to do is going to help.
Usually, providing supportive care until the professionals can get there is the best to hope for.
Make sure of airway and breathing.
Try to stop any blood flow or slow it as much as possible.
Keep blood as close to the core and head as possible. Elevate legs. Elevate arms.
Keep the patient calm. Assure them help is on the way.

Nobody on here is likely to be doing field surgery with a pen knife and a ball point pen.

A Red Cross or Boy Scout first aid manual is helpful but do you have time to read it while somebody is bleeding out? Read it first before trouble, learn it, at least the basics for stopping blood flow, where to tie a tourniquet, how to immobilize a broken limb, how to prevent shock.

 

[1911 guy]

I'm getting the idea everyone thinks I was advocating giving aspirin to a gunshot victim. Nope, I just listed some of the junk I keep in my bag.

**Aspirin is a blood thinning agent, prevents clotting. Do not give to someone with serious bleeding issues. That's beyond the capability of an aspirin to treat, anyway.
**

 

[Clipper]

A few psckages of forceps for torn arteries that may be exposed enough to reach might be a good idea...

 

[kir_kenix]

others have given some excellent advice...i just want to throw in there that u might want a CAT type tournequet that u can put on w/ one hand. pretty much the most important life saving thing to keep in mind are to stop the bleeding, keep them breathing, make sure they have circulation, and make sure u either called for help, or sent someone for help. there is only so much u can do urself with a first aid kit, u need to get an ambulance on the way as soon as possible.

 

[Charles S]

Great thread. I am glad to see the interest.

1911 guy

Great post and great advice.

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Agreed....again great input.

As has been stated take a class.

ShackleMeNot...I am glad to see a shooter focused class available to the general public. Very interesting.

Mike...Great post and great advice.

If they have a hole in their chest take the most airtight thing you can find and put it on the hole. If you can tape it down, tape 3 sides and leave one open. Otherwise just hold it.

Everyone should read that and understand it. Mike is explaining how to get by until someone with the equipment and training can place a chest tube.

Evan...you are correct.

I'm getting the idea everyone thinks I was advocating giving aspirin to a gunshot victim. Nope, I just listed some of the junk I keep in my bag.

I really did not get that idea from your post. However I would and do keep aspirin in a first aid kit because I am a lot more likely to see an individual with crushing chest pain at the range than I am to see a gunshot wound. If I suspect someone is having a heart attack I am going to call 911 (time is muscle) and then give a 325 mg aspirin.

Aspirin should be in every first aid kit.

However aspirin, ibuprofen (and all NSAIDS), and Celebrex (and all COX II inhibitors) do affect platelet function to a varying degree. Some are does dependent, some as a function of time.