Most likely, you'll never have to deal with a gunshot wound. Some paramedics even go their whole careers without treating one.
Treatment and recovery for a gunshot wound depend on the size of the bullet, where the bullet enters your body, and how soon you seek medical care. Prompt medical attention often prevents a gunshot wound from becoming deadly.
This article walks you through what to do and how to handle gunshot wounds in different parts of the body.
Stop the Bleeding
Stopping the bleeding is a crucial part of managing a gunshot wound.1 You can do that with:
• Strong pressure on the wound: If blood is coming out of a hole, put a lot of pressure on it. For heavy bleeding, don't be afraid to use your knee and really lean hard on the wound.
• Dressing: Dressings help the blood clot and seal the wound. Use whatever's available—gauze, towels, a shirt, etc.
• A tourniquet (maybe): Professional tourniquets work well. But using them properly takes practice. If used correctly, they're uncomfortable or even painful.
Improvised tourniquets often fail. If you don't have a professional version, focus on strong pressure. Really lean into it.
Don't Elevate Legs
In general, you shouldn't elevate a gunshot victim's legs.2 That can make abdominal and chest wounds bleed more quickly. It might also make it harder for the person to breathe.
• If the person is conscious, have them sit or lie in the position that's most comfortable for them.
• If they're unconscious, put them in the recovery position (on their side with the top leg bent at a right angle.
Treatment by Wound Location
Gunshot wounds are puncture wounds. Don't expect to be able to tell the difference between entrance and exit wounds.
It's a myth that one type is significantly worse than the other. There's no reliable way to tell and it actually doesn't matter.
Someone with a gunshot wound might have substantial internal injuries. That can lead to breathing difficulties, low blood pressure, and heart issues. Begin CPR if they're not breathing.
It helps to have some information about wounds in specific areas.
Chest Injuries
Chest wounds can injure the heart, lungs, and/or aorta (the major artery leaving the heart). This could be deadly.
Some gunshot wounds to the chest are sucking chest wounds. These allow air to enter the chest.
To treat a chest wound, seal the wound with some type of plastic to keep air from being sucked in.4 This helps prevent a collapsed lung.
If shortness of breath gets worse after you seal the wound, remove the seal.
Abdominal Injuries
A gunshot wound to the abdomen can cause:
• Severe bleeding
• Organ damage
• Abdominal wall damage
Be sure to hold pressure on it. A wound that punctures the stomach or intestines can lead to an infection. That's due to gastrointestinal fluid or feces leaking into the abdominal cavity.
You might notice rapid swelling of the abdomen. That can happen even with a relatively small puncture wound.
Emergency surgery is generally necessary with abdominal bullet wounds.
Recovering From a Gunshot Wound
Bullets can cause a range of different types of injury from minor to severe. The location of the injury, the size of the bullet, your overall health, and how soon after the injury you received medical attention can affect how long it takes for your bullet wound to fully heal.
A simple injury that does not damage organs or cause a fracture may heal in as little as 10 days.6 More complicated injuries can take much longer to heal. As you recover physically, you may also experience mental health-related problems such as anxiety, nightmares, poor appetite, and emotional distress. If these are severe or persistent, contact your healthcare provider.7
Complications
Gunshot injuries may cause complications such as:
• Nerve damage
• Infection
• Soft tissue loss
• Blood vessel injury
Bullets and bullet fragments aren't always removed after a gunshot injury. This is because removing the bullet can lead to additional tissue damage, infection, bleeding, and other serious complications.
If the bullet is not removed, there is an increased risk for later problems such as arthritis, lead toxicity, or bullet migration, though these are not common. Some people with a retained bullet may have it removed at a later time, but it is not always necessary.
BDST: 2000 HRS, JULY 29, 2024
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