How to Treat a Bullet Wound

Basic Treatment

1. 1
   Make sure you are safe.
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3. • If the victim was shot unintentionally (e.g., while hunting), make sure that everyone'sfirearm is pointed away from any other person(s), cleared of ammo, safe and secured.
   • If the victim was shot in a crime, try to make sure that the shooter is no longer on the scene and that both you and the victim are safe from further injury. Wear personal protective equipment if available.
4. 2
   Call for help. Call for emergency medical assistance.
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6. 3
   Do not move the victim unless you must do so to keep him safe or to access care.
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8. 4
   Act quickly. Time is your enemy in treating the victim. Victims who reach medical facilities during the "Golden Hour" have a much better likelihood of surviving. Try to keep your movements swift without making them frenzied.
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10. 5
    Check the A, B, C, D, E's. Assess these five critical factors:
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    • A (Airway). If the person is talking, their airway is probably clear. If the person is unconscious, check to make sure that his airway is not obstructed. Turn the victim's head to the side to facilitate better breathing and get the tongue out of the way. If the victim's mouth is filled with blood, try to help them remove it by coughing or quickly sop it up with a rag or piece of clothing.
    • B (Breathing). Is the victim taking regular breaths? Can you see his or her chest rising and falling? If the victim is not breathing, sweep his or her mouth for obstructions and start rescue breathing immediately.
    • C (Circulation). Apply pressure to any bleeding, then check the victim's pulse at the wrist or throat. Does the victim have a discernible pulse? If not, begin CPR. Control any major bleeding.
    • D (Disability/Deformity). Disability refers to damage to the spinal cord or neck. Check to see if the victim can move hands and feet. If not, there may be an injury to thespinal cord. Deformity refers to things such as compound or obvious fractures, dislocations, or anything that looks out of place or unnatural. These injuries can be worsened by moving the victim.
    • E (Exposure). Always look for an exit wound. Check the victim as thoroughly as possible for other wounds that you may be unaware of. Pay special attention to the armpit, buttocks or other difficult-to-see areas. Avoid completely undressing the victim before emergency help arrives as this may advance shock.
12. 6
    Control bleeding. Controlling bleeding is most important thing you can do to save a gunshot victim's life.
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    • Applying direct pressure is the best way to control most wounds. Use a pad over the wound and apply pressure directly to the wound. If you have nothing available, even your hand or fingers can be used to control bleeding. Add new bandages over the old; do not remove bandages when they become soaked.
    • Use pressure points in the arm (between the elbow and armpit), groin (along the bikini line), or behind the knee to control bleeding in the arm, thigh, or lower leg, respectively.
    • There is little that can be done with conventional methods if the wound involves the torso, but chemical hemostats (QuickClot, Celox, etc.) have been proven to be very effective on all major bleeds. Ensure that you follow the instructions on the package for application, though it is usually as simple as holding the wound open, pouring in the powder or inserting the powder packet/sponge/applicator, and applying strong pressure for five minutes.
14. 7
    Be prepared to treat the victim for shock. Gunshot wounds frequently lead to shock, a condition caused by trauma or loss of blood that leads to reduced blood flow throughout the body. Expect that a gunshot victim will show signs of shock and treat it accordingly by making sure the victim's body temperature is as normal as possible – cover him up if his skin feels cold, or remove clothing and fan him if he's burning up. However, do not elevate the legs if the gunshot wound is to the torso, as this will increase bleeding and make it more difficult for the victim to breathe.
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Special Instructions for Regions of the Body

1. 1
   Learn how to treat a bullet wound to the head. Gunshot wounds to the head are frequently fatal. Keep the head elevated and get the victim to a trauma center as soon as possible.
2. 2
   Learn how to treat a bullet wound to the face and neck. These wounds typically bleed severely. Use direct pressure to control bleeding and keep the victim upright. Be careful not to obstruct breathing while controlling bleeding. With injuries to the neck, be careful that blood flow to the carotid arteries isn't disrupted, as this can reduce blood flow to the brain.
3. 3
   Learn how to treat a bullet wound to the chest and back. Apply direct pressure to control bleeding; understand that it may be difficult to control chest bleeding because the ribs make it difficult to compress the structures that are bleeding. Gunshots to the chest can cause what is known as a "sucking chest wound." These happen when air travels in and out of the wound with each breath. Treat these as follows:[1]
   • Seal wound with hand or airtight material (e.g., plastic film).
   • Apply an airtight bandage on three sides of the wound (see image below). Do not close the bandage on the fourth side. This will allow the chest to achieve its usual negative pressure state. Air will escape through the valve during inhalation.
4. 4
   Learn how to treat a bullet wound to the abdomen. Apply direct pressure to the injury site. As with the chest, controlling bleeding in these cases can be quite difficult.
5. 5
   Learn how to treat a bullet wound to the arm or leg. Use direct pressure to control bleeding. If you have a length of fabric or string on hand (or can tear one off clothing),make a tourniquet. Arm and leg injuries from gunshots can be elevated above the heart to help control bleeding. Use pressure points in the arm, groin, or behind the knee if direct pressure does not control bleeding.