How to Handle a Gunshot Wound

Safety and Treatment for Bullet Wounds

Most people will never have to deal with a gunshot wound, either as a patient or a rescuer. Many paramedics go their entire careers without treating a single firearm-related injury. But prompt medical attention can often prevent a gunshot wound from being deadly. If you are ever faced with a gunshot wound emergency, it's important to be prepared.

Bullets forming a spiral shape
Elizabeth Fernandez / Getty Images

Call 911

If you have been shot or if you're with someone who has been shot, it's vital that you get to a safe place. You can't help anyone if you get hurt. If the person who's been injured can walk or run, take them with you.

In the case of an accidental shooting, make sure the gun is secured.

Once safe, call 911 and follow the instructions from the dispatcher. Surviving a gunshot wound depends on how quickly a patient gets to a hospital. Ideally, the patient should be in an ambulance on the way to a hospital within 10 minutes of being shot.

Stop the Bleeding

Stopping the bleeding is a crucial part of managing a gunshot wound.

Methods for stopping bleeding include:

  • Place strong pressure on the wound: If blood is coming out of a hole, put a lot of pressure on it. For particularly bad bleeding, don't be afraid to use your knee and really lean hard on the wound.
  • Use a dressing: Dressings help the blood to clot and seal the wound. Use whatever is available—for example, gauze, towels, or a shirt.
  • Use a tourniquet if you can: Professional tourniquets are great, but using them properly takes practice. It should be very uncomfortable if it's on correctly—maybe even painful. Improvised tourniquets often fail. So, if you don't have a commercial version, just hold pressure and really lean into it.

Should You Elevate the Legs?

In general, you shouldn't elevate the legs of a gunshot victim. Gunshot wounds to the abdomen and chest will bleed more quickly if the legs are elevated, making it harder for the patient to breathe. 

Let conscious patients sit or lie in a position most comfortable for them. Unconscious patients should be placed in the recovery position (on their side with their top leg bent at a right angle).

Never give the patient anything to eat or drink, including water.

Treating Different Types of Wounds

Gunshot wounds are puncture wounds. Don't expect to be able to tell the difference between entrance and exit gunshot wounds. There's a myth that one type is significantly worse than the other. There's no reliable way to tell and it doesn't matter.

Someone who has had a gunshot wound might also have substantial internal injuries with various effects, such as breathing difficulties, low blood pressure, and heart effects. Begin CPR if the patient is not breathing, 

Chest Injuries

Chest wounds can injure the heart, lungs, and/or aorta. This could be deadly.

In some cases, a gunshot wound to the chest can be a seal-sucking wound that creates a pathway for air to enter the chest.

For gunshot wounds to the chest, seal the wound with some type of plastic to keep air from being sucked into the wound. This helps prevent the development of a collapsed lung.

If the patient begins complaining of worsening shortness of breath after you seal the wound, remove the seal.

Abdominal Injuries

A gunshot wound to the abdomen can cause severe bleeding, as well as organ damage and abdominal wall damage. A wound that punctures the stomach or intestines can lead to an infection due to leaking of gastrointestinal fluid or feces into the abdominal cavity. You might notice rapid swelling of the abdomen, even with a relatively small puncture wound.

For abdominal gunshot wounds, be sure to hold pressure on the wound. Emergency surgery is generally necessary.

Limb Injuries

A gunshot to a limb is likely to cause a vascular injury, and it may cause nerve damage or broken bones as well. In general, you should avoid moving a limb that has been shot. Preventing blood loss by holding pressure is the best approach you can take while waiting for medical help to arrive.

Neck Injuries

A gunshot wound to the spine can cause paralysis, and a wound to the front of the neck can damage the carotid artery, potentially preventing blood from reaching the brain.

Don't move someone who has been shot in the neck or back, as movement could damage the spinal cord, leading to permanent paralysis. And if someone was shot in the front of the neck, hold pressure to prevent bleeding.

Understanding Bullet Wounds

Gunshot wounds are not straightforward, and they can cause injuries beyond the visible puncture site. Bullets can bounce around inside a person's body, and various dynamics affect their path. A bullet can remain in the body, or it can exit after doing substantial damage.

The physical damage caused by a gunshot injury depends on several key factors:

  • Location of the injury
  • Size of the projectile
  • Speed of the projectile

While all of these are important, the speed of the bullet is the most significant factor on the amount of damage done by the round.

Rifles, for example, produce significantly faster-velocity projectiles than handguns, and therefore typically cause more severe injuries. That's not to say that handguns are not dangerous, just that rifles are generally even more dangerous.

One method that's used to calculate damage is by multiplying the mass (weight) of the round by the velocity of the round squared. Since the speed of the round is squared in this equation, doubling the speed quadruples the energy and the damage.

A bullet may be composed of materials that can degrade inside the body. Surgical removal of a bullet is often urgent, but it is done carefully to avoid further damage.

A Word From Verywell

If you are ever dealing with a gunshot wound, the key priorities are staying safe, calling for help, stopping the bleeding, and keeping the wound clean. You will need to make some quick decisions, but the more prepared you are, the better the outcome will be.

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