Gunshot Wounds: More Than Just Plugging Holes

I can’t tell you how many times I’ve heard gun owners talk about how, if they or someone else was shot, they would just “plug the hole” and wait for medics to arrive. As a trained first responder who has dealt with gunshot wounds, I just shake my head. I like to call the method of superficially plugging a wound “plug n’ pray” — because pretty much that’s what you’re doing when you attempt to plug a gunshot wound.

I can tell you that “plug n’ pray” method doesn’t work.

Good Samaritan Advice For Gunshot Wound Treatments

As a Good Samaritan, you are volunteering aid to another person. While it’s ideal you have some first aid or first responder training under your belt prior to jumping in, sometimes it’s not always possible. The biggest thing to remember is “primum non nocere“. That’s latin for ‘first, do no harm.’

Here’s some good tips to remember as a Good Samaritan treating a gunshot wound on a victim:

• Do not try to claim a better understanding of the human body than you have.
• Do not try to prescribe or diagnose a person. Let your senses report precisely what you can see, hear, feel, and smell and work from there.
• Always use protective equipment such as nitrile gloves, facemask (where applicable).
• Do not try to intubate another person unless you have been specifically trained to do so and are willing to accept the responsibility for such.
• Do not attempt to perform surgery of any kind unless you’re a trained surgeon.
• Always call 911 or have someone specifically get on the phone to 911 and start that call. Don’t just shout, “someone call 911”. Identify who is specifically calling 911. That person is your victim’s lifeline. You’re just there to attempt to stabilize the victim before trained medical help arrive.

If you feel a particular wound is above your understanding, you don’t need to immediately start digging around in another person’s body. Sometimes, just identifying the entry and exit wound (if applicable) or being able to assess the full range of damage can be helpful to pass on to medical professionals arriving to the scene.

If you are jumping in to help another person survive until trained medical professionals can show up, know that blood loss can happen both externally and internally. Even if you stop or slow blood loss externally, there can still be blood pouring into the body. This may not sound bad but it is pretty grizzly.

Ridiculous First Aid Gunshot Wound Supplies

I’ve heard some of the most ridiculous first aid pack recommendations based upon a faulty assumption that you can simply stick an object into an open wound and it will miraculously stop or slow the bleeding.

Here’s a pro-tip: if you don’t isolate the source of the blood flow and stop or severely slow it, you’re not helping.

Here’s a list of items you can just toss out from your bullet-plugging gunshot wound medical kit:

Tampon

Yep. I can’t tell you how many guys, with a straight face, will tell me that a tampon will plug a bullet hole. The sad truth: if you’re trying to stop a femoral arterial bleed with your wife’s extra heavy Tampax, you’re going to be unconscious or dead with a tampon sticking out of your thigh by the time first responders arrive.

Bandana or belt as a make-shift tourniquet

There’s probably a few people out there who can actually apply a correct make-shift tourniquet. If you think a bandana and twig are going to cut the mustard while you’re trying to stop somebody seeping out on the ground, you’re going to be in for a very rude awakening. Make-shift tourniquets are pretty useless unless you have good training and practice under your belt. Just whipping off your belt and torquing down on somebody’s bicep to stop his brachial artery from dumping out is frustratingly foolish from a medical perspective. Carry a real tourniquet.

Things You Should Have For Gunshot Wounds

Now that we’ve covered the ridiculous, let’s get to the serious. There are quite a few things you should see in your gunshot wound treatment kit. In no particular order (they’re all important):

QuikClot or a Kaolin-based clotting agent (also: Yunnan Baiyao)

I personally like Kaolin-based clotting agents based upon clinical studies but ultimately, your job is just to stabilize the patient until medical help can arrive.

Professional-grade tourniquet

Don’t balk at the price. Look for tourniquets that offer a strong toggle and reinforced strap materials. The big thing to remember when applying a tourniquet is to go above the entry and exit for appendage wounds. You want to ratchet that thing down until the blood flow stops. Remember: if blood is still flowing, you’re losing.

Sterile field dressing

This is used as packing material. When a real gunshot wound occurs, you’re going to use this field dressing to pack the wound completely. That means pressing the field dressing into the wound — as far as it will physically go. There’s the “ball and push” method. You ball up the tip of the field dressing and stuff, ball up the next section and stuff again. Your job is to apply a firm, hard packed layer to interrupt blood flowing out internally as well as externally.

Nitrile gloves

Because of latex allergies, carry about a dozen nitrile gloves in a Ziploc bag (or generic equivalent) in your gunshot wound treatment kit. Bloodborne pathogens ARE a thing. You have NO idea where the victim has been and the last thing you need to worry about is finding out. Nitrile gloves pack down real tight so they won’t take up a lot of space.

Surgical scissors

One of the first things you’re going to need to assess is the wound. If that wound is covered by clothing, that clothing needs to come off. Surgical scissors are one of the fastest ways to cut away clothing to reach the wound area.

Iodine solution

Iodine is one of the best sterilizing agents for superficial wounds and injuries. Gunshot wounds are rarely superficial but if you need to clean the external area of debris, iodine solution is ideal.

Surgical sponges

For especially nasty wounds in the abdomen and head, surgical sponges may be necessary. They can cover and absorb a wide range of fluids — which is sometimes the only thing you can do in an emergency Good Samaritan situation.

Medical tape

If you need to tape down gauze, dressings and other bulky medical supplies to the exterior of a wound, medical tape is your best bet. Relatively easy to remove but pretty adhesive, it can help keep a dressing secure until medical help can arrive.

This sort of advice is aimed specifically at people who deal with guns and those who may encounter the effects of guns. Accidents can happen. Negligence can happen. Willful, malicious acts can happen. It’s our job to train accordingly and work within a scope that doesn’t overstep the bounds of medical help and is beneficial to the person you’re helping.