Splinters from bullets, bouncing bullets, organs moved about in the body, shockwaves — the bottom line is, actual damage from the bullet is what occurs!
Preparation is priceless.
While we may choose the proper handgun and ammunition, as well as a proper holster, we ignore dealing with the worst scenario.
Let’s talk about what happens if there is a gunshot wound.
Editor’s note: This article isn’t meant to be medical advice. Consult a doctor for a professional opinion and always call 911 or seek emergency assistance if there is a life-threatening gunshot wound.
Why Gunshot Wounds Happen
Getting shot may happen at any number of junctures. There have been negligent discharges in shops, on the range and during training classes.
It isn’t always getting shot in a gun battle. It is always a good thing to be prepared and know how to take care of a gunshot wound.
No matter how much training, whether it be personal-defense classes or just time on the range you have had, an accident can happen.
At home, at the range, anywhere, at any time.
Nobody wants to end up in that situation, but always be ready to take care of yourself if you end up taking a bullet or someone else is wounded.
On the bright side, only about 10 percent of gunshot wounds are fatal.
It is possible to survive a gunshot, maybe even multiple wounds, it all depends where the bullet goes once it enters your body.
Getting it under control is what matters, because almost all fatalities from gunshots are due to blood loss.
There are many myths concerning bullet wounds. Handgun bullets make an entrance wound of caliber diameter.
The bullet then penetrates to damage bones or organs. Secondary missiles thrown from the bullet are rare.
Bullets don’t bounce around in the body, although a round-nosed bullet may bounce off bone to an extent.
Bullets don’t have enough energy to bounce around in the body.
Secondary infection may be a real problem, but that is a concern after you treat the initial injury.
How to Handle Gunshot Wounds
You can get shot anywhere, so I’m going to break down how to take care of different gunshot wounds on different areas of the body.
Some places could complicate issues a lot more, the head or chest for example.
Of course, your best option, if you can, is to make it to the hospital as soon as possible, if not, this should help you out.
Head
If someone takes a shot to the head and is still conscious, start off by sitting them up and leaning them forward so blood isn’t getting caught in their throat.
If they are unconscious, lay them on their side and pull their knees forward to keep them in that position.
Keep applying pressure to the wound to slow down bleeding, make sure you don’t use tourniquets around their neck while applying pressure to their head as well.
I have arrived and witness an individual set bolt upright after a bullet flattened on his brow.
Another case saw a bullet follow the line of the skull and exit the rear of the scalp, with little permanent damage.
Chest
A gunshot wound to the chest can be very serious. A lot of people tend to call them “sucking chest wounds.”
The reason for that is you face a major issue of a lung collapsing.
The first thing you need to do is get some kind of occlusive dressing or bandage for it.
What that is, is an air and water-tight trauma medical dressing. They normally have a waxy coating to provide that seal you will need.
That way you are closing off anything from entering the lung.
Use that and some pressure when applying it and you can drastically help something that could quickly turn into a fatal issue.
Another thing to take into consideration with a chest shot is how far it went through them.
There is always a chance that it went far enough through to damage the spine.
That’s why it is important to have them sit upright and keep them as still as possible.
Sudden movements can cause serious damage to the spinal cord, which can ultimately result in permanent paralysis.
If the heart or major blood vessels get hit, there isn’t much you can do. You will definitely need medical help.
Arms and Legs
Now on to the arms and legs. Like before, the main thing with these wounds is to keep pressure on them.
Watch for skin discoloration, swelling and hemorrhaging. These can all be signs of internal bleeding.
This is when you need to be very careful, because it can be fatal.
Try elevating either the arm or leg as well, because this may help some with the bleeding. If the bleeding will not stop, you may have to use a tourniquet.
A tourniquet is a medical device that helps slow down, but not cut off, the blood flow to whatever limb you are using it on.
You can also make one out of a rope and stick if you don’t have a medical one. Fasten it high and tight on the limb.
You may have some side effects from using these, such as nerve damage or soft-tissue damage.
But, if the person you are helping is losing a lot of blood quickly and nothing else is working, it is better to try and use a tourniquet than for them to end up losing an arm or leg.
Even then, it is better to lose a limb than your entire life.
There is also a possibility that a bone was injured during the shot, and in that case you would need to apply a splint.
Another main issue is organ damage, which often results in organ failure. If that happens, there really isn’t much you can do at that point.
Tissue damage isn’t anywhere near as bad. The thing about bullets, is you never know where they are going to go.
Once they enter you, there is no promise that they will tear straight through. They may strike bone or they may stop in the solid organs.
They may even hit more than one organ, and tear through arteries and veins in your body.
Just one gunshot to the arm or leg in the wrong spot can kill you if you’re not lucky.
We will never know what path a bullet is going to take unless we have observed the exact angle.
All we can try to do is help the person once it’s happened.
Aftermath Effects
I know you’re probably terrified by now, but think about it this way, statistics show that you only have about a one in 514,000 chance of dying from a gunshot wound in America — but then, the possibility is endless.
Keep in mind that number comes from a lot of deaths, such as mass murders, suicides and gun-handling accidents.
Some of which can’t be prevented. That’s really low and, like I said before, most of those deaths are from blood loss not being treated properly.
If you make it to the hospital with your heart still beating, you have a 95 percent survival rate!
Most survivors of gunshots say the worst feeling was their blood running down them, and said it feels like an “intense burning sensation.”
My friend Trevor remarked it was like getting hit by a strong boxer. (His was a 7.62 x39mm hit from a ‘Terr.’)
Most people’s problems come with dealing with the aftermath of a gunshot.
A lot of gunshot victims, survivors, suffer from PTSD afterward. Recovery can take from months to years.
Leaving the person emotionally scarred for a lifetime. About 77,000 people in America are recovering from gunshot wounds each year.
No one is alone in this. There are therapy groups for victims and special counseling they can go to that may help put their mind at ease.
All of the factors I showed above help out in gunshot survival, but there are many, many more that lead to recovery.
Physical and mental therapies are the main things that will lead and help to a road of recovery.
A Good Standard Kit
- Wound-Packing Gauze
- Pressure Dressing
- Trauma Shears
- 1-2 Pairs of Nitrile or Vinyl Disposable Gloves
- QuikClot or Celox Hemostatic Gauze
- Chest Spike or Decompression Needle (Only If Trained)
- Tourniquets
Do you keep a trauma kit for gunshot wounds? What do you pack? Let us know in the comments below!
@Doc,
Thank your for your service to our country (Even if it was the Navy) 😉 I have known more than a few Army medics and Navy Corpsman who continued on into the civilian medical/nursing professions after seeing what they did when they were where they were. No one who has not been there has a clue.
There are times that I miss the excitement of the ER, but most of the time, not so much. I am 70 and pretty much disabled secondary to multiple surgeries and other issues, but I am cognizant of those who still carry on. Thank you for what you have done and still do. Carry on, sir!
To: THE CRAZY SQUIRREL at FEBRUARY 13, 2021 AT 9:25 AM
I am very sorry to hear of you being shot. You went thru hell and back recovering and we of the pro-gun community are grateful you recovered (did not die…) and shared your horrifying story. I only hope that the “losers” who did this to you were caught, prosecuted and put away forever. They deserved an “immediate” death sentence for shooting you like they did. When CWII breaks out, “justice” will be rendered to the criminals who do such things…
Regarding Cayenne pepper stopping bleeding when applied to a wound, Snopes fact checking rates this claim as “False, and includes the following quote: “I’m unaware of any scientific data to support the claim that cayenne pepper can stop bleeding.” [Donna Di Michele, the Deputy Director of the Division of Blood Diseases and Resources at the National Heart, Lung, and Blood Institute, told us via email]. As far as oral cayenne preventing or reversing shock, I have no facts to offer, but let me point out that it is dangerous to place a powder that presumably could be inhaled, or any liquid, into the mouth of a person who is not fully conscious, which presumably would include a victim of traumatic shock unable to focus his/her eyes.
In my IFAC. I carry in my range bag. Combat gauze, 2 pairs of gloves, decompression needle, roll gauze, bandaids (large and regular size), trauma shear, pen light, burn gel, eye wash, chest seals (2 pair), tourniquet, ink pen, tampons (at least 2), safety pins, and aspirin.
I have been told by a medical doctor that this is crazy and can’t work. However I have 30 years of experience with its efficacy. Cayenne pepper should be immediately packed into any bleeding wound and a pressure dressing applied. If bleeding continues and it’s possible apply a tourniquet, < 15 minutes at a time. The bleeding will normally stop within minutes, even arterial, in an extremity. Within 3 days new skin will form over the wound, just leave it wrapped. Give the same cayenne orally as it will stop the patient from going into shock, within seconds their eyes will refocus. Haven't had the opportunity to use this on internal damage but suspect it will work just as well. later – jw
After a career in combat arms in the Army and several years as a DoD private security contractor in Iraq and Afghanistan, I have some experience with wounds and serious injuries. Outside of immediate death or shock to internal organs, bleeding in the number one killer. The average adult has about 1.2 to 1.5 gallons (4.5 to 5.5 liters) of blood in their body. This will evacuate very rapidly through a serious wound, so anyone who is serious about saving a life (theirs’s or someone else’s) needs to understand how to apply pressure bandages and tourniquets, as appropriate, and to use whatever they have at hand to stop the bleeding. And this will include the shock of the caregiver at the sheer volume of blood from the victim. Get some training and be prepared.
After paying attention to the ABC’s of patient evaluation, follow the bullet path to it’s conclusion. I treated a young man in the operating room with a 45 gunshot wound to the left lobe of the liver. He had been seen in the emergency room for transfer to the O.R. On moving from the stretcher to the O.R. table I noticed a large collection of blood beneath him. InvestigatingI found the bullet had exited his left side and transected his left brachial artery. He was exsanguinating from a wound not visible . I quickly compressed the artery stopping the blood loss, obtained a doppler and identified a complete loss of circulation below the wound. The 45 wound was through and through with little liver damage. He received a vascular graft to replace his brachial artery.
Regarding chest wound dressings. Dressings are currently available to seal wounds containing a flap to release pressure to prevent tension pneumothorax. If unavailable, use an occlusive dressing to minimize lung collapse. If the patient condition worsens, open the dressing and listen/ feel for an air exit which confirms a tension pneumothorax. Ask your personal physician to teach you how to percuss a chest with your hands which will identify a hyper inflated chest with no tools. 5 minute learn which can save lives.
I do not have anything to add, but just wanted to thank the author for the article and the very knowledgeable comments that followed – thank you all!
Former USN Corpsman and ER Physician.
i’ve seen a few people who have been shot; both accidentally and on purpose.
Rule #1: don’t get yourself killed trying to save a buddy.
Make sure the source of the gunshot is no longer a threat.
Rule #2: keep them breathing.
Learn basic CPR.
Rule #3: stop the bleeding.
Learn to use a tourniquet properly.
Rule #4: time is the enemy.
Your mobile phone is a powerful First Aid tool.
Evac ASAP to a facility with the capacity to definitively address the issue is key.
There is just not much you can do in the field other than the above.
I am more than qualified to handle gunshot wounds. I just do a better job of it when I have all my toys handy.
I would like to obtain a video or pamphlet book type educational media to teach trauma first aid, where would be the best place to find this info, pictures or video most appreciated to see actual treatment of wounds in a growing societal and geothermal breakdown???
About a month ago I spent several full days extensively shopping IFAKs (Individual First Aid Kit) which are, in fact, trauma kits. I ended up purchasing a Lightning X Rip-Away Officer’s Patrol Tactical Gunshot & Trauma IFAK Kit w/Headrest Mount – Desert TAN from Amazon. Although this kit is very complete, I added a few very minor things like band aids, anti-biotic cream, steri-strips, a foldable splint, Vet-Bond, Glo-sticks, etc.
***Name changed for privacy purposes ***Last year I got shot in the chest, left side, from a bad guy with a shotgun at nearly point blank range. I was in the middle of a public roadway when I was ambushed by two methheads, 200 yards from my driveway. Looking down I could see spaghetti on my shirt from that evenings dinner. The shooters took off leaving me to fight for my life in the middle of a dark road. Having 21 years of military service under my belt, I had to do a quick assessment of the situation. Putting distance and obstacles between me and them. I was able to call 911 and spent nine minutes on the phone with them, providing updates of my condition, giving a full MEDEVAC Nine Line for helo transport, as well as the location of the suspects. Officer arrived and he did absolutely nothing medically. He froze…..my best friend was just down the street with the family and seen the flashing lights, he called as they were all waiting my return. When I told him I’d been shot, he immediately came to the scene. He grabbed the trauma bag from the sheriff officers patrol car and immediately started Buddy Aid. He packed the wound and applied pressure to slow the bleeding. Ambulance arrived 20 minutes afterwards, the EMTs weren’t able to do much more than help me get on a stretcher and they loaded me in to the meat wagon to await the arrival of the helo. Ambulance service stood around as did fire department waiting for helo. 45 minutes later, helo was hovering. My Best Friend landed the helo in my front yard (I have 18+ acres of area and only need a 96×96 LZ). Still conscious, they put me in the helo amd started some IV’s to keep the veins open. It was a 55 mile flight to the Trauma Center, I remember 90% of it. The questions from the nurses, radio traffic, etc. the helo landed and I was handed off to an amazing Trauma Team. I remember talking to the Doc and he said I would be fine and he was gonna give me a little something to take the edge off the situation……..24 days in a deep coma and on life support they started waking me up, still no real memory until mid May. Ketamine was a trio, literally! The Chaplain and the Head Trauma Surgeon were there when I was alert enough to hear the damage report…..Shotgun blast from less than 12’ away to the left side of the chest, 4” deep x 8” wide hole below left nipple. Spleen destroyed and removed, a foot of large intestines removed, holes in diaphragm, stomach, pancreas severely injured, spaghetti throughout body cavity causing infections, split from navel to nipple, organs removed daily, washed, replaced, open for nearly two weeks, illyostomy bag in place. Wheeled out the hospital 47 days later. Home healthcare four days a week with OT/PT. Went back to work four months after getting shot, full duty. Illyostomy reversal six months after incident, eight week recovery and back at work again full duty 1 December……without the prior medical training that my and my best friend had, there most likely would have been a funeral that week. We both have 20+ years of Active Duty service. Yes I know this was long however, it’s a true testament that you never know what will happen, when, or where and if you’re ever in a situation like this, that training kicks in automatically. Had he not been there, I don’t think I’d be writing this today. Self Aid/Buddy Aid/First Aid……learn it! You never know when you will need it.
Great article and comments. R.I.P Damon
Disagree with your information regarding chest wounds. Agree with prior comment that a completely occlusive dressing will result in fatal tension pneumothorax (air trapped in the chest). Dressings to the chest should be secured on three of four sides in order to act as a one way valve, letting air escape and preventing tension pneumothorax. I have seen people nearly die because of a fully occlusive dressing applied to a chest wound and the resultant tension pneumothorax.
I was also going to mention tampons. During my deployment to Iraq, a member of my unit received a care package meant for a female. He proceeded to put the tampons through the MOLLE webbing in everyone’s plate carriers. What started as a joke became SOP.
I carry duct tape in
my first aid kit. Not only to hold splints, but it can also be used as a tourniquet, when treating a sucking chest wound, or as a component of a sling.
Great article! Way over due. We in the gun community need more information on how to save a life than how to take it.
We all are more likely to come across a situation where someone is injured then be involved in any type of a gun fight.
I’ve been that guy who jumped in to help someone injured while everyone else stood around as spectators. So many people are afraid to get involved.
We need to encourage everyone to learn to save a life. We all could face a situation where this kind of information may help save a family member, a friend or a neighbor.
I wouldn’t want to spend the rest of my life regretting not at least trying to help someone that really need help at that critical moment.
Good article, but I have a couple of comments on things I have seen in the ER after treating several hundred GSW’s over more than 30 years.
1. One thing the author stated was “Another case saw a bullet follow the line of the skull and exit the rear of the scalp, with little permanent damage.” I have seen that more than once with .38 Special and it is completely disorienting. The patient looks like it was through and through but they are talking and seem to have intact neuro function. X-rays showed no cranial penetration. The first one was when I decided that .38 Special was not a good caliber for self-dense; the other two were just confirmation of that.
2. The author also stated, “Bullets don’t bounce around in the body, although a round-nosed bullet may bounce off bone to an extent.” I have to disagree because I have seen several people whose chest we cracked that had this happen. They were all from low caliber, low powered handguns, like .25 ACP, .32, and .380 fired at close range in self-defense. The initial point of entry into the body came as the bullet passed between ribs. The bullet(s) then bounced off several ribs inside, and as the doc said, “played the marimba” in the chest. We found entrance wounds only and no exits. Each of these did kill the patient, eventually, as it created a number of small holes in major vessels inside the chest, like the aorta, pulmonary arteries, and veins. Even though these patients bled out from leaking blood vessels and died as I said, several of these GSW victims went on to kill the person who shot them before they bled out enough to be incapacitated.
3. Gunshot wounds to the chest are always a problem. Sucking chest wounds suck, but I have seen people place occlusive dressings on them which not only stopped air from entering the chest cavity, but it also prevented free air from leaving the chest, resulting in a life threatening condition called a “tension pneumothorax” (You can look it up online.) The dressing needs to be applied to allow air to leave, but not back in. If the pressure builds up because that air is not leaving, the patient can in extreme circumstances have both lungs and heart moved to the other side of the thoracic cavity and one side filling free air space. That patient will die unless treated immediately by someone trained in what to do, (read, an EMT-P or a military medic [Army]or corpsman [Navy or Marines]). This is where a decompression needle would be used.
4. For GSW’s to the head, our neuro docs liked them sitting up at 30 to 45 degrees, depending on the doc. A dressing was applied to the wound to catch the dripping, but not to stop the bleeding or keep it inside the skull if there was penetration, as any bleeding that was prevented from leaving the skull would build up pressure and further brain tissue damage.
Another memorable patient was struck in the forehead with a single round from a .32 at close range. She was taken to CT where we could see the pattern of a 4, with the bottom of the 4 being the entry point, the top being the back of the skull. The neurosurgeon declined to take her to surgery and she was shipped to the ICU. Sometime later, he told us that she had been discharged and the only deficits noted were a unilateral foot drop requiring orthotics and a difficulty in understanding her speech. Since no one had known her before, it was unknown as to whether that was even related to the GSW. I have seen the same kind of bounce happen with .22 lr. wounds to the head.
5. Extremity Wounds. The author is correct about extremity wounds in that people do die from those. In the old westerns and other movies, it would show someone being shot in the shoulder and they would say, “they just winged me.” A great number of people I have seen who were shot in that “winged me” area died as there are major blood vessel in that area; the subclavian, axillary and/or the brachial artery are all in that area and if any of those are affected the patient will not usually do well. Any wound high up on the extremity, be it the shoulder or the hip region can be life threatening as there is sometimes no way to address the bleeding other than direct pressure to the site IF pressure will even help. That means a person holding a pressure dressing directly to the wound and stopping the bleeding that way. I have seen several instances of people holding pressure to the area they thought was effective and could not understand why there was so much blood still leaking. It was leaking because the direct pressure was ineffective and those patients died from bleeding out.
4. The Standard Kit. That is a very good standard kit. I would only add one thing to put in any first aid/survival kit, and it something that I learned from a friend who was a combat medic in Afghanistan, (After that first tour, he went to OCS, became an officer. He, unfortunately, was killed by an IED on a subsequent tour in 2011, RIP Damon) and that is a box of tampons. They have several functions. He used them more than once on men who had nosebleeds from facial injuries after IED explosions nearby and the like, and for inserting into extremity GSW’s and the bleeding was not easily stopped with a standard pressure dressing. He told he used tampons in those cases before resorting to a tourniquet as the tourniquet could result in loss of a limb. The tampons would swell up with blood and provide an internal pressure dressing and stop the bleeding. And as he said, they are, at least in theory, clean and sterile in the unopened package.
As an aside, a tampon also makes very good tinder for starting a fire in an emergency situation. I have used them just for practice when starting a fire, either in the fireplace or campfire.
for minor wounds,corn starch will work for clotting blood-and is more readily available than those products that you listed
With this covid 19 nonsense how I in person renew my Wilderness First Aid 14471region]?