First aid for gunshot wounds

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A study conducted by American medical professionals using data from the World Health organisation and Cambridge University’s Small Arms Survey, found the top countries with the most guns per 100 people and total firearm-related deaths per 100,000. South Africans was found to have the second highest rate of gun-related deaths in the world at 9.4 deaths per 100,000 people (USA took the top spot). That statistic is made worse by the finding that South Africa only has the 16th highest number of guns per 100 people at 12.7.

If you are a victim of a gunshot, or a friend or family member is, Linda Buys, the author of The Illustrated South African First Aid Manual,  a qualified nurse and owner of a First Aid Training Company, explains what you should do:

There will be an exit as well as an entry wound, unless the bullet is still embedded inside the body. The exit wound is likely to be larger than the entry wound.

The exit wound will not necessarily be directly opposite the entry wound as the bullet sometimes ricochets inside the body. Severe internal damage and bleeding are likely (for treatment of hypovolemic shock, see pp. 180–181). 

Read: What happens when a gunshot enters the body, and what to do

Treatment

1. Contact Emergency Medical Services (EMS) right away and give details.

2. Wear medical gloves. 

3. Gunshot wounds should be treated like stab wounds. Be sure to treat both the entry and exit wounds.

4. With severe bleeding, raise the wound above the level of the heart. Apply direct pressure to the wound, using clean, absorbent material.

If the wound is bleeding profusely, control the bleeding by elevation, direct pressure, immobilisation of the limb and, if necessary, indirect pressure on the relevant pressure point (see pp. 174–175). Cover blood-drained bandages with more gauze and bandage.

5. Apply a tight bandage with continued hand pressure on the wound. Splint the limb. 

6. Do the nail bed test and other tests for signs of blood circulation (see p. 137). If blood circulation to the limb seems to be impaired, reposition the limb until you feel a distal pulse (see p. 26) and, if unsuccessful, arrange for very urgent medical attention.

7. Place the patient in the shock position (see p. 267), with feet elevated. Keep them warm and observe closely.

Should they vomit or lose consciousness, turn them onto his injured side to prevent blood draining internally to the uninjured parts due to gravity. 

8. Do not give fluids per mouth. Swab the lips with wet gauze.

9. Record the patient’s details. 

10. Continue to monitor the patient until EMS takes over.

Have a look at the The Illustrated South African First Aid manual for the full book on First Aid. 

Read more:

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How to treat bluebottle stings this Summer

Do you know when it's a first aid emergency?

Image: Gunshot wounds from iStock

Illustrations © James Berrangé/Penguin Random House (Pty) Ltd 2015

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