EMTs and Paramedics: How does one treat a gunshot wound?

Treating a gunshot wound requires immediate and effective first aid to manage bleeding and ensure the patient's safety until medical help arrives. Here's a step-by-step guide for EMTs and paramedics:

General Approach

1. Scene Safety: Ensure the scene is safe for both the patient and the responders. This is crucial to prevent further injuries or harm1.

2. Call for Help: Immediately call emergency services or alert dispatch if not already done2.

3. Assess the Patient: Check if the patient is awake and responsive using the tap-shout-tap method2.

Managing Bleeding

1. Direct Pressure: Apply firm, direct pressure to the wound using a clean cloth or gauze. This is the first line of treatment for bleeding control24.

2. Tourniquets: For severe bleeding in extremities (arms or legs), use a commercial tourniquet if available. If not, an improvised tourniquet can be made from a long piece of fabric (like a shirt or necktie) wrapped tightly above the wound21.

3. Wound Packing: For wounds that cannot be managed with a tourniquet (e.g., junctional sites like the neck, armpit, or groin), use wound packing with gauze or hemostatic agents to control bleeding41.

   • Technique: Insert gauze into the wound, maintaining direct pressure. Pack the wound tightly to ensure contact with the bleeding vessel4.

Additional Care

1. Airway and Breathing: Ensure the patient's airway is clear and they are breathing adequately. If not, provide appropriate interventions like CPR if necessary12.

2. Hypothermia Prevention: Keep the patient warm to prevent hypothermia, which can complicate bleeding control1.

3. Transport: Rapidly transport the patient to a medical facility for definitive care12.

Special Considerations

• Military vs. Civilian Contexts: In military settings, patients may have protective gear like vests, which can affect the type of injuries encountered. In civilian settings, torso and abdominal injuries are more common1.

• Long-term Care: After initial treatment, patients may require surgery, blood transfusions, antibiotics, and other interventions. Recovery can involve physical therapy and psychological support2.

By following these steps, EMTs and paramedics can provide critical care that significantly improves the chances of survival for gunshot wound victims.