A gunshot wound is a severe injury that requires immediate action. The extent of damage varies greatly depending on the bullet’s path, type, speed, and affected body part. While some wounds might appear minor, all gunshot injuries require swift medical attention. Knowing what to do in the moments following such an injury can significantly improve outcomes until professional medical help arrives.
Initial Response and First Aid
After a gunshot injury, ensure the safety of the injured person and bystanders, then immediately contact emergency services. Once the scene is safe, control severe bleeding, as it is the leading cause of death in gunshot wound cases. Apply direct, firm pressure to the wound using a clean cloth or gauze until emergency medical technicians (EMTs) arrive.
For significant bleeding from an arm or leg, a tourniquet may be necessary if direct pressure is insufficient. Place a commercial tourniquet two to three inches above the wound and tighten it until bleeding stops or significantly slows. Note the time the tourniquet was applied, as this information is crucial for medical professionals. If a commercial tourniquet is unavailable, an improvised one can be created using sturdy fabric and a stick for leverage.
Position the injured person correctly. If unconscious but breathing, place them in the recovery position to keep their airway clear and prevent choking. This involves turning them onto their side with their head tilted back and an arm supporting their head, allowing fluid drainage. If conscious, allow them to lie or sit in the most comfortable position, avoiding leg elevation, which could worsen bleeding in chest or abdominal wounds.
Maintain their body temperature, as hypothermia can worsen outcomes. Cover them with a blanket to prevent heat loss.
Emergency Medical Intervention
Once emergency medical services (EMS) arrive, their focus shifts to assessing the victim and stabilizing their condition for transport. Paramedics conduct a rapid assessment, including airway management, further bleeding control, and administering intravenous (IV) fluids to support circulation. They coordinate with the receiving trauma center to provide information about the patient’s injuries and condition.
The EMS team ensures the patient’s breathing and circulation are maintained, which may involve advanced airway techniques or additional measures to control severe hemorrhage. Rapid transport to a designated trauma center is then initiated, as specialized facilities are equipped to handle complex gunshot injuries. Provide accurate information about the incident and any first aid already rendered to help streamline care and prepare the hospital team.
Hospital Treatment and Recovery
Upon arrival at the hospital, typically a trauma center, the injured person undergoes immediate assessment in the Emergency Room (ER). This often involves rapid diagnostic imaging, such as X-rays and CT scans, to locate the bullet, identify internal damage, and determine its trajectory. Based on these findings, surgical interventions are frequently necessary to address the damage.
Surgery may involve removing bullet fragments, repairing damaged organs, controlling internal bleeding, and addressing bone fractures. The approach often follows principles of “damage control surgery,” prioritizing the immediate control of life-threatening conditions like severe bleeding. Following surgery, patients with severe injuries are often transferred to the Intensive Care Unit (ICU) for continuous monitoring, where specialized physicians manage complications such as shock, respiratory failure, or organ damage. Pain management is a priority, and antibiotics are administered to prevent infection, a common concern with gunshot wounds due to potential contamination. Initial physical healing and wound care begin in the hospital, with staff providing instructions on dressing changes and wound management.
Long-Term Rehabilitation and Support
Surviving a gunshot wound often requires a long recovery, extending beyond initial medical treatments. Physical and occupational therapy are frequently necessary to help individuals regain mobility, strength, and function, especially if muscles, nerves, or bones were affected. These therapies involve individualized exercise programs and training on assistive devices like walkers or crutches, aiming to restore independence in daily activities.
Chronic pain is a common long-term issue for gunshot survivors, with nearly 68% reporting daily pain six to twelve months post-injury. Pain management strategies extend beyond acute care, often combining medications with alternative therapies. Beyond physical aspects, gunshot injuries can have significant psychological repercussions, including anxiety, depression, and post-traumatic stress disorder (PTSD). Psychological support, such as talk therapy, helps process trauma and develop coping skills. Ongoing medical follow-up is important to monitor for potential long-term complications, such as retained bullet fragments, nerve damage, or the risk of re-injury.