Gunshot Wounds: How to Treat 4 Types Page 1 of 4

This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim
cannot get expert medical help. Please see the disclaimer.

How to Treat 4 Types of Gunshot Wounds (From One Shot?)

by James Hubbard, M.D., M.P.H.

A paramedic told me that when she was in training, a patient

came in who had been shot in the right upper chest. They
ended up finding the bullet not in the back, not even in the
other side of the chest, but way down in the right butt cheek,
pushing against the skin.

In my last post, I covered general gunshot-wound

treatment—the basics for survival situations when you can’t
get to a doctor. Now, I’ll go into more detail for specific
wounds.

As I said in the first post, one bullet can cause multiple

injuries—both internal and external. Even if you can’t get
expert treatment right away, you need to get it as soon as you
can. There are some lifesaving things I don’t cover here that
you just can’t do outside a hospital.

Bullet casing.
Signs of Internal Bleeding
Since you can’t see all the bleeding, it’s important to note the initial vital signs. Warning signs of internal bleeding
include:

• Decreasing alertness
• Nausea/vomiting
• Weak pulse
• Lowering blood pressure, or faster and faster pulse.

Someone with internal bleeding is probably not going to survive without

rapid transfer to a medical facility.
Important Note
For a Gunshot Wound in the Head These treatments for gunshot
Think about: the airway. wounds are complicated and
require advanced knowledge. I
Tips:
can’t cover everything in a blog
post. (I’ll be writing about gunshot
1. Attempt to control the bleeding with direct pressure as best you
wounds in a future book.)
can (no tourniquets around the neck).
2. Make sure the blood doesn’t choke the person. You can have I’ve tried to give you a good
a conscious person sit up and lean forward, or turn an overview so you have the best
unconscious person on their side and bend the top knee forward chance to save a life, but as always,
to keep them that way. my blog isn’t meant to be your sole
3. If you believe a carotid artery (that large artery on either side of source of information.
the neck that supplies the brain) is nicked, you can apply soft
direct pressure, and include an occlusive dressing. (See the box
to the right.)

Learn how to treat other wounds when there is no doctor in

The Survival Doctor’s Guide to Wounds.

For a Gunshot Wound in the Chest

Think about: air sucking, spine injury.

http://www.thesurvivaldoctor.com/2012/07/26/gunshot-wounds/ 7/6/2013
Gunshot Wounds: How to Treat 4 Types Page 2 of 4

Tips: How to Make an

1. Open chest wounds are also nicknamed sucking chest Occlusive Dressing out
wounds because they suck air in and can lead to a collapsed of a Driver’s License
lung. You can help stop the sucking by closing the open wound
with an occlusive dressing. For an open, or “sucking,” chest
2. Remember the spine is also included in the back of the chest. Be wound, you want to keep air from
very careful about movement of these victims. You want to keep getting in but also let excess air
them as still as possible and not damage the spinal cord. escape.
3. If the heart, the lungs, the spine, or a large blood vessel is
damaged, there’s not much you can do outside getting immediate One makeshift way to do this
expert medical care. is to lay a driver’s license or
plastic wrap on the wound.
When the diaphragm contracts and
For a Gunshot Wound in the Abdomen pulls in air (the same mechanism
that makes us breathe), the
Think about: organ protection.
vaccuum will suck the object onto
Tips: the wound. But if air needs to
escape, it can easily push the object
1. If the wound is open and you can see the intestines, find a moist, up.
sterile dressing to place on top of the wound (to protect the
organs). You could also use Vaseline gauze
2. If the intestines are ripped open, the victim needs immediate or put petroleum jelly on gauze. No
medical care. If they don’t bleed to death, they’ll likely die of the petroleum jelly? Try any type of
coming severe infection. ointment or even honey.
3. The victim should take nothing at all by mouth until the pain
The victim needs other
lets up, and then wait a day or two. This is obviously a difficult treatment, such as a chest
situation, but this step is very important and a time when a slow tube, right away. The occlusive
drip of IV fluids would be useful. dressing is just a temporary
treatment to keep the situation
from getting worse.

If an arm wound won’t stop bleeding despite direct pressure to the

wound and elevation, press on the brachial artery around the place
where the arrow in the left picture is pointing (below the armpit). Do
this by grabbing underneath the person’s arm, wrapping your fingers
to the artery (inner arm), and pressing firmly on it with your fingers.
You’ll know you probably have it right when the bleeding slows down.
If it’s still not controlled, try pressure nearer to the heart.

http://www.thesurvivaldoctor.com/2012/07/26/gunshot-wounds/ 7/6/2013
Gunshot Wounds: How to Treat 4 Types Page 3 of 4

Here’s a trick to try it out now: Get a partner, and find the person’s
radial pulse (in the wrist on the thumb side). Then grab the upper arm
as described above. You should feel the pulse stop. Only do this for a
couple of seconds, of course, since you’re stopping blood flow.

For a leg wound that won’t stop bleeding, apply pressure to the
femoral artery, shown in the picture on the right. The best place to do
this is in the middle of the bend between the front of leg and the hip.
(This is not the place where the arrow is pointing; it’s above it.)

For a Gunshot Wound in the Arms or Legs

Think about: bones.

Tips:

1. Direct pressure, elevation, pressure bandage—in that order. Elevate the wound above the heart, and
apply a pressure bandage. Then if it’s still bleeding, take your fingers and apply pressure to the brachial artery
for the arm or the femoral artery for the leg. (See the box to the right.)
2. If all else fails in an extremity, go to a tourniquet. (It may come down to “lose a limb or lose a life.” See The
Survival Doctor’s Guide to Wounds for dos and don’ts of tourniquet use.)
3. If the area is rapidly swelling, that’s a sign of internal bleeding. Also, consider that a bone might have been
injured, even shattered. If you suspect this, the area needs to be splinted.

For a Superficial Wound

If the gunshot wound is superficial, clean it as much as you can and follow the steps in “Puncture Wounds” in my
e-book The Survival Doctor’s Guide to Wounds. Start antibiotics when you’re finished taking care of the wounds.

One More Thing: What About the Bullet?

In most circumstances, you don’t want to remove an implanted bullet. It’s almost impossible to find, and it may
actually be corking up a big blood vessel.

Thousands of military members live daily with shrapnel in their bodies. Unless there’s initial infection from the wound
itself, the body adapts to most metal without much serious problem.

Gunshot wounds can run the gamut. Some people are too severely injured to save. Get expert treatment as soon as
possible.

Artery photos by Rob Swatski, assistant professor of biology, Harrisburg Area Community College – York Campus,
York, PA. Email: rjswatsk@hacc.edu.

Share this:
July 26th, 2012 | Tags: gunshot | Category: Other Wounds, Skin

« Previous: What To Do For A Gunshot Wound—and Next: Whooping Cough Is Making a Comeback. Know
How the War Changed the Treatment What to Do.

26 comments ★ 0

Leave a message...

http://www.thesurvivaldoctor.com/2012/07/26/gunshot-wounds/ 7/6/2013
Gunshot Wounds: How to Treat 4 Types Page 4 of 4

http://www.thesurvivaldoctor.com/2012/07/26/gunshot-wounds/ 7/6/2013