First response GSW treatment?

[Drew78]

Hello everyone.

Let me first start by saying that this sub forum is way outside of my lane. Like so far out, I need my passport to get near it.

I'm a sales manager, not a doc, medic, EMT, etc....

As of late, I have realized that having some very basic skills that I could possibly apply to myself or someone else who has sustained a bullet wound from a service handgun is likely a very good thing to have.

I don't want to come across as a Mall Ninja here, but I have tried to educate myself on the treatment of extremities and chest wounds by reading, researching, watching YouTube videos and understanding the hardware side of this stuff. types of chest seals and tourniquets for example.

SO, I have 2 scenarios to layout and try to get a few items answered by those of you whom are qualified to do so. My intent is to keep this as simple as possible due to the fact that should I ever be in this unfortunate scenario, I realize that I am going to be dealing with a LOT of things...

Scenario A:
Subject has been shot with clear entry and exit wounds in the upper chest. Appears by visually assessing and listening to the wound area that the chest is sucking air into the chest cavity. From what I have gathered so far the priority is to seal both holes ASAP. My question is, do you try to control the bleeding first or go right to sealing the holes? If you do want to try to control the blood flow first, how do you do that? Seeing as we have holes in the upper chest area and that wound channel is probably reasonably "thin" before we are into the chest cavity I'm not sure we want to be packing that wound with gauze, especially those treated with a hemostat as you may pack it to the point where we start to inadvertently apply pressure to some pretty important stuff like heart/lungs. I'm surely NOT worrying about decompressing the chest with an IV needle. I guess I could try to "burp" it if it appears it was needed but that's way down on my list as I'm not even sure I could diagnose that it would need to be done....

Scenario B1:
Subject has been shot in the leg, just above the knee. This question is going to be about how you assess the first steps in controlling the bleeding.
In this instance, we will assume the subjects artery has been severed. I have read several accounts that you will know when this has happened as the amount of blood shooting out from the wound will be like nothing you could imagine, like out of a horror movie. In this case, TQ immediately high above the wound and tighten the windless until the bleeding stops. Once that is done, do you go into the wound cavity and pack it with a hemostatic gauze apply pressure for 3min, and then top dress it and wrap it OR do you just leave it the hell alone once the bleeding stops and wait for help?

Scenario B2:
Subject has been shot in the leg, just above the knee. This question is going to be about how you assess the first steps in controlling the bleeding.
Obviously the wound is bleeding BUT not like the above situation. The question is do you TQ it first or try to control the bleeding by packing the would with Hemo gauze and applying 3min of pressure only. In other words, how do you assess which should be your first step at controlling the bleed? TQ or Hemo gauze and in what if any order. Maybe it doesn't matter as long as you can get the bleed under control or maybe I'm all twisted up and confused over this....

Again fellas, I'm not trying to play doctor here. I am just trying to put myself in a situation (mentally) where I need to administer aid in the above scenarios in order to just keep someone above water until a professional can take over the situation. I agree 110% that attending a training on this topic is the ideal solution, but for a myriad of reasons I am unable for the foreseeable future and am trying to learn just enough to be of assistance to myself, family member, or stranger.

Long post, lots of questions... I thank you in advance for any feedback you may have.

Drew

[Treehopr]

Scenario A: apply chest seals and evacuate patient asap to medical care. The chest cavity has hollow space that you are not going to be able to pack.

Scenario B1: apply TQ and evacuate patient asap to medical care.

Scenario B2: apply TQ and evacuate patient asap to medical care. You could possibly "just" apply direct pressure and bandage but if you don't stop the bleeding you'll end up having to apply a TQ anyway. Save the wound packing for junctional injuries- the areas between the extremities and the torso & pelvis.

Good on you for educating yourself however you can, but you need to get some hands on training from a qualified instructor.

[chuckman]

Treehopr said essentially what I was going to say. His most important sentence was his last: get training.

[Hmac]

If it's bleeding put pressure on it. If it's an extremity and is spurting bright red blood, put pressure on it, or if you have a tourniquet and know how to use it, use that. If it's bubbling, seal it if you get a chance. The most important thing for you to do is call 911 and get qualified help.

You can get training if you want, but as a sales manager that's pretty much all you need to know in the extraordinarily unlikely event you will ever have to deal with a gunshot wound


.

[Drew78]

Thank you for the replies. As I stated I'd love some training, but it isn't happening right now. I do quite a bit of hand gun shooting on a variety of range types and just want to have a VERY basic understanding of how to stop bleeding until the pros show up and do the real work.

[J8127]

If you can, attend a TCCC course- think of it like Battlefield EMT training minus the drugs. That plus a Red Cross First Aid class to covers CPR and defibrillators and you will be in the 99th percentile.

[Hmac]

Thank you for the replies. As I stated I'd love some training, but it isn't happening right now. I do quite a bit of hand gun shooting on a variety of range types and just want to have a VERY basic understanding of how to stop bleeding until the pros show up and do the real work.

Put pressure on it. All you need to know.

[quackhead]

GET TRAINING!!!!!!

Just " a sales manager" really means nothing. Having the knowledge for some Med response is important. accidents happen- do you want to be able to help a loved one or friend in a situation like this? Do you shoot? What about natural disasters you. You could have similar wounds caused my GSW or weather/accident caused impalements What if Med response is severely delayed - minutes count
There are plenty of TCCC courses being taught around thr country. Where are you located- maybe we can point you in direction of a reasonably priced course

[Drew78]

Yes I understand the importance of attending qualified training. It isn't a cost issue, it's time . The one thing most people don't have enough of. I'm sure someone is going to point out that I need to make it a priority, and I am. Just up to the point of having to travel and attend a class. I'd love it, but where I'm at in life and the people I have to be accountable for, leaves me short on availability time.
Me pointing out my profession wasn't done in an effort to somehow diminish my need for some medical knowledge, it was done to position the fact that I know and accept that I'm not a medical professional in any way shape or form.

Thank you to all for addressing my initial questions, it was very helpful!

[Kirkrv8]

Treehopr gave you the best advice,
Extremities get a TQ
High thoracic get sealed
Junctional gets packed and pressure