How to Treat a Gunshot Wound Until Emergency Help Arrives

Here are the steps to take.

First, assess your surroundings to see if you are safe to respond, says Jeffrey Luk, MD, director of prehospital and disaster medicine at University Hospitals Cleveland Medical Center in Cleveland, Ohio. Is there still active fire? Is the gunman gone? It’s critical to check in and think about whether you feel capable of responding under the circumstances.

“You can't help anyone if you yourself are injured, right?” Dr. Luk says.

It’s perfectly normal to feel overwhelmed in a scenario where other people have been shot. But your actions as a bystander can give emergency medicine the best chance of helping a gunshot victim, says Erin Hall, MD, MPH, the medical director of the MedStar Washington Hospital Center–Community Violence Intervention Program in Washington, DC. She’s also an instructor for Stop the Bleed, a national public service campaign and training program run by the American College of Surgeons’ Committee on Trauma to teach people how to effectively respond in emergency scenarios where someone is severely bleeding.

Dr. Hall says you can remember the next steps as the ABCs of responding:

• Alert the authorities
• Bleeding — find the source
• Compression on the wound

“If you apply pressure to stop the bleeding, they have less blood loss and they have a higher chance of survival,” he says.

No matter where the wound is, applying steady and firm compression directly over it is an effective way to slow the blood flow. For torso wounds, direct pressure is the only option until medical help arrives.

A tourniquet is a medical device that’s wrapped tightly around an extremity to stop severe, life-threatening bleeding. The goal of using one is to cut off blood flow to the arm or leg for a period of time.

[9]

Mark Conroy, MD, an emergency medicine physician at The Ohio State University Wexner Medical Center in Columbus, says to apply a tourniquet to an arm or leg, you should go high and tight. You should not be able to slip your fingers underneath.

Tourniquets can be helpful for gunshot wounds on the arms and legs. But fashioning a makeshift tourniquet out of common items like belts, neck ties, or ripped clothes can do more harm than good, according to Sharon M. Henry, MD, who works as a trauma surgeon at the University of Maryland Medical Center and serves as the Anne Scalea Professor of Trauma at the University of Maryland School of Medicine in Baltimore.

If you don’t have a medical-grade tourniquet, just apply direct pressure to the wound instead.

You could also shout out to ask any other bystanders if they have a medical-grade tourniquet, gauze, or gloves. Some people carry these items in their bags or keep them in their cars, or they might know of a nearby Stop the Bleed kit.

Henry says that when everyday people are asked what worries them most about intervening in a scenario when someone has been shot, their main concern is not their own safety. Most people worry about doing more harm than good and hurting the person further.

When in doubt, stick to the ABC’s: By alerting authorities, finding the bleeding, and applying compression, you can do your part to staunch bleeding before emergency medicine takes over.

• Knowing how to control bleeding from a gunshot wound while waiting for emergency responders could save someone’s life.
• First, check the scene for safety before intervening to help and call 911 or instruct someone else to do so.
• Look for a Stop the Bleed kit or equivalent aids, as prompt professional help and utilization of available emergency medical tools can be life-saving.
• Locate the gunshot wound, clear debris, and apply steady, direct pressure to it. This approach helps slow blood flow and supports blood clotting until emergency personnel arrive.