Gunshot wounds

**Mackie** · 30-09-2016, 21:42

Forest, the master of WTF...

**Mr_Medic** · 15-12-2016, 19:53

Festive holiday bump.

Have been reading about many mall/shopping center armed robberies recently.

If you frequent these places please make sure you are prepared, across all aspects!

Stay Bladed.

**saps-za** · 15-12-2016, 20:57

Mr Medic, Agree with you, have the tools of the trade as well as the tools/equipment to deal with any possible gunshot or injuries..

**Mr_Medic** · 08-01-2017, 19:28

See why tampons are useless for wound packing...

Stay Bladed.

**Fumbles** · 09-01-2017, 00:37

Just read this thread with interest. Nice one Mr Medic.

Being in the biz, I'm sure you are able to get/carry medications or supplies, that the average person cannot without a prescription or by way of being an EMT etc. What prescription medications would you recommend carrying in one's First Aid kit? I know you mentioned the importance of antibiotics earlier, for infection prevention. Do you think it a good idea to try to get your GP to prescribe something like an oral general purpose antibiotic for a bug out bag type IFAK? You know....explain to him it is just to have in case of an emergency situation where medical assistance is not available. I don't know if it is even possible to get the average Dr to do this. A friend of ours is a PA and she once prescribed antibiotics for my wife. So I know it can be done. How about radiation protection in the event of a dirty bomb type nuke? Potassium Iodide.

Also.....let's just say someone gets a very serious injury....gunshot, very bad leg break compound fracture type thing, very bad partial amputation in a motor accident or motorcycle....etc etc etc. So as regards femoral bleeding and some people saying the tourniquet should only be used as a last resort if pressure and bandaging is not enough to stop bleeding. You said to try a 2nd packing and if that doesn't work to consider going to the tourniquet. Something like that, not holding you to it.

When do you know you absolutely must do your best to get a TQ going? Will it always be obvious? I mean of course if blood is pissing/pumping out very fast I'd say it's obvious. But is it possible that you could have major arterial bleeding and it's more internal, less obvious and visible? Say in the case of a broken femur that has severed the femoral but did not break the skin.

Sorry, I'm a total layman on this. I self treat my own superficial wounds like cuts and scrapes, splinters, roasties and major zits

and that's about it. But my fear is I will one day be in a position where TQ use comes up and I'm faced with the decision that whoever I'm helping (possibly a friend) might lose a limb because of me. Say we are way out and he (or even myself) accidentally/negligently ends up with a GSW and it's bleeding for days.

Lastly as a general comment.....while reading that article about the so called "ineffectiveness" of a 9mm, .45 and 5.56mm to do a one shot kill.......while I am sure this dude is very experienced in such matters....I wonder if he was mostly referring to FMJ ammo and did not have a lot of GSW patients shot with SJHP type ammo, especially the newer stuff? Military after all uses FMJ to the most part.

**Mr_Medic** · 09-01-2017, 13:18

Thank you very much, I have waited to get to the office so I could reply via Laptop rather, see responses in Red.

Originally Posted by Fumbles

Just read this thread with interest. Nice one Mr Medic.

Being in the biz, I'm sure you are able to get/carry medications or supplies, that the average person cannot without a prescription or by way of being an EMT etc. What prescription medications would you recommend carrying in one's First Aid kit? Difficult one to answer, mostly due to contra indications and such. However my "never leave home without" drug is Adrenaline. I always have an ampule on me. if I am venturing outdoors I add the following as a bare-minimum:
Metoclopramride
Promethazine
Voltaren for IM
Broad spectrum oral/IV antibiotics
Pain meds IV and Oral.
Not forgetting the Adrenaline.

That will cover most issues that your standard Boo-boo kit wont (Remember this is in addition to a stock OTC med kit)

I know you mentioned the importance of antibiotics earlier, for infection prevention. Do you think it a good idea to try to get your GP to prescribe something Yes, most regular family Gp's will understand. Get an Epipen while you're there. Just remember expiry dates. like an oral general purpose antibiotic for a bug out bag type IFAK? You know....explain to him it is just to have in case of an emergency situation where medical assistance is not available. I don't know if it is even possible to get the average Dr to do this. A friend of ours is a PA and she once prescribed antibiotics for my wife. So I know it can be done. How about radiation protection in the event of a dirty bomb type nuke? You're fucked from many directions here. Potassium Iodide.

Also.....let's just say someone gets a very serious injury....gunshot, very bad leg break compound fracture type thing, very bad partial amputation in a motor accident or motorcycle....etc etc etc. So as regards femoral bleeding and some people saying the tourniquet should only be used as a last resort It's actually become one of the first things to do now in an austere environment. if pressure and bandaging is not enough to stop bleeding. You said to try a 2nd packing and if that doesn't work to consider going to the tourniquet. Something like that, not holding you to it. That's the idea in a non-combat environment. Basically, direct accurate pressure by your fingers/hand/knee followed by packing the wound aggressively with gauze then lastly applying a firm compression dressing. If the desired result is not achieved then add the Tq. In a combat/dangerous environment slap the Tq on first then move person to safety then dress wound.

When do you know you absolutely must do your best to get a TQ going?This is situational, once bloodloss poses a imminent threat would be my best answer. Will it always be obvious? Yup. usually blood is pissing from the wound. I mean of course if blood is pissing/pumping out very fast I'd say it's obvious. Bingo. But is it possible that you could have major arterial bleeding and it's more internal, less obvious and visible? Absolutely, I lost a patient that had a torn ascending aorta. sweet fuck all I could do. Say in the case of a broken femur that has severed the femoral but did not break the skin. The discoloration/swelling and general patient appearance and presentation would swiftly show there is a major underlying problem.

Sorry, I'm a total layman on this. I self treat my own superficial wounds like cuts and scrapes, splinters, roasties and major zits

and that's about it. But my fear is I will one day be in a position where TQ use comes up and I'm faced with the decision that whoever I'm helping (possibly a friend) might lose a limb because of me.Learn these words mate "Save the life, salvage the limb" Say we are way out and he (or even myself) accidentally/negligently ends up with a GSW and it's bleeding for days.

Lastly as a general comment.....while reading that article about the so called "ineffectiveness" of a 9mm, .45 and 5.56mm to do a one shot kill.......while I am sure this dude is very experienced in such matters....I wonder if he was mostly referring to FMJ ammo and did not have a lot of GSW patients shot with SJHP type ammo, especially the newer stuff? Military after all uses FMJ to the most part. Calibre and ammunition type does play a role, however without getting into this debate I'll say that you would treat the injury in the moment and "fix as you find"

Hope that makes sense!

**Fumbles** · 09-01-2017, 21:14

Thanks man, very much so.

**Mr_Medic** · 09-01-2017, 21:20

Originally Posted by Fumbles

Thanks man, very much so.

Heya, just noticed now that on tapatalk most of my answers did not come out in red. I did reply alot more than the 3 sentences it's showing me on my mobile.

Stay Bladed.

**mastermamo** · 01-02-2017, 18:16

A really interesting thread and one I could not recommend highly enough. I've been instructing firearm combat courses and martial arts in the past, have worked with the Flying Squad, done a paramedic course etc and have seen my fair share of injuries ranging from shallow knife wounds to severe GSWs. The OP is spot on with all his advice and I commend his effort in educating others. Well done and looking forward to reading more on the topic.
Quick scenario:
U are in a firefight and a colleague is hit in the upper abdomen with a high velocity .40 or .45 hollow point that shows no exit wound. Let's isolate the region to roughly 2-3cm above his belly button.
I understand that there are many variables in this situation e.g. billet trajectory, distance from shooter, physical build and condition of the vic etc but what would u do first in this situation?

Sent from my iPhone using Tapatalk

**Dirk777** · 01-02-2017, 18:56

Originally Posted by mastermamo

A really interesting thread and one I could not recommend highly enough. I've been instructing firearm combat courses and martial arts in the past, have worked with the Flying Squad, done a paramedic course etc and have seen my fair share of injuries ranging from shallow knife wounds to severe GSWs. The OP is spot on with all his advice and I commend his effort in educating others. Well done and looking forward to reading more on the topic.
Quick scenario:
U are in a firefight and a colleague is hit in the upper abdomen with a high velocity .40 or .45 hollow point that shows no exit wound. Let's isolate the region to roughly 2-3cm above his belly button.
I understand that there are many variables in this situation e.g. billet trajectory, distance from shooter, physical build and condition of the vic etc but what would u do first in this situation?

Sent from my iPhone using Tapatalk

First Win the fight.