Gunshot wounds

**lithium** · 01-02-2017, 20:01

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?

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Firefight? Civilian or military? If civilian, win firefight, get medical help. Military responses will vary dependent on a number of variables.

**Mr_Medic** · 01-02-2017, 21:50

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?

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Thank you.

Making assumption your scenario is civilian based.

1st and foremost win the fight.

I can give an overly technical answer based on the underlying organs of the epigastric/umbilicus region that factors in wound channels as well as the effects the projectile could have on the surrounding structures however the variables are to high and I'm not really concentrating now ;)

So basically the first thing I would do is stop life threatening bleeding, in abdo injuries its a lucky packet wrt bleeding some bleed badly others bleed less. However a rule of thumb I was taught goes like so "just because its not bleeding outside doesn't mean it's not bleeding inside"

Watch your patient. If he exhibits signs of hypovolemia then treat accordingly.

Evac to definitive care asap.

Stay Bladed.

**BigT** · 01-02-2017, 22:07

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

I'm curious. Why would the response for a "high velocity 40 or 45 hollwpoint" be different to the treatment for a low velocity kne( which in 45 especially most are. ) or a 9mm hollwopoint. Or a ball round. Or a standard velocity 22lr solid.

I'm not a medical professional but I bet the response to all is the same.

**lithium** · 02-02-2017, 06:36

Originally Posted by BigT

I'm curious. Why would the response for a "high velocity 40 or 45 hollwpoint" be different to the treatment for a low velocity kne( which in 45 especially most are. ) or a 9mm hollwopoint. Or a ball round. Or a standard velocity 22lr solid.

I'm not a medical professional but I bet the response to all is the same.

I am. And it is. The scenario described ends in surgery. The quicker the better. There is almost nothing you can do in the field to treat a wound like that - establish IV access and GTFO there to a trauma hospital. Again - the quicker the better!

**Skaaphaas** · 02-02-2017, 06:46

Moomin has some first-hand experience on that wound with a 9mm.

**Mr_Medic** · 02-02-2017, 07:17

Originally Posted by BigT

I'm curious. Why would the response for a "high velocity 40 or 45 hollwpoint" be different to the treatment for a low velocity kne( which in 45 especially most are. ) or a 9mm hollwopoint. Or a ball round. Or a standard velocity 22lr solid.

I'm not a medical professional but I bet the response to all is the same.

What lithium said.

Makes fuckall difference in an emergent environment.

Stay Bladed.

**Mr_Medic** · 30-03-2017, 20:11

https://m.facebook.com/story.php?sto...70794739700312

This is a link to "Skinny Medics" facebook page, more specifically to a video where he demonstrates the use and contents of a basic IFAK.

It is a very very good video. I urge all to watch it.

Stay Bladed.

**junior1baby** · 04-05-2017, 17:04

It is not uncommon to see an projectile deviate from a certian trajectory once it goes into tissue.Velocity, projectile mass and terminal ballistics and deformation on impact all play roll on what happens to the projectile.The humble .22 is notorious for what it does to tissue.not the most deadly but it causes horrible of internal injuries cause it Bounces round after entry.Some of the newer generation SD projectiles are all going the route of limiting overpenetration and maximal dumping of kinetic energy to maximise the "stopping power".

Ammunition manufacturers spend millions of dollars on this subject and hence u also get what u pay for.

The same could be said for.Years ago the tourniquet was taboo and was seen as certianly that using it would lead to loss of limb.Now with proper placement..proper woundpacking and quick transfer to a medical centre your chances of survival increase greatly.and in transisional areas like armpits ans grion area wound packing and direct pressure works.all the great medical trauma emergency advances come from military fields.

My dream would be to do a tacmed course to help me be prepared.U can never train enough.we train with our firearms why not medical training. I am saving up for a tacmed basic course.

**Yellowfever** · 04-05-2017, 19:13

Originally Posted by junior1baby

The humble .22 is notorious for what it does to tissue.not the most deadly but it causes horrible of internal injuries cause it Bounces round after entry.

Why would that be? Why not a lead 9mm round or FMJ?

**Mr_Medic** · 04-05-2017, 23:06

Originally Posted by junior1baby

.

My dream would be to do a tacmed course to help me be prepared.U can never train enough.we train with our firearms why not medical training. I am saving up for a tacmed basic course.

Well done om taking initiative. A cheaper more achievable outcome would be a general first aid course, level 1,2 and 3.

Good Tacmed/T3C/TCCC course are only offered to qualified medical practitioners.

I am also making the assumption you are not currently medically qualified, so forgive me if I am wrong.

Stay Bladed.