8/13/2019 First aid for gunshot wounds and fractures
1/42
MANAGEMENT OF GUNSHOT
INJURIES, BLEEDING & FRACTURES.
BY
Dr Ejidike Amaka
8/13/2019 First aid for gunshot wounds and fractures
2/42
OUTLINE
Introduction
Gunshot wounds
Fractures Control of bleeding
Shock
CPRCardiopulmonary Resuscitation Conclusion
8/13/2019 First aid for gunshot wounds and fractures
3/42
INTRODUCTION
As a rule, all gunshot wounds are consideredmedical emergency that requires immediatehospital treatment.
It can vary widely from case to case with widevariations in entry points since the location ofinjury can be in any part of the body.
The immediate damaging effect of the bulletare typically severe bleeding and frequentlyfracture of surrounding bones.
8/13/2019 First aid for gunshot wounds and fractures
4/42
With the potential of hypovolemic shock in
severe bleeding (a condition characterized by
inadequate delivery of oxygen to vital organs)
as well as the unpredictability of bullet
wounds, it is paramount that immediate aid
be given while awaiting help or transportation
to a hospital.
8/13/2019 First aid for gunshot wounds and fractures
5/42
GUNSHOT WOUNDS
Unpredictable puncture wounds that causemajor tissue damage
Has entry/exit points
It is difficult to assess the extent of damageand most far exceed what you can reasonablytreat with first aid.
For this reason, the best option for most bulletwounds is to get the victim to a hospital assoon as possible.
8/13/2019 First aid for gunshot wounds and fractures
6/42
How do you to stabilize the victim in
the meantime?
Make sure you are safe
If shooting was unintentionally (e.g., while
hunting or at the range),secure all firearms If shooting was at a crime, ensure the
shooter is no longer on the scene and that
both you and the victim are safe from
further injury.
8/13/2019 First aid for gunshot wounds and fractures
7/42
Call for help.
Do not move the victim unless you must doso to keep him safe or to access care.
Assess quickly how deep the gunshot wound
is- a big hole indicates serious injuryAvoid moving the victim as unnecessary
motion worsens the condition
Apply direct pressure to the wound to stopbleeding
8/13/2019 First aid for gunshot wounds and fractures
8/42
Do NOT attempt to remove the bullet
If victim is not breathing, commence
CPR
Transfer to hospital
8/13/2019 First aid for gunshot wounds and fractures
9/42
If wound is on the chestApply direct
pressure to control bleeding.
Seal wound with hand or airtight material
(e.g., plastic film) to keep air from being
sucked into the wound
DO NOT elevate the legs to treat for shock in
wounds on the chest or stomach
Victim should NOT eat or drink anything
including water
8/13/2019 First aid for gunshot wounds and fractures
10/42
If wound is to the arm or legUse direct
pressure to control bleeding.
Elevation of limbs can be employed in
this case to control bleeding and preventshock.
8/13/2019 First aid for gunshot wounds and fractures
11/42
FRACTURE
A broken or cracked bone
Occurs when pressure is applied to bone
Occurs with / without displacement of bonefragments
8/13/2019 First aid for gunshot wounds and fractures
12/42
Types of fracture
Open fracture: Skin breaks causing open
wound
Closed fracture: Skin not broken
Commuted fracture: involving 3 or more bone
fragments
Stress fracture: hairline crack due to repeated
stress eg marching (soldiers)
8/13/2019 First aid for gunshot wounds and fractures
13/42
8/13/2019 First aid for gunshot wounds and fractures
14/42
SYMPTOMSSevere pain
Difficulty in movementSwelling/ bruising /
bleeding
Deformity / abnormaltwist of limb
Tenderness on applying
pressureDiscoloration
+/- signs of shock
8/13/2019 First aid for gunshot wounds and fractures
15/42
First-aid
Depends on type & location of fracture
For open fractures:
Control bleeding
Rinse and dress the wound
8/13/2019 First aid for gunshot wounds and fractures
16/42
For open / closed fractures
Check the breathing
Calm the person
Check for other injuries Immobilize the broken wound
Apply ice, if available, to reduce pain /
swelling Consult a doctor
8/13/2019 First aid for gunshot wounds and fractures
17/42
DO NOT:
Massage the affected area
Straighten the broken bone
Move without support to broken bone Move joints above / below the fracture
Give oral liquids / food
8/13/2019 First aid for gunshot wounds and fractures
18/42
HOW TO CONTROL BLEEDING
Could be mild, moderate or severe
All bleeding however must be controlled , if
left uncontrolled, severe bleeding may lead to
shock or even death
First step is to plug the hole, blood needs to
clot in order to begin the healing process
8/13/2019 First aid for gunshot wounds and fractures
19/42
1) Apply
direct
pressure
8/13/2019 First aid for gunshot wounds and fractures
20/42
2) Elevate above the
heart
Only for wounds outside
the chest or abdomen
This is because gravity
helps blood flow down
easier than it flows up
8/13/2019 First aid for gunshot wounds and fractures
21/42
3) Use pressure points
Areas of the body where blood vessels
run close to the surface
By pressing on these vessels, bloodflow towards the wound will be slowed
Press on a point above the wound (ie
closer to the heart) than below it
8/13/2019 First aid for gunshot wounds and fractures
22/42
Common pressure points:
Arm between the shoulder and the
elbow - brachial artery
Groin area along bikini linefemoralartery
Behind the knee popliteal area
8/13/2019 First aid for gunshot wounds and fractures
23/42
8/13/2019 First aid for gunshot wounds and fractures
24/42
You should almost
never apply tourniquet
to these pressure
points as they have the
potential to damage
the entire limb by
blocking blood flow
8/13/2019 First aid for gunshot wounds and fractures
25/42
SHOCK
Uncontrolled bleeding may lead to a condition
known as shock.
Shock is essentially a decrease in blood flow
to the brain and other important organs.
Untreated, shock from bleeding will almost
always cause death.
Hence,the most important step in treating
shock is to control bleeding.
8/13/2019 First aid for gunshot wounds and fractures
26/42
WHAT ARE THE SIGNS?
Pallor
Fast tready pulse
Cold clammy extremities (hands and feet) Air hunger
Oliguria (not making urine)
8/13/2019 First aid for gunshot wounds and fractures
27/42
If the victim is already showing signs of
shock, it's important to take these
necessary steps to stabilize the victim
until help arrives.
As with all emergency treatment, make sureyou remain safe.
Call for help
Make sure the victim is breathing. If not,begin rescue breathing.
8/13/2019 First aid for gunshot wounds and fractures
28/42
Bleeding must be stopped.
If you do not suspect a neck injury, laythe victim on his or her back (supine)
and elevate the legs.
If you suspect a neck injury, do notmove the victim. Car and other vehicle
accidents often lead to neck injuries as
well as falls from a height taller thanthe victim.
8/13/2019 First aid for gunshot wounds and fractures
29/42
Keep the victim warm.
Continue to check on the victim. If thevictim stops breathing, begin rescue
breathing.
If the victim vomits, roll the victim to
one side and sweep the vomit from his
or her mouth with your fingers
8/13/2019 First aid for gunshot wounds and fractures
30/42
CPR- Cardiopulmonary Resuscitation
Life saving technique
Useful in emergencies (heart attack,
drowning) where a persons breathing or
heartbeat has stopped
WHY IS IT NECESSARY?
Without oxygenated blood = brain damage in
a few mins and death in 8-10 mins
Do something!!!
8/13/2019 First aid for gunshot wounds and fractures
31/42
CAB is the new ABC
C = CIRCULATIONensure blood flow
A = AIRWAYis the airway patent?
B = BREATHINGbreathe for the victim
8/13/2019 First aid for gunshot wounds and fractures
32/42
8/13/2019 First aid for gunshot wounds and fractures
33/42
AIRWAY
Ensure airway is patent Remove any debris in the
mouth
Head tilt (if no spineinjury) + chin lift = opens
airway
Look out for chest motion,listen for normal breath
sounds
8/13/2019 First aid for gunshot wounds and fractures
34/42
BREATHING
Breathe for the person
Mouth to mouth (or mouth tonose if the mouth is seriouslyinjured)
Give 2 rescue breathes, look outto see if chest rises
30 compressions to 2 rescuebreathe
If after 5 cycles (about 2 mins) nomovementpatient would needadvanced life support
DO NOT stop CPR until help comes
8/13/2019 First aid for gunshot wounds and fractures
35/42
IN SUMMARY:
8/13/2019 First aid for gunshot wounds and fractures
36/42
8/13/2019 First aid for gunshot wounds and fractures
37/42
8/13/2019 First aid for gunshot wounds and fractures
38/42
8/13/2019 First aid for gunshot wounds and fractures
39/42
8/13/2019 First aid for gunshot wounds and fractures
40/42
8/13/2019 First aid for gunshot wounds and fractures
41/42
CONCLUSION
Aim to DO SOMETHING before medical help
arrives
The difference between what you do and not
doing anything could just be SOMEONES LIFE.
Thank you for listening.
8/13/2019 First aid for gunshot wounds and fractures
42/42
Top Related