Gun shot ???

[Smok]

How to survive a gun shot ??? Miles out, days from help..

[Rick]

Make sure it's your partner.

You probably need to define the wound a bit more. What kind of weapon and where is the wound? What resources do I have on me (Survival kit, first aid kit, nothing)?

[ditchmedic]

It all depends on where the wound is. Head/Face/Neck, either will be dead already or die from swelling of the airway or brain. Chest as long is its not a heart wound, need to watch out for tension pneumothorax aka collapsed lung. Stop the bleeding and cover with an occlusive dressing, made from plastic or something else that will not let air in. The dressing should be taped down on 3 sides so air can come out but not in. Abdominal wound would be stop the bleeding, if the shot hit a solid organ such as the liver you will most likely die without surgery, but if it was just the intestines you may be able to survive a few days without surgery. Lower extremities as long as it did not hit the femoral artery you should be able to survive a long time, upper extremities also has high survival rates. Without proper medical equipment you will most likely have an infected wound, but if you are only a day or 2 out the hospital should be able to treat the infection. Clothing could be used to stop the bleeding as regardless you will have an infected wound so being sterile is not #1 priority. Wouldn't it be nice to survive long enough to worry about infection?

[Rick]

Doc - Once again, thanks! You're earlier post talked about pain meds. so I'll combine two questions into one. If the wound is abdominal away from vital organs can I consume liquids to stay hydrated and can I take those pain meds to improve comfort? I'm guessing I'm going to have a belly full of waste if the intestines are involved so peritonitis is a given without help, right?

[Beo]

I agree with Rick , and if your miles out and its a flesh wound or thru and thru in a meaty area no problem but soreness and stiff ness bind it up and push on (cause u got no choice), if its a gut shot, leg shot or arm shot, hit an organ or hit an artery your screwd.

[AdventureDoc]

Rick--I'd love to take credit for the post by DitchMedic, but I deserve none. Well written DitchMedic! I agree entirely! You raised an interesting point, about antibiotics. I agree with your quote "Wouldn't it be nice to survive long enough to worry about infection?". I have seen some of the research coming out of the middle east conflicts, with respect to mortality related to GSW (gun shot wounds). One great book, the Ranger Medical Handbook, lists some pretty heavy antibiotics for abdominal wounds. It seems we are in agreement that antibiotics are vital. I guess the question is when should they be started. Obviously, the sooner the better. In the field?

A person in combat has a much higher chance of being shot that a hiker, hunter, camper. In my opinion, the carrying of these "bowel wound/gram negative bacterial" antibiotics in a standard first aid kit is excessive.

As for the consumption of liquids to stay warm, after an abdominal wound. Very tough call, as it could go either way. I am sure most people have heard of the "emergency medical medical history" remembered with the AMPLE nemonic:
Allergies
Medications being taken
Prior medical problems
Last meal
Events leading to the problem

I learned these as an EMT, a few years ago and after a bit more experience, I learned the "last meal" question was to determine candidacy for anaesthesia. If you've been shot in the abdomen, you're gonna likely need, at the minimum, some invasive tests. These require soem analgesia/pain control/anaesthesia. Also, as pointed out above, the bowel could be perforated. This means anything inside the stomach/intestines/colon will spill out into the peritoneum (abdominal cavity). This is manifested as a rigid/hard abdomen. This is an infection nightmare. So is dying of hypothermia. I'd try my best o keep myself NPO (nothing per oral) for as long as I could. However, if oral is your only route to add fluids...you are looking at rescue time.

Tough decisions...I think these are merely things to think about, as each sitituation is an extreme and unique problem. A knowledge of quick rescue changes a lot of things. A need to spend a few days outside, without care, is another story.

Also, the use of pain meds is a variable that depends on who you are with. If you were alone, with a poor level of consciousness already (blood loss/shock), taking a narcotic would be a bad choice. If you had some reliable help, I'd feel better about considering better pain control.

Great thread by the way!

[AdventureDoc]

Excellent idea, in my opinion. The QuickClot brand is seeing some heavy use in Iraq and Afghanistan, right now. A wonderful product that uses chitosan (a product extracted from shrimp and crab shells) to enhance blood clotting. The idea is to place this dressing/sponge (impregnated with with this substance) as the first layer onto the wound. Surprisingly, the stuff isn't that bad to clean out of the wounds. At least better than super glue

Check out the manufacturer's link:
http://www.z-medica.com/

I think a few of these would be an excellent addition to a hunter's (anybody who is around weapons) first aid kit. Cabellas has some for sale, around 20-40 US dollars depending on the size of the sponge. Very good idea!

[Rick]

Mea Culpa, DitchMedic for missing you as the poster. I should have been more observant. A big thanks to both of you for your excellent, profession input!

[Tony uk]

Make sure that the wound area is firstly clean then apply QuickClot, Next get a field dressing and wrap it tight around the wound. Dont take off bandages but only put on clean ones untill you get to help

Take anti biotics to help with infection

[Rick]

Tony, if you see someone flailing wildly as they come screaming down the lane toward you. That would be me and I've been shot. Don't concern yourself about cleaning anything or wrapping anything. Jab me in the neck with morphine and haul my carcass to the ER. Oh, if I don't happen to think of it while I'm bleeding to death all over you. Thank you. Cheers.

I think the only thing that could possibly be worse that being shot is being served Haggis (no offense but, really).

[Smok]

Again I would like think you for the great response to this post . I know that its was very general but it is a bit hard not to be so thinks for taking the time and helping us all

[Tony uk]

Tony, if you see someone flailing wildly as they come screaming down the lane toward you. That would be me and I've been shot. Don't concern yourself about cleaning anything or wrapping anything. Jab me in the neck with morphine and haul my carcass to the ER. Oh, if I don't happen to think of it while I'm bleeding to death all over you. Thank you. Cheers.

I think the only thing that could possibly be worse that being shot is being served Haggis (no offense but, really).

Okay, so if i understand you right, You want me to inject you with haggis ??

OKAY now go get shot Rick

[Rick]

Uncle. I give.

[Tony uk]

Im jokeing. But the question on the first post is that your no where near help so i was telling them what i wuld do in that situation

Haggis is only guts boiled in a stomache, Its The Queens Beans if you ask me

[Rick]

I was just giving you a hard time. I do know what Haggis is, thank you. I'll stand waaaaaay over here while you eat it and peer at you through the darkness of an Orkney Skullsplitter. Queens Beans or not.

[Tony uk]

Whats wrong with guts ???

If your where outback cold and hungry and had plenty of water and caught a animal that is mostly guts wouldnt you eat them

Haggis neeps and taties are amazeing

I reccomend it to you Rick

[Sarge47]

Whats wrong with guts ???

No guts no glory, right?

[Tony uk]

No guts no glory, right?

No guts no food since notthing would be alive

Eyes are one of the bests bits on an animal in a survival situation just suck them out raw and swallow, the large fluid content will help keep you going

viewer discresion is advised:

The anus is also eddible, boil it or use as a ingrediant in stews of the heart with a blood sauce is B-E-A-Utifull

[Sarge47]

No guts no food since notthing would be alive

Eyes are one of the bests bits on an animal in a survival situation just suck them out raw and swallow, the large fluid content will help keep you going

viewer discresion is advised:

The anus is also eddible, boil it or use as a ingrediant in stews of the heart with a blood sauce is B-E-A-Utifull

I'm not touching this...RIIIICCCKKKK!

[Tony uk]

I did say VIEWER DISCRETION IS ADVISED

I personaly dont eat them but its good knowing that