Tactical Treatment of Gunshot & Knife Wounds

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shaman
 
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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby shaman » Tue Jan 22, 2013 8:41 am

This is a somewhat uninformed opinion. However, I used to know a Vietnam-era medic. He was the one that taught me about using sanitary napkins as a makeshift pressure bandage. We got to talking about bullet wounds one time, and he said that civilian wounds could be much worse than battlefield wounds due to the use of soft-pointed ammo. A hard-ball round would pencil through, and you had a pretty good chance of doing something. He'd seen a hunting-related wound while working as an EMT and looked to him more like shrapnel/land mine stuff--very ugly and the victim died.

About this same time, I chanced to meet up with a vet who'd gotten wounded several times over the years. Her worst experience was getting shot by a merc that caught her in the side with soft point civilian ammo-- very nasty wound.

My guess is that if you catch a bullet anywhere significant while out hunting, chances are you are going to bleed out and buy the farm before anyone can do anything. You can also forget about broadheads. I've known of very few archery-related incidents, but they were almost all fatal. The one that wasn't was a guy guiding boar down in TN. He caught a richochet in the leg from a client's miss.
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JPH
 
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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby JPH » Tue Jan 22, 2013 9:24 am

shaman wrote:My guess is that if you catch a bullet anywhere significant while out hunting, chances are you are going to bleed out and buy the farm before anyone can do anything.


I'd say you are in a very, very dire situation but not necessarily doomed. Modern hunting ammo to the head or chest? Better use your remaining breath for an Act of Contrition. But if the wound is a ricochet, a fragment or to a non-vitial region, the right knowledge and equipment just might save you.

When I became an EMT in 1991 the use of tourniquets was all but forbidden and there was no such thing as a clotting agent. When I became a paramedic in 1995 the treatment for massive blood loss was to fill the patients veins with worthless salt water. We were dealing with a lot of shootings in our little city (mostly 9mm) due to a 3-way war between the Crips, Vice Lords and the BGD's. The people we saved were saved by getting them to a trauma surgeon quickly, and not the treatments we gave in the field. Over a decade of war has changed much of this.

My son is an Air Force medic and I supervise the new generation on firefighter/paramedics. I am amazed at how things have evolved. Tourniquets are back. Clotting agents and trauma dressings (see sanitary napkins) can be purchased by civilians. They are also learning that maintaining proper airway pressure trumps volume replacement during traumatic blood loss. Enter the ResQgard. Cops and soldiers are already carrying them for self-rescue.

Most of this cutting edge is actually easy to apply with minimal training. I suspect that is why the civilian medical community has been slow to adopt them. Doctors don't like to admit that they are wrong and they don't like to trust their magical powers to the unwashed masses. Anyway, I think we will see more and more of these things advancing into common use as our boys come home from war and populate our local ER's, volunteer EMS crews, and hunting camps.

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shaman
 
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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby shaman » Tue Jan 22, 2013 9:55 am

I'd say you are in a very, very dire situation but not necessarily doomed. Modern hunting ammo to the head or chest? Better use your remaining breath for an Act of Contrition. But if the wound is a ricochet, a fragment or to a non-vitial region, the right knowledge and equipment just might save you.


Yeah, I'm thinking a lot like you. Most hunting accidents are not to non-vital regions, however. From what I understand, the average deer hunting accident is a mistaken-for-game kind of thing where somebody gets drilled in the chest at fairly close range.

I watched our local EMS respond to a full cardiac arrest a few years ago-- lady died on the dance floor. The joint was just over on the adjoining ridge. They got her breathing again and got her successfully transported to the hospital. The problem was that it took 20 minutes from when the 911 call was placed for the squad to get to the scene. I'm sure they came as fast as they could, but we're out in the sticks. You could add another 5-10 minutes to get from my gate back to where I usually hunt. A man can do a LOT of bleeding in that time, and that's assuming I could pull out my phone and make the call myself. More likely than not, I wouldn't show up for lunch and somebody would have to go out looking for me. By that time, I'd prolly be mulch.

You're right, if I come to, hanging off my harness with a sucking chest wound, I will ask the Good Lord for Forgiveness and figure that's it.
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JPH
 
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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby JPH » Tue Jan 22, 2013 10:09 am

shaman wrote:
I'd say you are in a very, very dire situation but not necessarily doomed. Modern hunting ammo to the head or chest? Better use your remaining breath for an Act of Contrition. But if the wound is a ricochet, a fragment or to a non-vitial region, the right knowledge and equipment just might save you.


Yeah, I'm thinking a lot like you. Most hunting accidents are not to non-vital regions, however. From what I understand, the average deer hunting accident is a mistaken-for-game kind of thing where somebody gets drilled in the chest at fairly close range.


Yeah, I don't know.

My guess is that the majority of hunting related emergencies are heart or breathing related. Hunters are not getting any younger and we're in awful shape. Sprains, strains and short falls might rank pretty high as well. I suspect neither of these are likely to make the national statistics as "hunting accidents". Within the category that might get reported, I have to think accidental cuts and superficial, self-inflicted gunshots must also be represented.

A guy up the road from where I hunted this year double loaded his ML and mangled his hand when he fired it. He lost a tremendous amount of blood as he walked from his blind, back to his pickup to call for help (don't know if he left it behind or did not have signal). He is lucky to be alive. Place another half-mile in his path and this sort of information could have been the difference between life and death.

I always remind my guys at work that as unpredictable as the job is, we can survive by controlling the things we can control. Get in shape, train hard, always communicate, bring your equipment, and know it inside and out. Those things are pretty universal and you have control over all of them.

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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby shaman » Tue Jan 22, 2013 10:36 am

Oh, there are all kinds of ancillary types of hunting related injuries. The morbidity for the sport is quite low; more people die at church social than deer hunting. However, if you get shot, chances are you die. There are few exceptions. The typical deer hunting accident takes place in very close quarters. Somebody mistakes their buddy for a deer and aces him. Bang. Dead. Done. The average perp has less than 3 years experience hunting. The average victim is not wearing hunter orange.The average victim and perp know each other. In an average year the states around me see 2 of these incidents per state per season. A small minority of the incidents are a shoot-through type of thing where the bullet travels beyond the intended target. The rest are background noise.

A shotgun-only state like Ohio has about the same morbidity as a rifle state like Kentucky or a pistol-caliber state like Indiana. The reason is the shots usually happen at close range-- inside 50 yards. Somebody usually hears something in the bushes, or sees something moving in the woods. Bang.
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Re: Tactical Treatment of Gunshot & Knife Wounds

Postby DrG » Tue Jan 29, 2013 11:51 pm

My apologies for breaking the rules, I should have read more before posting. It is a legit class taught by a 27 yr. veteran paramedic with the CFD. I am a firm believer that "hope" is not a strategy, nor a substitute for skill.

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