May 22, 2009
When most people think of yachting, they think of pretty boats in warm climates with palm trees and pretty ladies sunning themselves on deck.
Lately, though, the yachting we see on television more often involves pirates with guns.
Due to all of the media coverage about pirates, the number of gunshot questions I receive in my classes has increased dramatically. So I consulted with a friend and former co-worker who has treated numerous gunshot wounds, Rick Sosa, a lieutenant paramedic with the Stuart Fire Rescue. Sosa has first-hand experience treating bullet wounds of various calibers from pistols, rifles and shotguns.
“Treating gunshot victims is not like it is in the movies or on TV,” Sosa said. “Gunshot wounds, even larger caliber, can sometimes be deceiving. They may look like a small puncture wound and may not bleed very much.
“The wound may appear little but the damage inside is not. Due to body mass, the torso is usually a much easier target than the rest of the body. Again, this spells danger. The torso contains all the major vital organs: heart, lungs, kidneys, liver, stomach, spleen, etc.
“Gunshot victims belong in the hospital emergency room as quickly as possible,” he said.
Here are the steps to treat a bullet wound.
The first step, as in any first-aid rescue situation, is to make sure the scene is safe for you. After you are certain you can safely help, protect yourself from bloodborne pathogens. This means putting on medical exam gloves and eye protection. Consider every drop of another person’s blood infectious and avoid direct contract with it.
The second step is to get help. This means calling for medical help and getting the victim to a hospital as quickly as possible. Our victim’s chance of survival is greatest with prompt, professional medical treatment at a hospital.
Moving the victim is never a good idea when you are on land and help is on the way, unless the victim is in a dangerous location. At sea, you must be careful when moving the victim. You do not want to cause further injury.
Our next step is basic first aid. If the victim is unconscious, look, listen and feel for breathing. Place your head next to the victim’s mouth and look at their chest for a rise and fall. Listen to his breathing, and you should feel his breath against your face. If the victim is not breathing, begin CPR and apply the AED (automated external defibrillator) immediately.
Next, we must control any bleeding. Be sure to check the victim thoroughly for bleeding as you may have more than one wound to treat. Bullets often create a second hole when they exit the body.
To control bleeding, use your gloved hand and sterile dressing to apply direct pressure to the wound. If the wound is still bleeding, try more pressure and more dressing. If this does not work, try more pressure, more dressing, and if possible, elevate the wound above the heart.
Gunshot wounds to the chest, often called sucking chest wounds, should be sealed to keep air from being sucked into the wound. Cover the wound using a piece of plastic. Tape three sides of the plastic to the body, leaving the fourth side open. The open side will act as a valve allowing air to escape, which should prevent a collapsed lung.
If the victim is conscious, allow them to sit or lay in a comfortable position. Try to keep him relaxed, which should slow his heart rate and limit blood loss. Keeping the victim warm will also help.
If the victim is unconscious, he should be closely monitored for signs of cardiac or respiratory arrest.
If the victim experiences signs of shock, such as thirst, rapid heart rate, or profuse sweating, have him lay flat and slightly elevate his legs if he can tolerate it. This will move blood to the body’s core.
If oxygen is available, give it to the patient.
Do not give gunshot wound victims anything to eat or drink without approval by a medical professional.
Keith Murray, a former Florida firefighter EMT, is the owner of The CPR School, a mobile training company that provides CPR, AED and first aid training. He also sells and services automated external defibrillators. Contact him at +1-561-762-0500 or keith@theCPRschool.com. Comments on this column are welcome at editorial@the-triton.com.
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