Prepping for Trauma

Whether in a defense scenario or at the range, having the gear necessary to care for a gunshot wound is crucial.

February 18, 2022 By Richard Nance

If you choose to carry a concealed handgun every day, it’s probably because you realize it could come in real handy when faced with a deadly threat. Your gun may not be comfortable to lug around day in day out, but you do it because having a gun and the skill to employ it effectively could save your life or enable you to save someone else’s.

You know what else saves lives? First aid supplies and training in gunshot wound care. What sense does it make to be armed and trained to protect yourself and others yet are ill-equipped and incapable of providing first aid or self-aid to treat a gunshot wound? As my friend and retired Fire Service Lieutenant Jonathan Willis says, “Always be able to defend yourself and always be able to fix yourself.” Sage advice.

And it’s not just defensive situations that might require first aid. Most of us spend time at the range, training to be proficient with our carry guns, and negligent discharges can happen—to us or to someone else. The faster the wound is treated, the better. If you accidentally shoot yourself while alone, having a first aid kit could be the difference between life and death.

Being able to treat your own gunshot wound is part of being self-sufficient. You can’t rely on first responders to arrive in time.

So, as a layperson, what medical supplies should you have on hand, and what are your priorities when treating a gunshot wound, either to yourself or to someone else? I’ll address these issues without delving into the tactics involved when you’re still facing an active threat. Suffice it to say shooting the bad guy takes priority. Tending to a gunshot wound when bullets are still flying is foolhardy.

I’m not a doctor, a paramedic or an EMT. I am a police officer and firearms instructor who’s carried a gun on- and off-duty for the last quarter-century. I’ve seen my share of gunshot wounds—some fatal, some relatively minor. Each wound was different, based on such factors as caliber, bullet construction, proximity and the part of the victim’s anatomy that was shot.

When at the range, the most common type of gunshot wound is one that’s accidentally self-inflicted, often a result of “speed holstering.” If you’re at the range, a medical treatment and evacuation plan should already be in place and understood by all. If someone is shot, call a ceasefire immediately. Instruct shooters to holster their handguns, render their long guns safe, and down them. Designate someone to summon help via phone or radio, depending on the particulars of the range.

If the wound is to an arm or leg and is bleeding heavily, apply direct pressure and a tourniquet. Then arrange for transport to a nearby hospital by car, ambulance or helicopter, as appropriate based on the severity of the wound and your location.

Tourniquets are key. Years ago there was a widely held misconception that if you applied a tourniquet and it remained in place for any length of time, the injured party would invariably lose the affected limb. Applying a tourniquet was considered appropriate only in situations where the wound was so severe that death seemed the only likely alternative.

But things changed when U.S. military forces in Iraq and Afghanistan gained hard-won knowledge that dispelled the myth that a properly applied tourniquet would lead to amputation. Tourniquets saved countless lives of servicemen and servicewomen who suffered severe injuries to an extremity, oftentimes more than one.

There are several types of tourniquets on the market. The one I’m most familiar with and carry on a daily basis is the Combat Application Tourniquet (C-A-T), which is the official tourniquet of the U.S. Army. You can pick one up for about $30.

They come in black and orange. For a police officer who wears a tourniquet openly as part of his duty gear, black makes the most sense, but orange is a lot easier to find in a range bag or pack as well as in low-light situations. When someone’s bleeding severely, the last thing you need is trouble finding your tourniquet.

First, route the band around the affected limb and pass the red tip through the slit in the buckle. Although the instructions still recommend placing the C-A-T two to three inches above the wound, it cannot be applied to distal long bones so to avoid confusion, most instructors advocate applying it as high as possible.

When feasible, the C-A-T should be applied directly to the skin, and that’s where trauma shears come in handy. Clothing can be difficult to cut, and your handy pocketknife isn’t going to do much good. But realistically, if you’re at the range and the wound is to the leg, and especially if you’re applying the tourniquet to yourself, it’s probably going on over your pants.

Cinch the band down and fasten the hook and loop material back on itself. It should be tight enough that you can’t insert three fingertips between the band and the limb. Wind the rod until the bleeding stops then secure the rod inside one of the clips to lock it in place.

Pull the band between the clips and over the rod then record the time of application. Time of application will be useful information for medical personnel, and that’s why it’s a good idea to keep a Sharpie with your tourniquet.

One-handed application is identical except that rather than routing the band through the buckle, you would loop the band around the affected limb. You might find it easier to loop the band around the limb even when applying it with both hands. Of course, you need to be proficient in one-handed application in case you need to apply the tourniquet to one of your own arms. For the same reason, you need to practice the procedure right- and left-handed.

Whatever type of tourniquet you have, make sure you are familiar with how to apply it. Obviously, if you should ever need to apply it for real, there will be a level of stress that tends to make even innocuous tasks seem overwhelming. The more practiced you are at applying a tourniquet, the better your odds of success, but only if you have it with you.

That begs the question, where should you keep your tourniquet? When several people are shooting on the same range, as would be the case when taking a training course, there should be a rather large, clearly identifiable first aid kit nearby that contains more than one tourniquet.

That said, it’s not a bad idea to have a first aid kit on your person for faster deployment. You could purchase a kit that comes with the contents you want and wear it in a pouch on your belt or even stuff it into a cargo pocket (as I do on patrol).

The great thing about having your own first aid kit is you know the tourniquet and other important first aid supplies are there. If you’re relying on the “community” first aid kit, that’s not necessarily the case. Having your own kit on your person means you’ll be more familiar with its contents and that the contents will be readily accessible.

The most common gunshot wounds on the range are to the extremities, which is why it’s so important to have a tourniquet. However, a tourniquet is useless in treating wounds to the torso or head, which, although less common, could be much more severe.

In many cases, the way to stop the bleeding to a gunshot wound to these areas is through direct pressure. Packing the wound with gauze will also help control bleeding. Regular gauze works, but Combat Gauze offers several advantages.

Combat Gauze—commonly sold under the brand name QuikClot—is a hemostatic dressing combined with surgical gauze and a proprietary inorganic material. Not only can Combat Gauze stop even arterial bleeding in seconds, but also it’s inert and non-allergenic. It’s pliable enough to fit into wounds of all shapes and sizes, and it’s easily removed once clotting occurs.

Combat Gauze comes in rolls three inches wide and four yards long. It retails for just over $40. It’s a great way to pack a gunshot wound, but having an elastic bandage is also beneficial in applying direct pressure.

Emergency trauma dressing is a popular elastic-style bandage featuring a sterile, non-adherent pad. It’s a great way to provide direct pressure to a wound. This dressing is simple to apply, relying on quick-grip control tabs that prevent the bandage from unrolling during application. Its vacuum-sealed packaging is both easy to store and quick to open. This type of dressing comes in four- or six-inch versions and retails for less than $10.

Of course, your kit can be as expansive as you want it to be. It could include occlusive dressings for treating sucking chest wounds and maybe a nasopharyngeal airway to create and maintain an open airway in an unconscious or semi-conscious patient. These items, though useful, are beyond the scope of this article and of most people’s training. Also, the more items in your first aid kit, the more cumbersome it is to have with you.

Don’t feel as though you must be an EMT to stop a gunshot wound from bleeding. All it takes is the right equipment, some basic training and practice. Build yourself a first aid kit—or order one—that includes at least a tourniquet, gauze and an emergency trauma dressing.

Practice with the contents of the kit to build familiarity and, of course, make sure the kit is on hand. The best time to prepare for treating a gunshot wound is now. The worst time is when seconds count and you desperately need to stop the bleeding.