Here is some information on first aid situations that might arise while hunting or at the range.


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Gunshot Wounds While At the Range

Gunshot wounds are serious. Gunshots cause three types of trauma: penetration (destruction of flesh by the projectile), cavitation (damage from the bullet's shock wave in the body), and fragmentation (caused by pieces of the projectile or lead). It is very difficult to predict the degree of damage done by a gunshot wound, and many of the injuries caused by a bullet far exceed what you can reasonably treat. For this reason, the best option is to get the victim to a hospital as soon as possible.

1. Call 911. Point at someone and say “You call 911”.
2. Have someone secure the firearm involved.
3. Wear personal protective equipment (gloves) if available.
4. Do not move the victim unless you must do so to keep him safe. Gunshot wounds are a common cause of spinal cord injury. If the victim appears to have a spinal cord injury, do not move him unless you absolutely must. If you must move the victim, be sure to keep the head, neck and back aligned.
5. Do not give them anything to eat or drink.

Check the A, B, C, D, E's. Assess these five critical factors:

• A (Airway) - If the person is unconscious, check to make sure that his airway is not obstructed. The tongue can be a common cause of airway obstruction, and simply turning his head can solve the problem.
• B (Breathing) - Is the victim taking regular breaths? Can you see his chest rising and falling? If the patient is not breathing, start rescue breathing immediately.
• C (Circulation) - Does the victim have a discernible pulse? If the victims does not have a pulse, begin CPR. Control any major bleeding.
• D (Disability/Deformity) - Disability refers to damage to the spinal cord or neck - always suspect injury to the spinal cord. Deformity refers to things such as compound or obvious fractures, dislocations, or anything that looks out of place or unnatural. These injuries can be worsened by moving him.
• E (Exposure) - Make sure that you fully expose the patient so that you do not miss wounds to the armpit, buttocks or other difficult-to-see areas. Remember, you are also looking for an exit wound.

Control bleeding. Controlling bleeding is most important thing you can do to save a gunshot victim's life. Do not worry about having sterile dressings or dirty hands. An infection can be treated later.

• Applying direct pressure is the best way to
  
  control most wounds. Use a pad over the wound and apply pressure directly to the wound. If you have nothing available, even your hand or fingers can be used to control bleeding. When applying bandages, add new bandages over the old; do not remove bandages when they become soaked.
• Use pressure points in the arm (between the elbow and armpit), groin (along the bikini line), or behind the knee to control bleeding in the arm, thigh, or lower leg.
• There is little that can be done with conventional methods if the wound involves the torso, but chemical hemostats (Quickclot, Celox, etc) have been proven to be very effective on all major bleeds. Ensure that you follow the instructions on the package for application, usually as simple as holding the wound open, pouring in the powder or inserting the powder packet / sponge / applicator, and applying strong pressure for five minutes. It will heat up.

• Tourniquet last resort if you can’t stop bleeding from an arm or leg. Tighten only enough to stop the bleeding.
• Always look for an exit wound (especially in difficult to see or reach areas of patient, i.e: back, under patient).
• Be prepared to treat the victim for shock. GSWs frequently lead to shock, a condition caused by trauma or loss of blood that leads to reduced blood flow throughout the body. Expect that a gunshot victim will show signs of shock and treat him accordingly. Do not elevate the legs if the gunshot wound is to the torso, as this will increase bleeding and make it more difficult for the victim to breathe.

• It is very difficult to accurately assess the severity of a gunshot wound based upon what is visible on the victim; internal damage may be severe even in circumstances where the entrance and exit wounds are small.

Special Instructions for regions of the body

• Head – GSWs to the head are frequently fatal. Keep the head elevated and get the victim to a trauma center ASAP.
• Face and neck – These wounds typically bleed severely. Use direct pressure to control bleeding and keep the victim upright. Be careful not to obstruct breathing while controlling bleeding. With injuries to the neck, be careful that blood flow to the carotid arteries (sides of neck) isn't disrupted, as this can reduce blood flow to the brain.
  
• Chest and back – Apply direct pressure to control bleeding; understand that it may be difficult to control chest bleeding because the ribs make it difficult to compress the structures that are bleeding. Gunshots to the chest can cause what is known as a "sucking chest wound". These happen when air travels in and out of the wound with each breath. Treat these as follows:

• Seal wound with hand or airtight material (e.g., plastic film).
• Apply an airtight bandage on three sides of the wound (see image).
• Do not close the bandage on the fourth side. This will allow the chest to achieve its usual negative pressure state. Air will escape through the valve during inhalation.

• Abdomen – Use direct pressure to the injury site. Controlling bleeding in these cases can be quite difficult.
• Arm or leg – Use direct pressure to control bleeding. Arm and leg injuries from gunshots can be elevated above the heart to help control bleeding. Use pressure points in the arm, groin, or behind the knee if direct pressure does not control bleeding.

Other Emergencies While At the Range

Heat-related emergencies

• Hypothermia - Early signs & symptoms: Uncontrollable shivering (at extremely low body temperatures, shivering may stop), weakness and loss of coordination, confusion, drowsiness, fatigue, stumbling. Put them inside a vehicle with the heat on, remove their coat so warm air can reach them better. Call 911 if they do not improve.
• Heat Exhaustion - Symptoms include heavy sweating, rapid breathing and a fast, weak pulse, possibly cramps. Get victim out of the sun & have them rest and drink cool water.

• Heat Stroke - Similar to Hear Exhaustion, but skin is DRY. This is an emergency. Cool the patient by soaking their clothes in cool water. Call 911.

Cardiac emergencies

• The onset of symptoms of a heart attack are usually gradual, over several minutes, and rarely instantaneous. Chest pain is the most common symptom and is often described as a sensation of tightness, pressure, or squeezing. Chest pain due to a lack of blood of the heart muscle is termed angina pectoris. Pain radiates most often to the left arm, but may also radiate to the lower jaw, neck, right arm, back, and epigastrium, where it may mimic heartburn. Call 911.

• Shortness of breath / difficulty breathing. Call 911.

Allergic Reactions

• Pain and swelling due to bee sting or insect bite: Two antihistamine (Benadryl) tablets. If difficulty breathing: Call 911.

Basic First Aid Kit (Zip-loc bag); keep it in your car

• Band aids
• Gauze pads (4x4s)
• Roller bandage (cling)
• Hand towel / paper towels / napkins / Wet Wipes
• Trauma shears (not a pointy knife)
• Several Maxipads
• Adhesive tape
• Tourniquet
• Hand Sanitizer (Travel size)
• 35mm film canister: Tylenol, ibuprofen, antihistamine, anti-diarrheal
• You could start with a small store-bought First Aid kit and enhance it

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