Tactics: Firearms First Aid

Must-know gunshot wound procedures, shock treatment & supplies

• Dave Grossi
• Law Officer Volume 5 Issue 10
• 2009 Oct 1

Firearms training and shootings go hand in hand. Whether your firing range is indoors or outdoors, the potential for serious injury is real. As Officer Murphy might say, “Medical care is likely to be a great distance away.” This is especially true when training at an outdoor range and especially because many police outdoor ranges have been moved from urban areas to distant rural locations. If borrowing a civilian shooting range, you may not know where their first aid kit is stored when you need it most, so having one in your range transport vehicle is critical.

Ideally, every firearms instructor should hold at least a standard first aid card. However, time and personnel resources being what they are today, a minimum of at least one first aid trained firearms instructor on the range at all times during both basic and in-service classes is a must. This month, I’ll focus on two important issues: equipment and supplies every firearms first aid kit should contain, and basic emergency procedures and protocols for gunshot wound shock treatment.

How It Works
This firearms first aid kit should be permanently affixed in plain view at all times. Ours was attached right to the wall of our indoor range, near the cleaning area. At outdoor ranges, it can be stored inside the range office, but taken out and placed in plain view at, or very near, the shooting line or cleaning table prior to the start of the training session. If you’re doing your training at a civilian range, keep your firearms first aid kit in plain view, plainly marked in or near your transport vehicle to prevent critical time from being wasted searching for the kit. Write down patient information so the ER folks can readily view it. For example, if severe bleeding has occurred, but has been cleaned up before the officer has been transported, a rough estimate of the amount of blood lost should be written down. The officer’s name and any specific injury information should also be noted somewhere on the patient, such as the caliber of round, victim’s blood type and group, if known, and/or any other pertinent information.

If you’re putting together your own firearms first aid kit or wish to add to an existing kit, some commercially available items listed in this article are nice to have. There are many fine kits available that contain most of the items mentioned below. Most have a first aid quick reference guide affixed to the inside in the event an untrained officer is going to be the first responder. Some of the more specific items, you might have to purchase at a medical supply store and keep in stock in your range office. For example, the saline solution I prefer for eye care is Dacriose solution (normally used for hard contact lens wearers for lubrication) and is excellent for washing out eye injuries. The pre-wrapped wound dressing called Xeroflo (2" x 2" patches) or Xeroform (5" x 9" patches) packaged in foil aren’t too expensive, and they’re available at any medical or surgical supply store.

The Johnson & Johnson or Kwik-Kold Instant Ice Packs are also inexpensive.   Combat Gauze (or Woundstat) clotting agents are $30–40 a pack but can be a lifesaver in a crisis when EMS is a considerable distance away.

Most importantly, condition yourself through training to not panic. Through preparation and a little knowledge, you can be the difference in a range gunshot injury.

For first aid procedure, an emergency plan and necessary equipment, read below.

First Aid Procedures
Primary steps in wound care:

1. Have the victim lie down.
2. Expose the wound—remove clothing.
3. Inspect the wound.
   • Estimate the amount and speed of bleeding.
   • Type of bleeding:
     • Arterial—bright red.
     • Venous—dark red. 
4. Place pressure dressing on the wound.
   • Bulky, tight, pinpoint direct pressure.
   • Hold with your hand, if necessary, for 3–6 minutes. Wait for the blood to clot, or use the clotting agent 

1. Do not panic.
2. Do not underestimate puncture wounds or sucking chest wounds.

Symptoms of shock (inadequate blood flow, frequently due to blood loss):

1. Pale face (cyanosis), blue lips and fingernails.
2. Beads of perspiration on the upper lip or forehead.
3. Fast and shallow respiration.
4. Weak and rapid pulse or no pulse.
5. Cold and clammy skin.
6. Unconsciousness or semi-consciousness.
7. Chills, teeth chattering.
8. Eyes dull and/or lackluster. 

Treatment for shock:
Treat to prevent shock—even if the victim is not in shock or you’re not sure.

1. Elevate the victim’s feet (use the blanket) and injury, but be careful if broken bones are suspected. 
2. Keep the victim warm. Maintain body temperature.
3. Oral fluids should generally be avoided because of possible internal injuries, vomiting, hemorrhage or difficulty in breathing. 

Gunshot wounds:

1. Attempt to locate the entrance and any exit wounds.
2. If the lung is punctured, air will go in and out of the wound.
   • Lung may collapse and stop working.
   • Bandage chest firmly to prevent lung from not working. 

Emergency Plan & Necessary Equipment

Medical requirements for transportation:

1. Communications
   • Cell phone
   • Landline
   • Portable or mobile radio
   •  Push-to-talk device 

Firearms First-Aid Kit (components):

1. A clearly marked, waterproof container
2. 4" x 4" sterile gauze pads (10)
3. Triangular bandages
   • Tie-downs and splinting 
4. Sticks, 6" long (4)
5. Bottle of Betadine antiseptic solution
6. Bottle of saline solution (eye wash or Dacriose)
7. Ammonia inhalants
8. 1" bandages (10)
9. Several rolls of 1" and 2" adhesive tape
10. Roll of 2" cling gauze
11. Black permanent laundry marker and pad
12. Scissors
13. Occlusive-type bandages
    • Aluminum foil or heavy-duty plastic wrap (air tight)
    • Gauze with Vaseline or Xeroform
    • Two-sided tape 
14. Instant ice packs—Johnson & Johnson Coach or Kwik-kold #101
15. Blanket for victim
16. Combat Gauze (or Woundstat) clotting agent (4)
17. Rubber or latex gloves (several pairs)
18. Neosporin or other antibiotic ointment
19. Flexible fabric extra large 1-3/4" x 4" adhesive bandages (1 box)
20. Cleansing wipes or moist towelettes (6)
21. C-A-T or SOF Tourniquet 

Information on Standard, Advanced or Lifesaving First-Aid or CPR certification courses can be obtained through your local chapter of the American Red Cross. With enough advance notice, they may be willing to put on a private class for your range/firearms staff.

Dave Grossi is a retired police lieutenant from upstate New York now residing in southwest Florida. A member of the Force Science Research Center’s National Advisory Board, he consults regularly with departments on use-of-force policy and procedure.

References

• American Red Cross; Handal KA: The American Red Cross Standard First Aid & Safety Handbook. Little, Brown and Company, New York, N.Y. 1992.
• American Academy of Orthopaedic Surgeons: Emergency Care and Transportation of the Sick and Injured. Jones & Bartlett Publishers, Sudbury, Mass. 2006. 

• Download first aid procedure, an emergency plan and necessary equipment list here

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• Law Officer Magazine Volume 5 Issue 10

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