Shooter puts a Round Through His Foot... What do you do NEXT?

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ScottRiqui

New member
People generally don't want to get involved unless they are "put on the spot," so to speak. If you need to get someone else to call 911 for you, don't just yell "someone call 911," because there's a good chance no one will call, because everyone is thinking someone else will do it. Tell one person, specifically, to call, and make sure they are able to pass along the pertinent info. Make eye contact, and be sure they know you are talking to them specifically.
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Very true. When I took my first CPR/First Aid course, it was back before cell phones were commonplace, and the assumption was that if you were out in public, the call to 911 was likely going to be placed using a pay phone or a nearby business phone. We were instructed to tell someone to go call 911 **and then to come right back to the scene**. The rationale was that if they didn't come back, you could pretty much assume that they had just bolted, and that the 911 call probably wasn't made.
 
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msshooter

New member
A friend of mine shot his foot, not sure how it all happened, however, it did and he has phantom pains, and other issues. Being the man I am I would stop shooting and help a fellow shooter out.
 
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Crankgrinder

New member
take his gun away, the laugh, then get him/her medical assistance. :D Not realy folks. Getting the person help i dont think would be a problem every cell phone in the class is bound to come out as soon as it happens jamming up 911 lines in the process. To stop the bleeding would have to be the first thing i believe. Knew a guy who shot himself throught the foot because he didnt want to go to school that day once. I still laugh about that one though.
 
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Vermonter

New member
Unbelievalbe It could happen to you

Professionals at every level of every sport make mistakes and injure themselves all the time. This could happen to anyone.

Made me think about the location of the first aid kit in the truck. Sure the truck is only a short walk from the firing line but still it would burn 45 seconds at least. I did notice that Rob touched the wound without gloves as well. In the end I think this and videos like it are a great reminder. I just walked outside dug through the tool box and put my first aid kit back on top where it should be. If nothing else take that away from it.

I would like to raise another point regarding communication. The great state of VT is known for its hit or miss cell phone coverage. Where it is wall to wall one second may be non existant the next. I think the reality is that we need to be equipped to deal with an emergency and transport if needed at least to a point where Cell service is achievable.

Regards, Vermonter
 
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markj

New member
If you have not had at least an 8 hour class on first aid get one.
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Yes, everyone should have this, wife is EMS on the VFD, we take classes together, she teaches this stuff at the hospitals she works at too. I got involed from riding motorcycles, seems someone will fall off and get hurt. Keep a kit in the bike, and the truck. One out in the barn too.

Had 6 wrecks myself, last one almost killed me. Lets not talk about the hunting accident where I was shot. or the bar brawl where I was also shot (was a bouncer) folks were there acted quick.

Saw a guy stick himself in his neck with a knife, cut the artery, 2 nurses in the bar took ice, towles and used pressure, he lived thru that. First aid is something you need but hope to never need to use.

Now when I was stuck in the back of my neck with a pig sticker, had to run myself to the hospital, made a mess in the truck.
 
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scrubcedar

New member
At one point Ice was recommended when you had an EXTENDED period of time before you got help. The dangers are similar to, though not as bad as a tourniquet. Frostbite/ freezing tissue damage is remarkably easy to cause and the water can be a source of contamination in and of itself. It's not worth playing with. This is a great example of what we did at one point but found out later was harmful. I'll recommend again, first aid/CPR classes taken regularly so you don't end up with bad solutions to life and death problems. MarkDozier mentioned that he had been trained starting in 1975 in first aid and they were trying to get people to stop using tourniquets at that point. When we had patients come in with tourniquet damage quite often it was Grandpa who used the method in WWII to save his buddies life while under fire. His training was so effective he was still doing it that many decades later! Get good training, update it regularly. In my experience you are statistically more likely to have to use it on a family member, think of it that way.
 
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Mike38

New member
How many folks actually keep an IFAK/BOK with their range gear, just in case someone has a blow out?
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I do. I'm an EMT. First thing I load into my Jeep, even before the guns and gear. I've never used my kit at the range, and hope I never have to.
 
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insomni

New member
Not too much to this one. Get someone to call EMS, and get a first aid kit. Put a knee into the femoral artery to stop bleeding while you apply a pressure dressing. pack the hole with kerlix or gauze. Lots of it (beware of sharp bits... Protruding bones are VERY sharp). Mostly, this is for 1 stopping blood flow, 2. Padding for the wound and bones. After that, wrap it with an ACE wrap or a decently tight bandage. Find any toes that may have been blown off, wrap them in some moist gauze and put them in a baggie of ice. Surgeons will most likely be able to reattach them if they show up cold. immobilize the patient, and wait for EMS. if you're incredibly rural, have the operator have EMS meet you half way.

I say call EMS instead of evac him yourself because EMS will have some things you don't: IV's with fluids, and more importantly immediate access without paperwork or a wait when he gets to the hospital.


Also, if you DON'T go to the range without an IFAK/first aid kit you're setting yourself up for failure.
 
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insomni

New member
for those of y'all that are wondering, here is a good begining packing list for a range first aid kit. Guys with experience and training, let me know if I left out any bandaging supplies. to reiterate what's been said a few times: Appropriately educate yourself. Go take a class. Learn from professionals how to put a bandage on correctly.

Look around at surplus stores, and on line and you'll be able to find something to hold it in, as well as good deals on some things inside it.

gloves (Stretchy Nitrile)
2 4" Israeli Bandages
- - - If you can't get these, use old style Army bandages for their bulk and
- - - absorbancy. Use the white part to stop the bleeding, and secure with an
- - - ACEwrap sports bandage for an instant homemade pressure dressing,
- - - though be careful not to cut circulation off in the process if you don't
- - - need to.
Tourniquet materials (CAT Tourniquet, or a cravat with a sturdy stick to use
- - -as a windlass)
Trauma sheers (BLUNT ROUND NOSED SCISSORS for cutting a pant leg if need be)
2x cravat (These are used to immobilize a shoulder, or to hold a dressing in place if it's on the abdomen or chest)
1 roll Kerlix (for stopping bleeding, and padding a wound.
1 roll 1" medical tape (sticks to absolutely everything.... except sweaty skin :[ )
Hand sanitizer. Small travel sized bottle will suffice.
Baby powder. Unscented, sprinkle it on your hands and your gloves will slip on like magic.
assorted bandaids. Yah I know, they're for kids, but you never know when
- - -you're going to nick yourself with with a knife, etc.



other things to note:
*NSAIDs like Asprin, Ibuprofen, Naprosyn (found in Aleive, Excedrin, Motrin), though they work very well to control pain, negatively affect blood as far as clotting goes (which is why asprin works for people during a heart attack). Tylenol (acetamenophen) is a much better choice since it has analgesic effects, and does not "thin" the blood.
*Tampons. well they kinda work for exit wounds, but look at the size of an entrance wound and tell me a tampon applicator will fit in that!
*Gloves: There's nothing inherently wrong with latex gloves, they work quite well. However there are enough people with latex allergies out there that you want to stick with Nitrile, Vinyl, or another latex free. Yes it's a good idea to put gloves on before touching blood.
*Bandages: practice with them. You DEFINITELY don't want the first time you bandage someone to be when they're bleeding. Take a class in first aid one weekend. Try to take a Red Cross or similar class through Gander Mountain or the NRA if possible so it's geared towards hunting accidents, or some sort of penetrating trauma.
*Gauze: Regular gauze. 4x4's or 6x6's. Get about 4 or 5 of each. There is a product called Combat Gauze. It isn't plain old regular gauze. it has a clotting and chemical cauterizing agent in it, and requires extra familiarization and training to use.
*POUCH - make it easily accessible, and PORTABLE. You probably don't want to be lugging your whole range bag to someone in need, but you definitely want this pouch to be IN your bag. Find something that either has a full clamshell zipper, or an old style plastic box that can hold everything, but is easily accessable.
*Sterility: Don't open the packages till you need to use the contents.
* KNOW YOUR LIMITS: You are doing this to keep some sort of control over bleeding until the emergency crew arrives. Don't try to be a hero.


cheaperthandirt.com sells LOTS of these items, Amazon.com does as well actually.
 
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scrubcedar

New member
I'm sorry to have to disagree with you about the tourniquet insomni, here are a couple of links that might help everyone understand better. The first is from the American red cross site.
http://www.redcross.org/email/safetynet/v1n9/firstaid.asp
It specifically lists the idea that a tourniquet is the best method as a "Myth" The red cross is considered the gold standard for up to date information. Notice the title of the article "Ten Common First Aid Mistakes".

Tourniquet use in surgery is even being looked at because the tourniquets are permanently damaging the nerves, in some cases in a matter of minutes.

You guys made me curious so I accessed a couple my old medical sites as well as doing more normal research. Found some interesting things a fairly recent army manual thought they were a good solution, providing you had already diagnosed severe arterial bleeding that couldn't be stopped with pressure,and you were under HEAVY fire. That's almost an exact quote, I couldn't figure out how copy off of the type of file it was. If you're at the range and he is pumping blood,at the same time someone is shooting at you, the Army is on your side.:D

The next quote is from military research as well. The rate of limbs with fasciotomies
with tourniquet time <2 hours
was 28% (75 of 272) and >2 hours was
36% (9 of 25, p  0.4).
Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure (and treat the resulting loss of circulation to an area of tissue or muscle). Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome.

DO NOT CLICK ON THESE PICTURES WHILE EATING!
http://en.wikipedia.org/wiki/File:Fasciotomy_leg.jpg
http://en.wikipedia.org/wiki/File:Fasciotomy.JPG
http://en.wikipedia.org/wiki/File:Fasciotomy_(Post_Skin-Graft).jpg

The figures come from a study published in 2008 in The Journal of TRAUMA Injury, Infection, and Critical Care and were compiled in the field in Iraq. I was in trauma nursing for more than 20 years, as well as being a CPR instructer. I have no idea how many dearly held beliefs from my training I had to walk away from! It was very hard each time but sometimes it was the difference between life and death.
 
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insomni

New member
Yah, I was thinking on that one a bit last night. I dont think I would use a tourniquet at the range for a foot either. Its risky, especially without training or fast access to a hospotal. Im going to edit the above post for that one.
 
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insomni

New member
that's a really great video!

I especially liked the finer points like ensuring Emergency crews know it was accidental, and moving vehicles for ease of access for the ambulance.

Thanks a ton! Hope people learn alot from all of this.
 
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Sport45

New member
It took fourteen posts before someone said to make the gun safe.
You don't need two, or more, people hurt.
Make the gun safe then tend to the victum.
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I don't agree. Tend to the injured first and leave the gun alone. It's not going to go off all by itself. Tell others to leave it alone too, if necessary.
 
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Nanuk

New member
Actually current combat medicine calls for tourniquet use. Last year I attended an advanced combat trauma management class. The most common cause of preventable death on the battlefield is bleeding from extremities. A CAT or similar TQ that is at least 1" wide does NOT harm tissue underneath it and prevent it from being viable when properly used. The second most common cause of preventable death on the battlefield is bleeding from the torso. In this situation, you must locate the severed artery and pack the wound in such a manner as to stop the bleeding. It has nothing to do with being a hero, it has to do with saving a life. Treating a GSW is the same where ever you find yourself, hopefully you will not be getting shot at while doing it. I was a NREMT, EMT instructor and clinical instructor.

If you are going to be around guns as a hobby or profession you owe it to yourself and your shooting friends/partners to obtain realistic trauma management training.

Every shooter should carry a blowout kit and know how to use it.

A shot to the foot will rarely require much first aid, it is usually load and go. The funniest one I saw was a hunter that put his rifle in the truck and shot himself in the foot with a 270, put a nice neat hole thru his boot, foot, transmission, deflecting into the front tire.
 
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scrubcedar

New member
Nanuk, you might want to go back and read through all of my posts. A tourniquet is still a viable tool to save a life, no one is disputing that.
In my first post I emphasized that a tourniquet was to save a life that was bleeding away. Multiple GSW's, damage from explosions and shrapnel, those are the things that are most likely to need a tourniquet and that is why they teach combat medics to use them.
This was a different scenario than that. The statistics you saw above about limb damage were compiled in Iraq by our military in 2006 and published in 2008. Obviously they are concerned about whether their training is teaching the medics to use this tool appropriately.
If it becomes a choice between loss of life due to bleeding (exsanguination), or loss of limb due to tissue damage, you sacrifice the limb. That is the yes/no question for it's use, will they die without it? Combat medics are trained quite well to make that call. I've seen way too many civilians get that call wrong. Maybe your class was good enough, I don't know.Keep in mind most of the people I saw get the call wrong were military vets thinking like they were in a combat situation.
 
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Nanuk

New member
Scrub,

I agree that too many untrained people use the wrong thing for a TQ, electrical cords and such, causing irreparable damage. Its really quite simple, if it's not called for its not called for. In this example I would probably have not even removed his shoe/boot until arrival at the ER.
 
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