Doctor advises how to treat gunshot wounds

DETROIT – Do you know what to do if you are the first one to help at the scene of a shooting? What if you're the victim?

It's an emergency you hope you never have to face, but it happens.

Whether you're the victim of a crime, a hunting accident or a mass shooting, what you do in the first moments can determine if you live or die.

Dr. Craig Silverton is a Henry Ford Hospital surgeon and retired Air Force colonel. As a flight surgeon who served three tours of duty in Iraq and Afghanistan, he has significant insight into field combat medicine that can be applied to civilian settings.

"The best thing that you can do is not so much apply medical care to that patient, but it's call 911 and make sure that we can get that patient to the next echelon of care to treat them," Silverton said.

--Dr. Craig Silverton

If you're in a remote location, or can't call for help, there are a few important things to know.

Traditionally, in first aid, you are taught ABC (airway, breathing, circulation), which is the order you prioritize treatment. But with bullet injuries, airway and breathing aren't usually the most pressing problems. Circulation is the most important because of bleeding.

Initially, the best thing to do is apply pressure to the injury with anything available. The pressure needs to be firm and constant. Don't lift the dressing up to peek at the area. Every time you do that, the delicate clot is disrupted, causing the bleeding to start again. You'll know the pressure isn't working if blood continues to flow out from the material you're using to hold pressure.

If pressure isn't enough, build a tourniquet – which is a device used to compress.

Anything long enough to go around the limb can work, but ideally it should be something soft and about 2 inches wide so it won't cut into the skin as it's tightened. While a belt might seem logical, it may be too stiff to tighten down enough.

To use a tourniquet, wrap it around the limb at least a couple inches closer to the body than the injury, but not over the knee or elbow, since those areas can't be compressed.

Tie one simple knot and make sure it's snug. Then, put any elongated long rigid object, like a stick, over the knot and tie it down with another couple of knots. Applying pressure is as simple as twisting the stick until the bright red bleeding stops. Keep the twisted part from unraveling by holding it in place or tying it with remaining fabric.

At that point, Silverton said the best thing is to lay the victim down and reassure them.

"Make sure that they don't move. You don't move them. You don't give them anything to eat or drink," he said.

Contrary to what is often seen in movies, a gunshot is not universally fatal. For torso injuries, it just depends on what is hit. And gunshots to the body are impossible to predict, just because you can't see bleeding doesn't mean it's not serious. It could be internal.

On Local 4 News at 5 p.m. on Thursday, Dr. Frank McGeorge will elaborate on the different types of gunshot wounds.