What Does It Feel Like To Be In A Car Accident?

This one is actually a true story from my own experience. I've written it as if it were in a book, but everything here happened in real life, on November 5th, 2017.


We were picking up a pony.
That was the whole reason for this road trip. A week earlier we had made the same trip to the same place, but it was to trial the pony before we considered buying him. Timbit (then called Twilight)
had performed admirably despite the unexpected gale-force winds and hailstorm, and his level head and enormous talent had led us to decide that he was perfect for my nine year old sister.
The roads had been in excellent condition, dry and pleasantly warm for November.
But there had been a change in weather in the week that followed, and the Coquihalla had received a heavy snowfall a few days before our second trip.

Before I go any further, I want to make it clear that we had done our research. We tracked the weather, checked the highway cams, and made an informed decision.
For anyone who doesn't often drive in winter conditions and so may not understand what the risks are, I'll explain why you have to be so careful when driving in such conditions.

If it is actively snowing while you drive, the flakes swooping toward your windshield have a hypnotic effect that will take even the most experienced driver's eyes off the road without them even realizing it. Snow swirling across the asphalt has the same effect, drawing your eyes to the swirling, mesmerizing patterns on the road, and this can happen even on a clear day when it's not actually snowing.

Ice is one of the biggest problems. Sometimes its simply the result of water freezing on the road, sometimes its the result of packed snow generated by the snowplows. Whatever the cause, it makes for a nerve-wracking drive. Sanding trucks are often a common sight on northern roads in the winter, spreading a mix of sand and salt on the roads to help melt the ice and provide grip for tires.

And when you're driving on a mountain road with unpredictable weather, all these things get magnified significantly.

But on November 5th, the roads were actually pretty good. It had warmed up significantly, so the snow along the sides of the road was already melting. The sun shone brightly and turned our winter surroundings into a silver and white dreamland worthy of a movie set. We had left around 6:30 that morning, budgeting plenty of extra time so we could drive carefully and slowly if we needed to.
But so far it had been a breeze. The Coquihalla has a 24 kilometer stretch of highway that is equipped with variable speed signs, where sensors collect real-time data and calculate what is a safe speed to be traveling at that particular moment. The regular speed limit along that stretch is 120 kilometers an hour, but the signs will adjust if needed and drivers are required to slow to the speed posted.
And as we passed those signs they stated that 120 was the safe speed to be going.

But we had extra time and were towing a horse trailer, so the fastest we went on that drive was 80kmh. Why risk an accident?

About three hours into the drive, my siblings had all fallen asleep. The two youngest were in the back with me, and my parents and my other sister were in the front. Our red F350 had a crew cab, so while it wasn't exactly a luxury vehicle, it fit all of us in and it towed our three hauler horse trailer, so it served our needs just fine. It had previously been used as a railtruck, so the whole front end had been reinforced with steel plates. This is an important detail. You'll see why soon enough.
Mom was dozing, Dad was driving, and I was sitting behind Mom on the passenger side with my earbuds in. There's a stretch of road where the foothills and trees bordering the road give way to a stunning view of the valley below, and I remember that I was listening to "Best day of My Life' by American Authors. I had it synced up so that the chorus started just as we came out of the hills and to that amazing view. It was like something out of a movie, with that stunning visual paired with the music timing and the happy, content, hopeful feeling about the future I had in that moment.

Looking back, I now realize just how ironic that was.

We were just cresting the hill. The sun was shining, the snow was sparkling, and suddenly something seemed...off. I was looking out the rear passenger window, but I had the view of the front windshield.
We had hit black ice, and were now sliding sideways. I clearly remember exactly where I was in the song when I realized what was happening. The song was at 0:50. Remember this, because it is also important.

Shifting my gaze to the front, I saw the concrete barrier coming toward us at a speed that seemed slow, almost stately. Dad had had lots of experience with driving on ice; he had grown up in the prairies of Canada, after all. He was doing everything he could to avoid hitting, but when you're on black ice, you're helpless. Adrenaline and fear shot through me, and a million thoughts raced through my head. I knew we were going to crash. I knew that we had a lot of momentum, and since the truck was very front heavy (remember I said it had been a reinforced rail truck?), there was a high chance of our momentum causing us to flip over the barrier and slide off the road. And on the other side of the road, that beautiful view of the valley, was a three hundred foot cliff.

I remember that time seemed to slow down. I know it sounds corny, cliché and overused, but it's true that your perception of time passing changes in the face of something like this. I remember looking at my two younger siblings who were just starting to wake up and realize that something was wrong. I remember looking at my parents and my other sister in the front, and knowing full well that a collision with that barrier could easily crush their legs and trap them in the truck.

I remember wondering if this was the last time I would see them all alive, and wondering if we were all going to slide off the cliff to the rocks below in the next ten seconds.

I can honestly tell you that I have never been so paralyzed with fear, both for myself and for my family, than I was at that moment.

Then the right front corner of the truck hit the barrier with a crash that was immensely loud even through my earbuds. I lurched forward in my seat, feeling the full force of the impact. The truck was going about 75kmh when we hit. Now imagine taking a two ton vehicle traveling that fast and stopping it instantly. The truck and trailer jackknifed, and the trailer skidded around us. It had enough momentum to pull us away from the barricade and slingshot us back around and sideways across the lane. It's hard to describe what happened even with pictures, so I can't convey it all here. But just picture what happens if a car catches a corner while racing at full speed. It spins out. Now imagine doing that on ice, in a truck, with a trailer attached. Everything in the cab flew everywhere, the extra jackets on the floor, the phone at the end of the AUX cord, the box of muffins and the water bottles.

When the truck finally stopped spinning, there was smoke filling the cab and everything smelled like gunpowder. It was because the airbags had gone off, but in the heat of the moment my confused brain thought the truck was on fire. And exactly how many seconds had elapsed? 11.
The song was now at 1:01.
Everything that had happened, all the thoughts running through my head, the whole accident from start to finish had been eleven seconds long.

Someone was screaming. Pain or fear? I couldn't tell. Dad yelled, "Everyone out of the truck, NOW! NOW!"
We all scrambled out of the truck as fast as we could. Dad had to kick the door open because the front of the truck was so bent and crumpled that it was jammed shut. Outside it was sunny but cold,
hovering around -12 degrees Celcius. That's 10 Fahrenheit.
Snow was eight inches deep on the ground. Thank God we had all listened to Mom for once and actually kept our winter boots and jackets on instead of shedding them I the warm and comfortable interior of the truck.

As we all hurried across the road to the shoulder, we saw what Dad had seen, and the reason he had panicked and ordered us to get out of the wreck. A semi truck was just cresting the hill, and there was no guarantee that he could stop in time. Thankfully the driver saw the accident from a ways back, and slowed down well in advance. He actually parked his rig at an angle across the highway to protect us. We had blocked all lanes on our side, and one of the lanes on the other side. When we had hit, debris had flown everywhere, as far as ninety feet away in a few cases. The truck was completely written off, the front end completely smashed in. And the front of our trailer was crumpled like a tin can.

There were actually a few cases of irony here. One was the hopeful feeling I had about the future, right before we crashed. One was the fact that the same steel plates that made the truck so front heavy and so likely to flip had also protected us. No one in the front seat was injured; the reinforcement had prevented the barrier from shoving the engine into the cab. And the last one was the fact that the trailer had been the biggest reason Dad hadn't been able to avoid the crash, but it had also been the thing that prevented us from flipping. There were actually imprints of the back wheels on the front of the trailer, and they showed that the truck had in fact started to lift, but that the weight of the trailer had pulled the truck back down.

As our parents ran around collecting the debris and throwing it in the bed of the truck, the aftermath started to set in. My little brother was in mild shock, (as in very shaken up) but he was unhurt. My little sister was on her knees in the snow, yelling to the sky, "We could have diiiiiiiiiiiiiieeeeeed!!!!"
(no joke, she really was), but she was also unhurt. My other sister and I were fine. So were our parents. Amazingly, the worst injury sustained from a near-lethal crash was a pulled neck muscle for my dad, from tensing up right before impact. We were all weak kneed and on the verge of hyperventilating. We were scared and cold, and all we could think of was "What if? What if we had flipped? What if we had been going the speed limit, almost 50kmh faster than we were? What if we had hit harder? What if someone had ended up in the hospital, or worse? What if we had been on the way back, and had little Timbit in the trailer?"
I still have nightmares about that last one. The dividers in the trailer had been partially ripped of their hinges, and those things are built to withstand several thousand pounds of horse regularly leaning on the divider. The amount of force it takes to deal the damage the trailer sustained is immense. When I think about what we would have seen when we opened those doors...I shudder to think of the scene. Timbit wouldn't have survived. No question.

I won't tell you all the details of what happened after, because this post is to tell people what it feels like to be in a major crash. But I will tell you that the wreck closed the highway for several hours, and that there are now five new barricades where we hit. The old ones were too badly damaged and had to be replaced.

And I will say that I wasn't able to listen to "Best Day of My Life" for almost a year after without breaking into a cold sweat. To this day I still get a knot in my stomach and a faster pulse whenever I hear it. Another bit of irony, that this song was playing during one of the worst days of my life.

I hope this conveyed the sheer amount of emotion I felt, as well as given you an idea what its like.

Treating A Bullet Wound

This is my first post, so I decided to research something I had been exploring for the purpose of writing my latest book; how to treat a bullet wound. I found several different sources and circumstances, so under each paragraph I've provided a link to the page I found it on in case you want to visit the site and see what other information it has to offer. Enjoy!

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WikiHow says: "Gunshot wounds are one of the most traumatic injuries you can suffer. It's difficult to assess the extent of damage done by a gunshot wound, and it typically far exceeds what you can reasonably treat with first aid. For this reason, the best option is to get the victim to a hospital as soon as possible. However, there are some first aid measures that you can take before professional assistance arrives."

Part One: Providing Basic First Aid

1 - Establish that you are in a safe position.  If the victim was shot unintentionally (e.g., while hunting), make sure that everyone's firearm is pointed away from others, cleared of ammo, safe, and secured. If the victim was shot in a crime, verify that the shooter is no longer on the scene and that both you and the victim are safe from further injury. Wear personal protective equipment, such as latex gloves, if available. 

2 - Call for help. Dial 911 for emergency medical assistance. If you are calling from a cell phone, be certain that you can provide the operator with your location. The operator will have difficulty locating you otherwise.^[1]

3 - Keep the victim in place. Do not move the victim unless you must do so to keep him safe or access care. Moving the victim could aggravate a spinal injury. Elevating the wound can limit bleeding, but should not be considered unless you are confident that there is no spinal injury. 

4 - Act quickly.  Time is your enemy in treating the victim. Victims who reach medical facilities during the "Golden Hour" have a much better likelihood of surviving. Try to keep your movements swift without making the person feel more upset or panicked. 

5 - Apply direct pressure.  Take cloth, bandage, or gauze and press directly against the wound using the palm of your hand. Continue for at least ten minutes. If bleeding does not stop, check the location of the wound and consider re-positioning yourself.^[2] Add new bandages over the old; do not remove bandages when they become soaked. ^[3] 

6 - Apply dressing.  If the bleeding subsides, apply cloth or gauze to the wound. Wrap it around the wound to apply pressure. Do not, however, wrap so tightly that the victim loses circulation or feeling in her extremities.^[4] 

7 - Be prepared to treat the victim for shock.  Gunshot wounds frequently lead to shock, a condition caused by trauma or loss of blood. Expect that a gunshot victim will show signs of shock and treat them accordingly by making sure the victim's body temperature remains consistent — cover the person so that he does not get cold. Loosen tight clothing and drape him in a blanket or coat. Typically you would want to elevate the legs of someone experiencing shock, but refrain from doing so if they might have a spinal injury or a wound in the torso.^[5] 

8 - Give reassurance. Tell the person that she's okay and that you're helping. Reassurance is important. Ask the person to talk to you. Keep the person warm. 
If possible, ask the person about any medications she is taking, any medical conditions (i.e. diabetes, hypertension), and any drug allergies she may have. This is important information and may distract her from her wound.

9 - Stay with the person. Continue to reassure and keep the victim warm. Wait for the authorities. If the blood congeals around the bullet wound, do not remove blood mats on wound, as this is acting to stopper the blood and prevent any more from flowing out. 

Part Two: Assessing The Victim's Status

1 - Remember the A, B, C, D, E's.  For advanced treatment it is important to consider the status of the person. A, B, C, D, E is an easy way to remember the important factors you should consider. Assess these five critical factors to see what sort of assistance the victim requires.^[6] 

2 - Check the airway.  If the person is talking, his airway is probably clear. If the person is unconscious, check to make sure that his airway is not obstructed. If it is and there is no spine injury, perform a head tilt.^[7]
        ~Apply gentle pressure to the forehead with the palm of one hand, while placing the other under the chin and using it to tilt the head back. 

3 - Monitor breathing.  Is the victim taking regular breaths? Can you see her chest rising and falling? If the victim is not breathing, sweep her mouth for obstructions and start rescue breathing immediately. 

4 - Check circulation. Apply pressure to any bleeding, then check the victim's pulse at the wrist or throat. Does the victim have a discernible pulse? If not, begin CPR. Control any major bleeding. 

5 - Look for disability. Disability refers to damage to the spinal cord or neck. Check to see if the victim can move his hands and feet. If not, there may be an injury to the spinal cord. Look for compound or obvious fractures, dislocations, or anything that looks out of place or unnatural. If the victim shows signs of disability, you should refrain from moving him or her. 

6 - Check for exposure.  Look for an exit wound. Check the victim as thoroughly as possible for other wounds that you may be unaware of. Pay special attention to the armpit, buttocks or other difficult-to-see areas. Avoid completely undressing the victim before emergency help arrives as this may advance shock. 

Part Three: Treating A Wound In The Arms Or Legs

1 - Elevate the limb and apply direct pressure to the wound. Carefully assess the situation to determine that there is no sign of disability or any wounds that would suggest the victim sustained a spinal injury. If this is the case elevate the limb above the heart to reduce blood flow. Apply direct pressure to stop bleeding as described above. 

2 - Apply indirect pressure. In addition to direct pressure, it is also possible to apply indirect pressure for limb injuries to limit the blood flow to the wound. This is done by putting pressure on arteries or, as they are sometimes called, pressure points. They will feel like particularly large and hard veins. Applying pressure to them will limit internal bleeding, but you need to apply pressure to verify that the artery applies to the wound. ^[8] 

        ~To slow blood flow to the arm, press on the brachial artery on the inner side of the arm, opposite the elbow.

        ~For groin or thigh injuries, apply pressure to the femoral artery, between the groin and the upper thigh. This one is particularly large. You will have to use the entire heel of your hand to reduce circulation.

        ~For lower leg wounds, apply pressure to the popliteal artery, behind the knee.

3 - Make a Tourniquet. The decision to apply a tourniquet should not be taken lightly because it might result in loss of limb. But if the bleeding is extremely severe and you have bandage or fabric on hand you can, consider making a tourniquet. 

        ~Wrap bandage tightly around the limb, between the wound and the heart, as close to the wound as possible. Wrap around limb several times and tie a knot. Leave enough fabric to tie a second knot around a stick. Twist stick to restrict blood flow.^[9]

Part Four: Treating A Sucking Chest Wound

1 - Recognize a sucking chest wound.  If a bullet has penetrated the chest, it is probable that a sucking chest wound exists. Air is coming in through the wound, but not coming out, collapsing the lung. Signs of a sucking chest wound include a sucking sound emanating from the chest, coughing up blood, frothy blood coming from wound, and shortness of breath. When in doubt, treat the wound as a sucking chest wound.^[10] 

2 - Find and expose wound. Look for the wound. Remove clothes from wound. If some fabric is stuck to the wound, cut around it. Determine if there is an exit wound and if so apply procedure to both sides of the victim’s wound. 

3 - Seal the wound on three sides. Take airtight material, plastic is best, and tape it around the wound, covering all sides except for the bottom corner. Oxygen will escape from this hole.^[11] 

        ~As you seal the wound, encourage the patient to completely exhale and hold his or her breath. This will force air out of the wound before you seal it.^[12] 

4 - Apply direct pressure to both sides of the wound.  It is possible to do this with two pads over each wound, held very tightly in place by a wrapped bandage. 

5 - Carefully monitor the patient's breathing. You can do this by talking to the conscious patient, or watching the chest rise and fall. 

        ~If there is evidence of respiratory failure (stopping breathing), reduce pressure on the wound to allow the chest to rise and fall.

        ~Prepare to perform rescue breathing.

6 - Do not release pressure or remove the seal you made when medical assistance arrives. They will either use your seal or replace it with a better one. 

Extra Tips

~When medical assistance arrives, be prepared to inform them what you have done so far.

~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).^[13] 

~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.

~Do not worry about having sterile dressings or dirty hands. An infection can be treated later. However, do take precautions to protect yourself from the victim's blood or other liquids. Do yourself a favor and wear gloves if at all possible.

~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.

~Pressure is key: it stops the flow and contains the blood to help create a blood clot.

~If a sucking chest wound is present, tilt the person on their side or blood may fill the other lung.

~Keep calm. If you panic you'll cause the victim to panic.

Warnings

~Avoid blood-borne illnesses. Make sure any open wounds you may have do not come in contact with the victim's blood.

~Do not put your own life at risk when treating a gunshot victim.

~And remember; even with the best first aid, gunshot wounds may be fatal.

Everything above was found at https://www.wikihow.com/Treat-a-Bullet-Wound

More information as well as citations and links to other sites can be found here, as well as excellent pictures and illustrations.

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Note: this next answer is from a different perspective. The previous answer focused on treating another person (i.e. you were out hunting with your buddy and he was accidentally shot), while this one focuses more on administering first aid to yourself. (i.e. scenes from movies like "Shooter", or any of the films in the Bourne series)

         

You just got shot.   

There’s no help and no medical facility for days. You are left to treat yourself.
 
Immediately, you'll be in a state of denial.  If you're hit in the body, you won't even register pain for a few seconds...just a tremendous pressure or the sensation of a focal shove where the bullet hit you.  Quickly thereafter, pain will be searing...a combination of shattered nerves from ripped flesh, chipped bones, torn viscera and burning from the bullet's frenetic energy dissipating into the surrounding flesh.  But mostly, you'll be in denial and shock.

Day One:

• Accept your reality. Every survivor accepts the cards dealt before them.  Non-survivors fight their reality: they continue to walk in denial of being lost rather than seeking shelter.  Your pain and sudden blood loss will evoke a sudden surge of circulating endogenous catecholamines – the same hormones that produces euphoria – the sensation of a "second wind" in the middle of a sporting activity.  Because of this, a part of your brain will convincingly reassure you that the wound is not serious.  Realize and accept you have a mortal wound and that the very next steps are crucial to your survival.

• Don’t get shot again. Seek shelter. Your mind may argue to save your energy, but cumulative GSW’s are no fun (just ask Michael Corrleone’s older brother Sonny).

• Address bleeding.   Extremity bleeding is relatively easy to control (use your belt as a tourniquet).  Internal bleeding is infinitely harder.  There’s no way you can apply direct pressure.  Don’t insert things into the bullet hole...you won't stop the internal bleeding and you may not be able to retrieve it later setting yourself up for infection and toxic shock syndrome (that will certainly kill you).  In any medical facility, ongoing internal hemorrhage is an indication for surgical exploration.  As this is not an option, take the following steps: 

1 -  Stay calm. High blood pressure from panic, stress and fear will pump the blood out of your system quicker than otherwise.  Control your breathing and stay calm to control your blood pressure. 

2 - Lay down. Laying down will significantly help direct what blood you have left to your brain to keep you alert and thinking clearly (i.e., blood does not have to fight gravity to get to your brain).  Prop your legs up to drain the blood in your feet  towards your head.  

3 - Preserve heat. Lay down on a surface that will preserve your heat (blanket, jacket, sleeping bag/pad).  Your body’s attempt at thermoregulation wastes a significant amount of energy.  Stay warm to keep your metabolic needs to a minimum.

4 - Drink. This is your only method of replenishing your intravascular volume.  Small amounts frequently to avoid vomiting.  

5 - Don’t worry about the wound right now. Don’t walk around wasting energy looking to clean or dress the wound.  If it’s a body shot, you just need to initially survive the blood loss.  Pray that your coagulation system will gain control of the hemorrhage...even a shattered spleen may be self-contained.  

Day Two:

If you survived your first night, chances are your hemorrhage is under control.

• Continue to drink. A lot.  You will likely feel dizzy, lightheaded.  Be careful when standing as you may faint.  This is in all likelihood due to anemia and dehydration.
• Inspect thoroughly. Remove articles of clothing to do so.  Entry wounds are clean.  Exit wounds are shambolic.  Whether or not the bullet remains within you doesn’t matter as you can’t do anything about it. 
• Thoroughly clean the wound (this is the most important step). Clean water is best, but anything should be fine.  Some would even advocate urine.  It doesn’t matter what type of fluid you use to wash just as long as you use large volumes of it and ideally under pressure.  Take a standard water bottle and poke a small hole.  Squeeze the bottle to create a jet stream to thoroughly irrigate your wound.  In the emergency room, we have a saying: The solution to pollution is dilution. 
• Don’t attempt to suture close any open wounds.  Leave the wound open to allow drainage of any pus that may result from a deeper infection.  If you confine the infection by closing the wound, you’ll set yourself up for sepsis (spread of bacteria/fungus into your bloodstream) which will likely kill you.  No matter how unpleasant the smell, a draining wound is always better and generally not life-threatening.
• Dress the wound.  Cover your wounds with a clean dressing.  Replace your dressing daily.
• You will likely struggle with a wound infection.  If possible place a warm compress directly on the infected wound.  Heat vasodilates the capillaries around the infected tissue which enables your immune cells to gain access to the infected site.   Repeat the warm compress multiple times throughout the day
• If the infection is getting worse, expose your wound to flies (don’t shoo them away).  Check for maggots and when you see them, cover your wound. 
• Remove maggots after they have debrided the necrotic tissue (before they start in on healthy tissue).  Flush with water copiously.  Constantly check the wound for new maggots and remove as you see them.
• Eat something.  Nutrition is a key component to fighting a serious infection.  Eat leafy green vegetables to replenish your iron stores.  Iron is key for your bone marrow to manufacture new red blood cells. 
• Get to a medical facility.  Don't forget about getting a tetanus booster.

You’ve just self-treated and survived your gun shot wound.

The information above was found at https://www.quora.com/How-do-I-treat-a-gun-wound  

The Quora answer was provided by Drew Young, who works at the Boston Children's Hospital. 

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Note: This next answer was provided by an actual doctor, and offers advice on the basics of how to treat a bullet wound in a survival situation when you can't get to a doctor.

First Steps in Gunshot Treatment

1. Stop the bleeding. Direct pressure, elevation, and a pressure bandage (in that order) usually works for most extremities. This might be the time for that fancy Israeli bandage you’ve got in your bag. (If you have one, you hopefully know how to use it. If you don’t have one, there’s no need for me waste your time explaining.) Find more about stopping bleeding, including the proper use of tourniquets, in The Survival Doctor’s Guide to Wounds.

2. Treat for shock. You should be doing this as you’re doing the other steps.

Cover the victim for warmth. Keep covered unless there’s a reason not to, such as you’re checking for wounds. Use medical-grade oxygen if you have it.

3. Strip the person and look over the whole body for wounds. You can’t just depend on looking for an entry and exit wound, thinking you know where the bullet has traveled. Sometimes the bullet can hit a bone, break into fragments, and stray anywhere in the body. And some types of bullets can cause multiple injuries.

Look everywhere. I read of one instance where there were two wounds to a leg—supposedly the entrance and exit wounds. After further exam and X-rays, two bullets were found in the chest, with multiple areas of damage in the intestinal tract. Although you don’t have X-rays in the field, check for difficulty breathing or abdominal pain.

Remember to cover the person back up as soon as you can. Death from hypothermia is a real risk.

Beyond the Basics

Get the victim to medical treatment ASAP. There are all sort of things that can go wrong. For one thing, if the bleeding won’t stop, surgery may be the only treatment that helps. Also, they may need blood transfusions. Neither of these is an option outside a medical facility.

In this post, I’ve talked about the basics of initial gunshot-wound treatment when you can’t get expert help right away. In my next post, I’ll go over more in-depth treatment for specific types of gunshot wounds.

The information above was found at http://thesurvivaldoctor.com/2012/07/24/gunshot-treatment/ and provided by  James Hubbard, M.D., M.P.H.

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The last answer in this post is actually provided by the same source as the one above, and is sort of a more in-depth look at how to treat 4 different types of gunshot wounds.

Signs of Internal Bleeding

Since you can’t see all the bleeding, it’s important to note the initial vital signs. Warning signs of internal bleeding include:

• Decreasing alertness
• Nausea/vomiting
• Weak pulse
• Lowering blood pressure, or faster and faster pulse.

Someone with internal bleeding is probably not going to survive without rapid transfer to a medical facility.

For a Gunshot Wound in the Head
Think about: the airway.

Tips:

1: Attempt to control the bleeding with direct pressure as best you can (no tourniquets around the neck).

2: Make sure the blood doesn’t choke the person. You can have a conscious person sit up and lean forward, or turn an unconscious person on their side and bend the top knee forward to keep them that way.

3: If you believe a carotid artery (that large artery on either side of the neck that supplies the brain) is nicked, you can apply soft direct pressure, and include an occlusive dressing.

For a Gunshot Wound in the Chest

Think about: air sucking, spine injury.

Tips:

1: Open chest wounds are also nicknamed sucking chest wounds because they suck air in and can lead to a collapsed lung. You can help stop the sucking by closing the open wound with an occlusive dressing.

2: Remember the spine is also included in the back of the chest. Be very careful about movement of these victims. You want to keep them as still as possible and not damage the spinal cord.

3: If the heart, the lungs, the spine, or a large blood vessel is damaged, there’s not much you can do outside getting immediate expert medical care.

For a Gunshot Wound in the Abdomen

Think about: organ protection.

Tips:

1: If the wound is open and you can see the intestines, find a moist, sterile dressing to place on top of the wound (to protect the organs).

2: If the intestines are ripped open, the victim needs immediate medical care. If they don’t bleed to death, they’ll likely die of the coming severe infection.

3: The victim should take nothing at all by mouth until the pain lets up, and then wait a day or two. This is obviously a difficult situation, but this step is very important and a time when a slow drip of IV fluids would be useful.

For a Gunshot Wound in the Arms or Legs

Think about: bones.

Tips:

1: Direct pressure, elevation, pressure bandage—in that order. Elevate the wound above the heart, and apply a pressure bandage. Then if it’s still bleeding, take your fingers and apply pressure to the brachial artery for the arm or the femoral artery for the leg. 

2: If all else fails in an extremity, go to a tourniquet. (It may come down to “lose a limb or lose a life.” See The Survival Doctor’s Guide to Wounds for dos and don’ts of tourniquet use.)

3: If the area is rapidly swelling, that’s a sign of internal bleeding. Also, consider that a bone might have been injured, even shattered. If you suspect this, the area needs to be splinted.

If an arm wound won’t stop bleeding despite direct pressure to the wound and elevation, press on the brachial artery around the place where the arrow in the left picture is pointing (below the armpit). Do this by grabbing underneath the person’s arm, wrapping your fingers to the artery (inner arm), and pressing firmly on it with your fingers. You’ll know you probably have it right when the bleeding slows down. If it’s still not controlled, try pressure nearer to the heart.

Here’s a trick to try it out now: Get a partner, and find the person’s radial pulse (in the wrist on the thumb side). Then grab the upper arm as described above. You should feel the pulse stop. Only do this for a couple of seconds, of course, since you’re stopping blood flow.
For a leg wound that won’t stop bleeding, apply pressure to the femoral artery, shown in the picture on the right. The best place to do this is in the middle of the bend between the front of leg and the hip.

For a Superficial Wound

If the gunshot wound is superficial, clean it as much as you can and follow the steps in “Puncture Wounds” in my e-book The Survival Doctor’s Guide to Wounds. Start antibiotics when you’re finished taking care of the wounds.

One More Thing: What About the Bullet?

In most circumstances, you don’t want to remove an implanted bullet. It’s almost impossible to find, and it may actually be corking up a big blood vessel.

Thousands of military members live daily with shrapnel in their bodies. Unless there’s initial infection from the wound itself, the body adapts to most metal without much serious problem.

Gunshot wounds can run the gamut. Some people are too severely injured to save. Get expert treatment as soon as possible.

The information above was found at http://thesurvivaldoctor.com/2012/07/26/gunshot-wounds/
and provided by James Hubbard, M.D., M.P.H.

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