How to help someone after a gunshot wound, according to doctors, experts

In just 144 days this year, there were 129 deaths in 101 mass shootings in the United States. It’s sparking a national movement born from national tragedy with a focus on saving lives. But would you know how to help someone after a gunshot wound?

An AR-style firearm has been the weapon of choice by some shooters who have carried out acts of mass violence -- along with handguns, and just last week in Texas, a shotgun.

Tom Dorsch is director of operations at On Target Range and Tactical Center in northwest suburban Crystal Lake. WGN asked him to show us how a semi-automatic rifle works.

“The length of the barrel adds to that velocity,” Dorsch said.

At 16 inches, the long-rifled barrel creates spin, propelling the round. Its diameter about the same as a 22 caliber bullet head but with more powder behind it—3,200 feet per second. That’s the distance of 10 football fields. Handguns don’t generate the same speed.

“That is where you have that tremendous transference of energy on the target,” Dorsch said.

“It transfers so much energy, it generates what’s called a cavitary lesion, which basically means it creates like a shockwave and that destroys the soft tissue. This individual has been shot with a high-powered rifle. As you can see it went through his calf, and it’s destroyed his tibia and fibula,” Dr. Amir Vafa, Mount Sinai trauma surgeon, said.

The wound is one Dr. Amir Vafa is familiar with. The Mount Sinai trauma surgeon cares for victims of gun violence in Chicago – some injured by shooters using high-powered rifles. He said velocity changes the nature of the wound. In one patient, the round hit the pelvis, shattering the bone beyond repair.

“A handgun bullet may end up getting stuck in the bone. It usually pops a small hole. It doesn’t create this fracture pattern,” Dr. Vafa said.

“Because from these high-powered velocity injuries, you see more severe injuries to the arteries to the veins and more severe bleeding,” Dr. Grace Chang, Mount Sinai trauma surgeon and part of Stop the Bleed Chicago, said.

But no matter the weapon, bleeding is a critical factor in deciding who lives and who dies.

“People can actually die within 15 minutes from severe bleeding. Sometimes that’s before they reach the hospital,” Dr. Chang said.

Mount Sinai trauma surgeon Dr. Grace Chang, along with the American College of Surgeons, wants everyone to learn bleeding control techniques. Shortly after the 2012 shooting at Sandy Hook Elementary School, trauma experts wondered how can more lives be saved in an active shooter or mass casualty event? The answer: The survivors—compelling uninjured and minimally injured victims to act before EMS arrives. In other words, teaching ordinary citizens to stop the bleed.

“It should be as easy as teaching CPR. You take any cloth or gauze that you have, and you actually apply direct pressure to the wound with both hands. You apply this pressure with a lot of pressure, which will actually cause a lot of pain,” Dr. Chang said.

If that doesn’t help, pack the wound.

“And you need to hold firm pressure with both hands, and don’t look to see if the bleeding stopped. You need to continually hold pressure until EMS arrives,” Dr. Chang said.

Tourniquets can be a bit trickier but may be necessary if bleeding doesn’t stop. Place the band two to three centimeters above the wound.

“This is the windlass. This is what you actually turn and that’s what tightens the tourniquet. Once it’s tight enough you’ll know because the bleeding will stop, and then you just Velcro on top and you put the time because you want the tourniquet to be in place for less than two hours. Eventually we’d like this to be taught with every single CPR course. We’d like to have a bleeding control kit with gauze and gloves everywhere you have an AED in public, so we want this to be as widespread in public as first aid,” Dr. Chang said.

Through the years we’ve gotten used to seeing first-aid kits on the wall or portable defibrillators in case of a sudden heart attack. But you may soon start seeing bleeding control kits. Inside they have gauze, gloves and a tourniquet. And as the Stop the Bleed movement increases the hope is so, too, will the knowledge of how to use these tools properly, in schools, in businesses and public places.

“There are days that go by where schools are ordering 200 kits to make sure every classroom has a kit.” Rob Rogers, president School Health Corp, said.

The orders are packed, taped and rolled out. School Health Corporation in west suburban Hanover Park supplies schools with first-aid products like thermometers, bandages, AEDs and now bleeding kits. Rogers said the items have been added at the request of their school customers across the country.

“It was a real troubling feeling inside, but the fact of the matter is that’s what’s happening in schools today,” Rogers said.

“Unfortunately, our society is more dangerous as we go on, but our goal is to make it safer and improve survivability from terrible tragedies that we see every day,” Dr. Chang said.

A March 2018 study found victims of blood loss who did not receive a tourniquet had almost six times greater odds of death.

For more information about Stop the Bleed, check out bleedingcontrol.org.