Treating Gunshot Wounds to the Hand Before Medical Help Arrives

Gunshot wounds require emergency medical attention. However, knowing how to provide first aid until professional help arrives can be crucial for saving a life. Gunshot wounds to the hands and fingers are especially dangerous because there are so many blood vessels, nerves, tendons, and small bones that can be damaged.

Stop the Bleeding

The first priority with any gunshot wound is to stop the bleeding. Apply direct pressure on the wound with a clean cloth or piece of clothing. Elevating the injured hand above the level of the heart can also help slow blood loss. If possible, use a tourniquet above the wrist or elbow to cut off blood flow to the hand. Tighten it until the bleeding stops. Note the time you applied the tourniquet.

Pack the wound with gauze or clean cloth if you have it available. Apply pressure over the packing material. If blood soaks through, add more material on top rather than removing the original dressing. Once bleeding is controlled, wrap the wound securely with a bandage.

Immobilize the Hand

It's important to immobilize an injured hand to prevent further damage. Make a splint using a firm object like a board, stick, or even a rolled up magazine. Pad the splint before strapping it to the forearm to keep the wrist and hand from moving. Be careful not to make it too tight.

If fingers are injured, buddy tape them together to limit motion. Put padding between fingers for comfort if possible. Keep the hand elevated above heart level to reduce swelling.

Watch for Signs of Shock

Gunshot wounds can lead to dangerous blood loss. Monitor the victim for signs of shock like pale, cool, clammy skin; rapid breathing; weakness or dizziness; and confusion. Keep the person warm using coats or blankets, but do not overheat them.

If the person loses consciousness, lay them on their back and elevate their feet about 12 inches. Do not give them anything to eat or drink.

Additional Wound Care Tips

- Do not remove any clothing or material stuck in the wound as it may be helping control bleeding. Cut around stuck material if you need to expose the wound.

- Do not rinse the wound or apply ointments, powders, or anything else into it.

- Monitor circulation beyond the injury site by checking skin color and temperature. Pressing down on the fingernail and seeing how fast blood refills it can also check capillary refill.

- Record vital signs like pulse, breathing rate, and level of consciousness so you can provide this information to emergency responders.

- Be prepared to perform CPR if the person stops breathing or their heart stops beating before medical help arrives.

- Keep yourself safe. Put on protective gloves if available when dealing with wounds. Cover any of your own cuts or abrasions.

Be Ready to Go to the Hospital

Even with the best first aid, a gunshot wound requires emergency medical care. Call for emergency assistance as soon as it is safe to do so. When transport arrives, be ready with any supplies and the victim's personal information like medications.

Give the emergency responders a clear report about what happened, how long the victim has been bleeding, and the care you have provided. Follow any instructions they give you.

Depending on the nature and extent of the gunshot injury, the victim may require surgery and a hospital stay to treat damaged bones, nerves, and soft tissues. Healing can be a long process requiring months of rehabilitation.

Potential Damage Caused by Gunshot Wounds to the Hand

The hands contain an incredibly complex collection of bones, blood vessels, muscles, tendons, nerves, and soft tissues. All of these structures are at risk of damage when a bullet passes through the hand.

Bone and Joint Injuries

There are 27 bones in each hand and wrist. A gunshot can fracture or shatter any of these bones. This may require reconstructive surgery to repair. Joint spaces can also be damaged, leading to traumatic arthritis.

Vascular Damage

Several arteries and veins run through the hand to supply it with blood. The radial and ulnar arteries provide circulation to the fingers and palm. Gunshot wounds can sever these vessels, causing extensive bleeding. This requires surgical repair to prevent loss of the limb.

Nerve Injuries

Major nerves like the median, ulnar, and radial nerves control fine motor function and sensation in the hands. They pass through narrow spaces in the wrist that make them vulnerable to injury. Nerve damage may impair movement or feeling even after the wound itself has healed.

Tendon Lacerations

Tendons connect muscles to bone, allowing the fingers to flex and extend. They lack the protective coverings that shield nerves and vessels. A gunshot can easily sever flexor and extensor tendons in the hand or fingers, robbing them of function. This requires surgical tendon repair.

Soft Tissue Damage

The tissues in the hand are delicate. The passage of a bullet can damage skin, muscle, ligaments, and fat. Tissue loss, scarring, and wound infections are common complications. Healing may require skin grafts.

Infection Risks with Gunshot Wounds to the Hand

Any traumatic hand or finger injury risks dangerous infection because there are so many hiding places for bacteria. With gunshot wounds, the bullet pushes debris and contaminants into the tissues. Warning signs of infection include:

- Increased pain, swelling, or redness
- Green or foul-smelling drainage
- Red streaks spreading from the wound
- Fever or chills

Seek emergency medical care if you notice these infection signs. The doctor will likely prescribe intravenous antibiotics. Severe infections may require hospitalization for treatment.

Preventing Infection

There are steps you can take to lower the risks of infection if someone suffers a hand gunshot wound:

- Carefully clean the wound if debris is visible after bleeding is controlled.
- Apply antibiotic ointment if available.
- Keep the hand elevated to reduce swelling.
- Handle the injury with clean hands and tools.
- Cover with a sterile bandage.
- Check for signs of infection and seek medical care promptly.

Even with good first aid, infections may still develop after a gunshot injury. But diligent wound care gives the person the best chance at healing.

The Emotional Impact of Gunshot Wounds

Recovering from a serious hand or finger gunshot injury involves much more than just the physical trauma. There can be significant emotional impacts as well.

Pain and Loss of Function

Healing from a gunshot takes time. Ongoing pain during the recovery, as well as permanent stiffness, numbness, or disability can be demoralizing. Physical and occupational therapy helps improve function, but may not restore full use.

Post-Traumatic Stress

Experiencing gun violence can lead to psychological trauma. Anxiety, flashbacks, and difficulty coping are common. Seeking counseling and joining a support group may help the injured person process the incident in a healthy way.

Impact on Work and Livelihood

For those whose jobs depend on hand function, like surgeons or musicians, gunshot injuries can be career-ending. Even everyday tasks become difficult. Support services can assist in making adjustments and exploring new opportunities.

Financial Hardships

There may be significant medical bills, loss of income, disability costs, and other expenses following a severe hand injury. Organizations exist to help cover costs and provide practical support to survivors and their families.

Anger and Depression

It is natural to feel anger following a traumatic event, especially when it leads to

FAQs

How do I stop bleeding from a gunshot wound to the hand?

Apply direct pressure to the wound with a clean cloth. Elevate the hand above heart level. Use a tourniquet above the elbow or wrist to cut off blood flow. Pack the wound and wrap it securely if bleeding continues.

Should I remove any objects stuck in the wound?

No, leave any foreign material like clothing or debris in place. It may be helping control bleeding. Cut around embedded items if needed.

How can I lower the infection risk?

Carefully clean the wound if possible. Apply antibiotic ointment and cover with a sterile bandage. Keep the hand elevated to reduce swelling. Monitor for signs of infection like fever, redness, or foul drainage.

What are the emotional impacts of a gunshot wound?

There can be trauma, anxiety, depression, financial hardship, anger, and PTSD after experiencing gun violence. Seeking counseling and support groups can help with coping.

How long does recovery take from a hand gunshot wound?

Healing takes months and may involve surgery, rehabilitation, and therapy. Some permanent stiffness, pain, numbness or loss of function is likely even after recovery.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.

Treating Gunshot Wounds to the Hand Before Medical Help Arrives