Gunshot Wound: First Aid, Recovery, and Outlook

A gunshot wound is one of the most traumatic injuries a person can experience. It often causes extensive damage, not just to the body but also to the mind. Each year, gunshot wounds claim thousands of lives, while many survivors endure lifelong scars, both physical and emotional. In 2022, over 45,000 firearm-related deaths were reported in the United States, with many more people sustaining injuries. Survivors often face challenges ranging from severe bleeding to infections, broken bones, and psychological trauma. This guide provides essential insights into managing gunshot wounds, promoting healing, and addressing the long-term effects of these injuries.

What to Do if Someone is Shot

When someone is shot, the first moments are critical for the survival of the victim. These are also called the platinum 10 minutes. During this time, the victim can face complications, such as airway obstruction, bleeding, or tension pneumothorax (collapsed lungs). Therefore, you have to stay calm and act swiftly to prevent further harm. This way, you will be able to identify the severity of the situation properly and take the necessary steps, which are discussed as follows:

1. Make Sure You and the Victim are Safe

Before helping, ensure the area is safe for you and the injured person. In active shooter situations, the safest option is to run if you can escape safely. If escape isn’t possible, hide behind solid barriers such as concrete walls, metal doors, or heavy furniture that can block bullets. Be sure to silence your phone and minimize movement to avoid drawing attention. Only attempt to help the victim once law enforcement has secured the area.

For accidental gunshots, check if the firearm is still present. If it is, carefully ensure the weapon is unloaded and placed out of reach to prevent further injury. If you’re unsure how to handle the firearm safely, leave it untouched and focus on assisting the victim while awaiting emergency responders. When the environment feels unsafe, and the shooter’s location is unclear, or there’s ongoing violence, call 911 before approaching the victim.

2. Call Emergency Services

Immediately call 911 or local emergency services once you’re in a safe position. Provide clear, specific information about your location, including building name, floor number, and nearby landmarks. Inform dispatchers about the number of victims, visible injuries, and any ongoing threats. 

Stay on the line unless instructed otherwise, as dispatchers can provide important first-aid instructions and relay critical information to responding emergency teams. 

3. Control the Bleeding

Severe bleeding is the main cause of death from shotgun wounds. Apply firm direct pressure to the wound using a clean cloth. If the wound is on an arm or leg and is not stopping the bleeding, place a tourniquet above the wound. A commercial tourniquet is preferred. However, if available, tie a tight knot in some fabric, like a shirt. Mark the time when you apply the tourniquet, as this information is important for medical teams.

Note that improper or prolonged tourniquet use can lead to nerve or tissue damage, so it should only be used when bleeding is life-threatening and cannot be controlled by direct pressure. Remove it only under professional supervision.

4. Check Responsiveness

Use the “tap-shout-tap” method, which is the first step in CPR. Tap their shoulder, shout loudly (“Are you okay?”), and tap again. Watch for breathing patterns, such as normal, irregular, or absent. If unresponsive and not breathing, begin CPR if trained. For adults, perform 30 chest compressions followed by 2 rescue breaths. If an AED is available, follow its automated instructions. Continue until professional help arrives or the person shows signs of life.

5. Monitor Vital Signs

You also need to watch for signs of shock, like pale or clammy skin, rapid breathing, confusion, or weakness. Keep the person warm with blankets or coats, but avoid moving them unless necessary. Monitor breathing patterns and pulse if you can do so safely. Look for additional wounds, as gunshots can have both entry and exit points. Keep track of any changes in consciousness or breathing to report to emergency responders. To help manage shock:

• Keep the victim warm using a coat, blanket, or clothing.
• Avoid giving them food or drink, even if they ask for it.
• If you’re sure there’s no spinal injury, gently elevate their legs about 12 inches to improve blood flow to the brain.
• Continue to monitor breathing and pulse, and look for entry and exit wounds from the gunshot. Report all findings to the emergency responders.

6. Gather Information

If the person is conscious, collect crucial details about allergies, medications, and medical conditions. Look for medical ID bracelets or phone emergency information. Note the time of injury and any changes in symptoms. Get emergency contact information if possible. Don’t remove any clothing unless necessary to find wounds, as this could disturb evidence that might be important for law enforcement.

Read more: How to Stop Bleeding: A Guide to Stopping Bleeding

How is Hospital Treatment Provided for Gunshot Wounds?

The doctors assess the severity of the shotgun wound at the hospital. The emergency teams conduct a thorough trauma evaluation using the ABCDE protocol (Airway, Breathing, Circulation, Disability, Exposure). They identify the severity based on the type of firearm, the speed of the bullet, and the location of the wound. The common treatment approaches after reaching the hospital include the following: 

Surgery

Once at the hospital, trauma surgeons may need to perform emergency procedures to control bleeding, repair damage, and remove bullet fragments. These procedures depend on where the bullet struck and how deep it traveled. This may include exploratory laparotomy for abdominal wounds, thoracotomy for chest injuries, or vascular repair for damaged blood vessels. The type of surgery depends on the wound location and severity of organ damage.

IV Antibiotics

Gunshot wounds are considered contaminated due to the bullet carrying clothing, skin, and environmental debris into the wound track. Broad-spectrum antibiotics are administered immediately to prevent serious infections like sepsis. The choice of antibiotics depends on wound location and suspected contamination level.

Common bacteria associated with gunshot wounds include Staphylococcus aureus, Clostridium species, and E. coli, especially in abdominal or soft-tissue injuries. The specific antibiotics chosen may vary depending on the location of the wound and likely contaminants.

Blood Transfusion

Rapid blood loss is addressed through transfusion of packed red blood cells, plasma, and platelets as needed. For victims with severe bleeding, hospitals initiate massive transfusion protocols (MTP) for severe cases. This involves carefully balancing the delivery of red blood cells, plasma, and platelets to restore oxygen-carrying capacity and support blood clotting.

Medical teams also monitor electrolyte levels and clotting factors to avoid complications such as acidosis, hypothermia, or coagulopathy (inability to clot properly), which can make resuscitation more difficult.

Pain Management

Initially, doctors may use IV opioids for fast pain relief, along with nerve blocks for targeted pain control. Anti-inflammatory medications may also be prescribed to reduce swelling around the injury.

Long-term pain or complications can arise, especially when injuries affect nerves, organs, or bones. In such cases, a multimodal pain management plan is often necessary. This may include:

• Physical therapy to regain strength and mobility,
• Psychological support or counseling for trauma recovery or PTSD,
• Chronic pain medications, such as gabapentin or non-opioid analgesics,
• Occupational therapy for adapting to any lasting physical impairments.

Patients may also be referred to pain specialists for tailored treatment plans that balance pain relief with overall functional improvement.

Gunshot wounds that pass through without touching major organs heal faster. However, if the wounds damage organs, bones, or arteries, they may require more specialized care and leave permanent damage or scars.

What Steps To Take For Gunshot Wound Care?

Once the victim receives first aid and comprehensive treatment in the hospital later, they need to ensure good wound care for quick recovery. It prevents infection, aids in healing, and minimizes complications. Follow the below steps to care for your gun shot wound:

1. Wound Care 

Gunshot wounds may need to be covered with dressings that must be changed frequently. The victim also needs to keep the wound clean and dry. Apply the antibiotics prescribed by the doctor to prevent infection and bullet wound scars. Moreover, avoid alcohol, peroxide, and antibacterial soaps unless your doctor recommends them. These can irritate healing tissue. Elevating the injured area above the heart level can also help reduce swelling. If your doctor approves, ice on the bandage may also be useful.

To prevent infection and minimize scarring, apply prescribed topical antibiotic ointments, such as bacitracin, mupirocin (Bactroban), or silver sulfadiazine if recommended. Avoid using alcohol, hydrogen peroxide, or harsh antibacterial soaps on the wound unless explicitly instructed, as these can delay healing by irritating tissue.

2. Monitor for Signs of Infection

Gunshot wounds are at risk of becoming easily infected. Thus, once the gunshot wound is healed, patients should seek medical attention if they notice redness or swelling around the wound. Common infections following gunshot wounds include cellulitis (a skin infection) and osteomyelitis (a serious bone infection). These can develop even after the wound appears to be healing on the surface. 

Additionally, they should connect with their care provider if thick, yellow, or foul-smelling drainage also occurs. Moreover, a fever lasting for more than four hours at over 100°F can also be a sign of infection.

3. Immersion and Hygiene

Hygiene is especially important during recovery. Until the wound has fully closed, avoid immersing it in water. This includes baths, hot tubs, swimming pools, or lakes, as soaking can introduce bacteria. Instead, take brief showers and protect the wound with a waterproof barrier or dressing if advised by your doctor.

When cleaning the area, use gentle soap and clean, lukewarm water. Rinse lightly and pat dry with a clean, sterile towel. In cases where water access is limited (e.g., remote areas, disasters), use sterile saline solution, alcohol-free wound cleansing wipes, or pre-moistened antiseptic pads. Always follow your healthcare provider’s instructions for wound cleaning and dressing changes. 

4. Pain Relief

Follow prescribed pain management protocols strictly. Take medications exactly as directed by your healthcare provider. Avoid over-the-counter pain relievers unless specifically approved, as some can interfere with healing processes.

Recovery of Gunshot Wounds

Recovery from a gunshot wound depends on the injury’s severity and location. Some wounds heal within weeks, while others require years of treatment and may lead to lasting physical or emotional effects.

• Physical Recovery

Physical recovery often involves multiple stages of treatment. Many survivors need physical therapy to restore mobility, especially after fractures or muscle injuries. They may also commonly experience chronic pain, particularly if bullet fragments remain in the body. Thus, in some cases, extra surgeries may be required to address complications like infections, bullet wound scar, or nerve damage. The doctor may also suggest certain pain medications and an effective wound care strategy to aid recovery.

For individuals facing financial challenges, programs such as Medicaid, charity care programs, or victims’ compensation funds may assist with medical costs, rehabilitation, transportation, and assistive devices. Veterans or those covered under workers’ compensation may also access specialized support.

• Emotional Recovery

Even though a gunshot wound is healed, it often leaves emotional scars. Survivors may experience anxiety, depression, or post-traumatic stress disorder (PTSD). Nightmares and panic attacks are also common. Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for trauma-related conditions, helping individuals reframe harmful thought patterns. For these survivors, talk therapy can help process these feelings and regain emotional stability. They can also join support groups and connect with individuals who have faced similar experiences. Other options include:

• Eye Movement Desensitization and Reprocessing (EMDR),
• Trauma-focused therapy,
• Medication for anxiety or depression, prescribed by a psychiatrist.

Also read: How to Attend to a Stab Wound with First Aid: A Comprehensive Guide

Long-term Effects and Complications of Gunshot Wounds

Gunshot wounds can leave survivors with lasting disabilities. Spinal injuries may cause paralysis, impacting mobility and independence. Some individuals experience chronic pain due to bullet fragments that remain lodged in their bodies. Broken bones or nerve damage can result in limited movement, which requires long-term rehabilitation and adaptive strategies to manage daily life.

These gunshot injuries can cause severe complications, including the following:

• Infections: Bullets can carry debris and bacteria deep into the body, increasing the risk of severe infections. Proper wound care and antibiotics are critical to prevent complications.
• Organ Damage: Injuries to vital organs like the liver, intestines, or blood vessels often require emergency and complex surgeries. These injuries may result in long-term health challenges.
• Amputation: Severe damage to limbs may necessitate amputation when repair is impossible. This requires physical and emotional adjustment.
• Paralysis: Spinal cord injuries can cause partial or complete paralysis, depending on the damage’s location and severity.
• Brain Injuries: Head wounds may lead to memory loss, difficulty with motor coordination, persistent headaches, or other neurological issues.

Even if the victim is treated immediately, the survivors are left with constant after-effects, including visible marks and chronic illnesses. Some factors determine survival for gunshot wounds. These include:

• The number of wounds
• The location of the wound
• Time the victim receives medical attention

Generally, wounds to the arm and leg have a better survival rate than wounds to the head and chest. On the whole, bigger bullets and high-powered guns mean more serious injuries.

Technological Aids And Funding Options for Survivors

For individuals with severe disabilities, community resources can be life-changing. Many organizations or state-level independent living centers provide access to technological aids and mobility devices and financial aid for home modifications, assistive tech, and care assistance. 

Technological Aids & Devices

Gunshot wound survivors with long-term disabilities can benefit greatly from assistive technology that restores independence and mobility. Motorized wheelchairs and scooters with customizable features provide daily comfort and mobility. In addition, wearable exoskeleton suits like ReWalk allow some individuals with spinal injuries to stand and walk with support. 

Environmental control units (ECUs), often integrated with smart home systems like Alexa or Google Home, let users control household devices using voice or switches, which is ideal for those with limited mobility. For survivors with speech or cognitive challenges, assistive communication devices like speech-generating tablets or text-to-speech apps offer essential support in expressing needs.

Funding & Financial Assistance

Financial support is available through several channels. Crime Victims Compensation Programs in most U.S. states help cover medical bills, therapy, and assistive equipment for survivors of violent crimes. Medicaid Waiver Programs offer long-term care support, including home modifications and mobility aids, for those who qualify. 

State-run Vocational Rehabilitation Services can also fund training, education, or adaptive tech for individuals returning to work. Additionally, nonprofit organizations such as the Reeve Foundation and Help Hope Live provide grants and crowdfunding platforms to ease the financial burden of ongoing care and equipment needs.

Prevent Gunshot Injuries: Act Today for a Safer Tomorrow!

The end of gun violence would help in lowering the number of gunshot wounds. It is also important to support gun safety, teaching, and stronger gun laws. Therefore, everyone should take a basic first-aid training course. During emergencies like gunshot wounds, the knowledge of first aid enables bystanders to respond quickly and effectively to save a precious life.

Gun violence leaves deep physical and emotional scars that can last a lifetime. Thus, survivors need comprehensive support, both medical care and mental health resources, to heal fully. While we work together as a community to prevent these tragic incidents, we must also prepare ourselves to help in emergencies!

FAQs: 

1. What is the first aid for bullet injury?

First aid focuses on controlling bleeding and keeping the injured person stable. Apply firm pressure with a clean cloth to stop bleeding. If bleeding is severe, use a tourniquet above the wound. Keep the person still and calm. Call emergency services immediately. Avoid removing objects from the wound, as this may worsen damage.

2. How long does it take for a gunshot wound to heal?

The healing time depends on the severity and location of the wound. Minor injuries may heal in 6 to 8 weeks, while severe wounds can take months or even years. Factors like the extent of tissue damage, infection risk, and any required surgeries also affect recovery time. Physical therapy may be needed for full recovery.

3. What to do after a gunshot wound?

Follow medical advice for wound care. Keep the area clean and dry, and change dressings as instructed. Take prescribed antibiotics and pain relievers. Elevate the wounded area to reduce swelling. Watch for signs of infection, such as redness, fever, or unusual discharge. Seek emotional support to address any psychological effects, including PTSD.

4. What is the survival rate for gunshot wounds to the heart?

Gunshot wounds to the heart are extremely dangerous. Survival rates depend on the speed of medical care and the exact injury. Studies show that immediate surgery can save up to 35% of cases. Without prompt intervention, these injuries are almost always fatal due to massive blood loss or cardiac damage.

5. What are the complications of gunshot wounds?

Complications include severe bleeding, infections, and damage to organs, bones, or nerves. Internal injuries can lead to long-term problems like chronic pain or paralysis. Psychological effects, such as PTSD or depression, are common. In some cases, amputation or permanent disability may result.