How to Treat a Gunshot Wound to the Arm
A gunshot wound to the arm may be less life-threatening than a gunshot wound to the chest or head, but it’s still life-threatening nonetheless—especially without prompt intervention. This type of injury can severely damage bones, tendons, muscles, and major blood vessels, and it can also cause severe bleeding that leads to traumatic blood loss. If you or someone else sustains a gunshot wound to the arm, begin emergency procedures immediately.
Treating Gunshot Injuries to the Arm in 7 Steps
To stop the arm from bleeding, you’ll ideally need the following items:
- Latex gloves
- A sterile dressing
- Roller gauze (preferably a hemostatic variety)
- Sterile bandages
- A commercial tourniquet
Most of these items can be found in a first aid kit. The tourniquet should be included as part of a bleeding control kit. If you don’t have these items, you’ll need to use improvised dressings. Clean clothing or other cloth materials can work for this purpose.
1) Locate the Bullet Wound
If there’s a lot of blood present, the location of the wound might not be immediately obvious. You’ll have to examine the arm carefully and look for both entrance and exit wounds. Be careful when examining the arm and (if necessary) when moving the victim to a safe location. You don’t want to move the patient’s arm too aggressively, as a gunshot wound can shatter bones.
2) Apply Direct Pressure
Put on the latex gloves (if you have them), and apply direct pressure to the wound using your sterile dressing. The pressure should be extremely firm to the point of being uncomfortable. The skin should bow beneath your hands as you press down. In an ideal situation, this will help the blood to clot so that the bleeding slows down or stops altogether.
3) Elevate the Arm
With the victim lying flat on their back, elevate the injured arm above the victim’s heart and try to keep it elevated until help arrives. Research shows that elevating a hemorrhaging limb can slow the bleeding down. If you’re the one who’s injured and you’re unable to raise your arm, just continue applying pressure.
4) Call 911
If someone else is available to call 911, they should do so as soon as the injury occurs and while you begin your intervention. However, if you’re the only able-bodied person who’s present, it’s a good idea to call 911 while you’re already applying pressure. This will help to minimize blood loss. Put the phone in speaker mode and communicate with the dispatcher as you continue applying firm pressure.
5) Cover the Wound
If the patient is able to assist you by applying pressure themselves, have them hold the dressing in place while you secure it with gauze. Hemostatic gauze works best because it contains agents that assist with the clotting process. However, if you don’t have hemostatic gauze available, you can use standard gauze. If no gauze is available, continue applying pressure with your clean cloth material.
6) Monitor the Victim
While continuing to maintain firm pressure, you want to examine the wound closely to determine when and if the bleeding stops. Don’t lift the dressing to examine the rate of blood flow. Just note whether blood is still seeping through the dressing. If the bleeding continues, place additional gauze over it. If the bleeding slows to a trickle or stops altogether, cover it with a sterile bandage and wait for help to arrive. If you’ve done everything up to this point and the bleeding is still uncontrolled, proceed to the next step.
7) Apply a Tourniquet
In cases of severe uncontrolled bleeding when direct pressure alone doesn’t do the trick, you may need to apply a tourniquet. This is often the case in instances of arterial bleeding, whereby a ruptured artery causes blood to spill out of the body in rapid, rhythmic spurts. Arterial bleeding can cause a victim to bleed out in as little as 2 minutes without intervention. If you have a commercial tourniquet available, the application steps are as follows: Slide the tourniquet over the limb and situate it at least two inches above the injury (avoiding any joints). Then turn the windlass repeatedly until the bleeding stops. Write down the time of application on the tourniquet or on the patient’s forehead. See our full guide, How to Apply a Tourniquet Correctly, for more detailed information.
Treating Severe Gunshot Wounds to the Arm
When emergency services arrive, the real work begins. Medical professionals may provide various medications to manage pain and to prevent infection. A tetanus shot may also be advised. The victim may be given IV fluids to restore blood flow to vital organs and prevent dehydration. In the event of heavy blood loss, doctors may deliver a blood transfusion.
In some cases, surgery may also be required, such as if:
- The bullet needs to be removed from the arm
- The bones, tendons, or ligaments needs to be repaired
- The site of the gunshot injury needs to be cleaned and disinfected
- The wound needs to be closed with stitches or staples
Following discharge, the doctor or medical team will advise on aftercare. Common aftercare essentials include:
- Washing the wound with soap and water
- Replacing bandages regularly
- Applying ice to the wound periodically
- Frequently elevating the arm above the heart to reduce the risk of swelling
- Constantly monitoring the wound for signs of infection
- Physical therapy to restore a full range of motion
In addition, recovering victims are advised to seek medical assistance immediately if they experience warning signs to the injury site such as bleeding, numbness, tenderness, swelling, coldness to the touch, lightheadedness, or trouble breathing.
A Gunshot Wound to the Arm Is Treatable
While gun-related chest injuries and abdominal gunshot wounds are immediately life-threatening, a gunshot to an extremity like the arm is extremely treatable. The biggest threat is traumatic blood loss. As long as you remain calm, apply pressure, and minimize the loss of blood until emergency services arrive, the prognosis is excellent.
The best thing to do is to prepare for such a medical emergency before it happens. Invest in a Stop the Bleed® Kit, have a quality first aid kit close at hand, and understand the essentials of what to do in a bleeding emergency.