{"id":100614,"date":"2024-03-10T17:43:45","date_gmt":"2024-03-10T23:43:45","guid":{"rendered":"https:\/\/milesfortis.com\/?p=100614"},"modified":"2024-03-10T17:43:45","modified_gmt":"2024-03-10T23:43:45","slug":"100614","status":"publish","type":"post","link":"https:\/\/milesfortis.com\/?p=100614","title":{"rendered":""},"content":{"rendered":"

Lifesaving Skills Every Gun Owner Should Know<\/a><\/p>\n

With regard to home or personal defense, everyone knows the line: \u201cWhen seconds matter, help is minutes away.\u201d Such logic is the reason many of us carry daily or keep a firearm bedside. But what about those moments outside the home, perhaps in a remote location? We are indeed our first responder but it remains important to understand the term \u201cfirst responder\u201d applies to more than just those personnel carrying a sidearm.<\/p>\n

A critical situation \u2014 when emergency medical services are necessary \u2014 can happen anywhere, and it may occur when no threat is present. It could be a rural range, when you and friends are stretching the rifle out to a mile.<\/p>\n

Or in the backcountry, chasing elk. Accidental discharges \u2014 whether user or equipment error \u2014 are a scary reality. They happen.<\/p>\n

In these moments, that line we can recite like the Pledge of the Allegiance becomes: \u201cWhen seconds matter, help is hours away.\u201d<\/p>\n

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OVER 50 YEARS OF TRAUMA AND LIFESAVING EXPERIENCE<\/h2>\n

Dr. David Acuna, 62, has been a trauma surgeon for 30 years and serves as the Trauma Director at Wesley Medical Center, a Level I trauma center in Wichita, Kansas.<\/p>\n

A\u00a0first-generation American with a father from Argentina, Acuna grew up a farmer in Ohio but at a young age became fascinated with the world of trauma and surgery. He trained in the early \u201990s in Dayton, Ohio, which, at the time, was the number-one dual-homicide city in the nation (meaning two people died during the incident).<\/p>\n

\u201cDayton is at the crossroads between I -70, which crosses the country, and 75, which goes from Detroit down to Miami,\u201d he said. \u201cRight in the middle of cocaine central. So I\u2019ve taken care of so many gunshot wounds. Sometimes they got shot in the hospital parking lot. It was that crazy. Just a crazy time to train. There was almost not a day that I was not in the operating room tending to a gunshot wound.<\/p>\n

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The Wesley Medical Center trauma team occasionally, via ballistic gels, tests the effects of various-caliber bullets through different clothing. Pictured here are the results of a .22LR and a 9mm shot into gel clothed in denim.<\/em><\/span><\/span>\u00a0<\/figcaption><\/figure>\n

\u201cI trained in the glory days of trauma,\u201d he said. \u201cThe only place that you could go now to get that kind of volume is probably Chicago, Detroit, DC. I\u2019m sure LA is the same way. You\u2019d have to go to some huge city now to get the kind of volume that we had when we trained.\u201d<\/p>\n

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Growing up on a farm, Acuna became familiar with firearms at an early age, but it wasn\u2019t until 2005, following an incident with the family of a stabbing victim, that his view of guns changed completely. \u201cThe family told us that if we didn\u2019t save her, they were going to kill us,\u201d Acuna said. \u201cI could not \u2014 I did not save her.\u201d<\/div>\n
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Escorted by local police, Dr. Acuna shared the tragic news with the family and was attacked. Police intervened immediately. The next day, his wife was carjacked by gunpoint in an unrelated event.<\/p>\n

\u201cThat changed our world,\u201d Acuna said. \u201cOur house immediately became a gun house. I had to re-teach my dog how to bark, because we\u2019d tell him how to not bark. And I changed the way I was raising my boys.<\/p>\n

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Dr. Acuna holds a general kit to open the chest and clamp major structures that could be bleeding (e.g., blood vessels, lungs, or heart). Once the bleeding is stopped, the patient is immediately transported to the operating room.<\/em><\/span><\/span>\u00a0<\/figcaption><\/figure>\n

\u201cNow it\u2019s not just a need, but it\u2019s become kind of almost a lifestyle,\u201d Acuna said. \u201cI\u2019m very familiar with, professionally, the consequence of firearm activity, but I also understand the need to have them.\u201d<\/p>\n

THE 7 LIFESAVING SKILLS YOU SHOULD KNOW IN ORDER OF PRIORITY<\/h2>\n

1. Apply immediate and proper pressure.<\/h3>\n

\u201cIt literally takes one, at most two, fingers to stop the hemorrhage,\u201d Acuna said. \u201cYou don\u2019t want to get on the phone to call 911 when the patient\u2019s lifeforce is going into the ground.\u201d<\/p>\n

Find where the injury is, and then if there\u2019s an active hemorrhage, put two fingers on it and stop it. Once you\u2019ve done that, you can take a couple of breaths, get yourself re-oriented, calm yourself down so you can think, and determine, \u201cOK, and you should be able to feel with just your fingers, is it arterial or is it not arterial?\u201d<\/p>\n

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If it\u2019s an arterial hemorrhage, you\u2019re going feel it. If it\u2019s venous, you likely aren\u2019t. Venous has such low pressure that you can literally not feel the pulsation on your finger with the pressure gradient so low. Nevertheless, treat every bleed as if it\u2019s arterial until you can verify otherwise. Use a finger or two immediately.<\/p>\n

2. Secure a tourniquet.<\/h3>\n

If the patient is experiencing arterial hemorrhage on a limb, fastening a tourniquet may be your best option. Because an artery can retract 4 to 5 inches, it is advisable to secure a tourniquet 4 to 5 inches up from the wound, between the torso and the wound.<\/p>\n

Applying a tourniquet should also hurt like hell for the patient. \u201cI tell my patients, \u2018This going to be the worst pain of your life,\u2019\u201d said Sutton, \u201c\u2018But it\u2019s going to save your life.\u2019\u201d<\/p>\n

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Stopping the bleed with a tourniquet leaves you able to do other things, such as call 911 or work toward transporting the patient, if necessary. However, if the wound is too close to the torso, or on the torso or on the neck or above, a tourniquet isn\u2019t an option, and you must begin packing the wound.<\/p>\n

Note: Practicing with a tourniquet is crucial, but also understand once a tourniquet is used once, it\u2019ll no longer function at the necessary life-saving level. \u201cOnce a practice tourniquet, always a practice tourniquet.\u201d<\/p>\n

3. Pack a wound.<\/h3>\n

Start with QuikClot combat gauze, if you have it. If not, 2\u00d72 gauze may work. Compressed gauze is another option for deep wounds where direct pressure alone will not stop the bleeding.<\/p>\n

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Packing a gunshot wound, generally speaking, proceeds one knuckle length of gauze at a time until the wound is stuffed. Continue to apply pressure until the bleeding stops. Should you stop applying pressure and the bleeding continues, understand that you\u2019re starting from zero once you start reapplying pressure. Keep the pressure on until you\u2019re certain you\u2019ve stopped the bleeding.<\/div>\n

Once you\u2019re certain, you can wrap the wound with emergency trauma dressing and address other logistics. But also remember, when dressing a wound, just because you can\u2019t see bleeding, doesn\u2019t mean the wound isn\u2019t bleeding, so be careful with dressing too early.<\/p>\n

\u201cAs a paramedic student, we ran a call just south of here,\u201d Sutton said. \u201cFire responded and the ambulance responded. Fire responded and because it was a dialysis patient near their fistula they were bleeding horribly. Firefighters put huge bulky dressing on, and we were so close to Wesley we were like, \u2018Fine, let\u2019s go.\u2019 When we get to Wesley and that bulky dressing was pulled off, it was clear we hadn\u2019t stopped anything.<\/p>\n

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You should crack open your medical kit more than you do your favorite book. It\u2019s important to confirm contents are neat and in the order you\u2019ll need them. Plus, doing so serves as a great refresher of what you have in there. Sometimes, especially when owning multiple med kits, it\u2019s easier to forget what is where.<\/p>\n

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\u201cThe doctor kind of put us in our place, held up two fingers. But also a valuable lesson that day: do not assume another health care worker did the right thing.\u201d<\/p>\n

4. Communicate with 911.<\/h3>\n

Note how this doesn\u2019t read \u201cCall 911.\u201d You need to be able to communicate your location and the condition of your patient. Are they conscious? Can they talk? If they can\u2019t respond to your questions or talk, that means they\u2019ve likely lost 30 to 40 percent of their blood.<\/p>\n

Communicating with 911 could also serve the purpose of calming down you or someone in your party, as dispatchers are trained in being able to mitigate stress of callers. If the person next to you is freaking out, have them talk with 911 while you use your hands to work.<\/p>\n

Knowing your location in relation to the nearest medical facility is also crucial and should, ideally, occur ahead of travel. Example: If you anticipate spending the morning at a long-distance range, mark the closest facilities ahead of arrival. If medical services are farther than a half hour out, you may need to move the patient.<\/p>\n

\u201cSometimes the best resuscitation fluid is diesel fuel,\u201d Acuna said. \u201cYou just need to get them from point A to point B as fast as you can. Get them to where they can get the help.\u201d That could also mean meeting paramedics halfway, as paramedics will have the necessary IVs and likely O-negative blood to administer.<\/p>\n

Communication is paramount. The more concise, pertinent info that can be exchanged, the better. It\u2019s more than just a phone call.<\/p>\n

5. Prevent body-heat loss.<\/h3>\n

\u201cSo we\u2019re going to go back to chemistry 101,\u201d Acuna aid. \u201cCatalysts. Our body is a chemical thing, and catalysts are also driven by temperature.\u201d<\/p>\n

Within the coagulation cascade, those catalysts work at an optimal temperature range. And outside of that optimal temperature range, those catalysts won\u2019t work as effectively. So when a patient gets cold, they tend not to clot, which is why it\u2019s so important to keep the patient warm.<\/p>\n

\u201cIn fact, our trauma bays are hot,\u201d Acuna said. \u201cPeople hate working in there. It\u2019s just like 85 to 86 degrees in there. Because we don\u2019t want the patient to get hypothermic and cold.<\/p>\n

\u201cSo even in the summertime, let\u2019s say it\u2019s 75 degrees out and a patient is lying on the ground \u2014 guess what? They\u2019re getting cold. That ground is a massive heat sink. And 96.8 degrees is slowly dropping, because you\u2019re sitting on a ground that may have a temperature of 75 degrees.<\/p>\n

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Aaron Sutton, age 43, is the Trauma Outreach and Injury Prevention Coordinator at Wesley Medical Center and possesses over 20 years of EMS and trauma-bay experience. In addition to his work at Wesley, Sutton works a second job as MEDVAC EMS in western Kansas. He also serves as a \u201cStop the Bleed\u201d instructor in his region. His overall advice: Practice. And practice with family or household members. \u201cIf your heart stopped right now, I wouldn\u2019t feel emotion till later,\u201d he said, \u201cbut it\u2019d be CPR, monitored, because we do that training so much as medics. I could run code in my sleep.\u201d<\/p>\n

<\/em><\/span><\/figcaption><\/figure>\n

So it may not seem cold to you, but a patient who\u2019s in stress is all of a sudden starting to get colder and colder and colder, especially when their life force is poured out on the ground. Now your heart rate\u2019s going up, and you\u2019re going to cool off even faster.\u201d<\/p>\n

What this means: Have a thermal blanket on hand. It could be something as simple as those cheap aluminum foil blankets that you can purchased neatly and tightly packed into little squares.<\/p>\n

We also lose the majority of body heat through our heads. Though it may be summertime, it may make sense to include a quality winter hat in your med kit, because the bottom line is: A cold body will not clot. And regardless of how much pressure you apply, you will not stop the bleeding.<\/p>\n

6. Perform CPR (cardiopulmonary resuscitation).<\/h3>\n

When the heart stops beating, effective CPR can jumpstart and help save a life during cardiac arrest. The same as stopping bleeding, once you stop performing CPR, you\u2019re starting from zero.<\/p>\n

For this reason, medical professionals today don\u2019t recommend mouth-to-mouth. Continue compressions until the patient has a heartbeat. For this skillset \u2014 and for everything listed here, really \u2014 it\u2019s recommended that you take a course and practice.<\/p>\n

7. Properly pack a med kit.<\/h3>\n

The order in which you can access necessary items in your med kit could be the difference between life and death.<\/p>\n

\u201cIt is important to pack your kit in a way that doesn\u2019t make everything fall out when you open it,\u201d Sutton said. \u201cI utilize small plastic bags to keep Band-Aids and smaller items together. I like to have my pressure dressing, tourniquet, and trauma dressings on top ready to be grabbed at a moment\u2019s notice. I find it important to go through my kit at least once a month and keep it organized. The more things you have in your kit the more stuff you forget about. Not much of my trauma stuff goes bad, but I check it for out-dates once a year.\u201d<\/p>\n

Here are the must-have items in Sutton\u2019s med kit and why:<\/p>\n

1. Medical Gloves. Gloves reduce the risk of infection and cross-contamination. \u201cI keep a couple pairs in my kit in case I need to put on a new pair before rendering aid to a different person,\u201d Sutton said.<\/p>\n

2. 2\u00d72 Gauze Pads. \u201cLike a great trauma surgeon told me once, the vast amount of bleeding can be stopped with a 2\u00d72 and two fingers applying direct pressure.\u201d<\/p>\n

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The North American Rescue (NAR) Eagle IFAK. Perfect individual carrier for all medical items.<\/p>\n

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3. Emergency Trauma Dressing. This combination of an ACE bandage and dressing will allow you to apply constant pressure to a bleeding injury without you having to hold the pressure manually.<\/p>\n

4. Compressed Gauze. Wound packing is required for penetrating wounds where bleeding cannot be controlled using direct pressure alone. This is for injuries to junctional areas of the body, including the groin and armpits, where tourniquets cannot be applied, and direct pressure can be difficult to maintain. You can substitute other cloth items if you don\u2019t have compressed gauze or run out.<\/p>\n

5. Trauma Shears. Sometimes the hardest part of treating a bleeding penetrating injury is finding it. Trauma sheers will help you quickly and safely remove clothing while searching for the wound.<\/p>\n

6. Tourniquet. They\u2019re extremely effective at stopping bleeding in arms and legs. The risks associated with them are outweighed by their benefits. They can be kept in place for hours at a time with minimal risk to the limb.<\/p>\n

7. Band-Aids. While your kit may be ready for a gun fight, more times than not a simple Band-Aid will fix most injuries that you\u2019re confronted with.<\/p>\n

SUPPLEMENTARY SKILLS TO CONSIDER<\/h2>\n

Identify type and number of bullet holes. A .22 gunshot may just be a flap of skin with a bit of yellow fat underneath versus the noticeable red crevice from a 9mm. It\u2019s important to be mindful of the number of holes created by a gunshot. Someone shot in the arm at a certain angle could have three holes (two in arm, on in body).<\/p>\n

You can\u2019t stop the bleed if you can\u2019t find all the holes.<\/p>\n

Prevent a collapsed lung (tension pneumothorax). While fairly rare with a gunshot wound, there\u2019s a reason chest seals are included in medical kits.<\/p>\n

\u201cThe air leaves the lung,\u201d Acuna explained, \u201cthe lung collapses and then, with each subsequent breath, what can happen \u2014 doesn\u2019t happen all the time, most times actually doesn\u2019t \u2014 is if the wound is big enough, the lung will then slowly start to collapse as more and more air goes out. The pressure outside the lung ends up becoming higher than the pressure inside, so it just pushes it over. That process, depending on the size of the hole, is typically slow.\u201d<\/p>\n

Know your blood type and display an identifier on you somewhere if that type is rare. While O negative is a universal blood type, ambulances and trauma centers stock only a limited supply.<\/p>\n

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Once it\u2019s gone, they\u2019ll need to start a transfusion with your blood type. If that blood type is rare like AB positive (read: hard to source), the sooner they know they will need it, the better. (Again, this goes back to being able to communicate with 911 and other emergency personnel.)<\/p>\n

Educate those in your household and with whom you keep company and practice. \u201cEveryone has a plan until they get punched in the mouth.\u201d<\/p>\n

If you\u2019re the one punched in the mouth, it may be easier for someone else to remain calm, especially if they\u2019re trained, and act to save your life. Or if the plan is so well-rehearsed among you, your friends and family, it won\u2019t matter who gets punched in the mouth. Training will take over and muscle memory will kick in.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Lifesaving Skills Every Gun Owner Should Know With regard to home or personal defense, everyone knows the line: \u201cWhen seconds matter, help is minutes away.\u201d Such logic is the reason many of us carry daily or keep a firearm bedside. But what about those moments outside the home, perhaps in a remote location? We are … Continue reading “”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[41,29],"tags":[],"class_list":["post-100614","post","type-post","status-publish","format-standard","hentry","category-health-medicine","category-safety"],"_links":{"self":[{"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/posts\/100614","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/milesfortis.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=100614"}],"version-history":[{"count":1,"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/posts\/100614\/revisions"}],"predecessor-version":[{"id":100615,"href":"https:\/\/milesfortis.com\/index.php?rest_route=\/wp\/v2\/posts\/100614\/revisions\/100615"}],"wp:attachment":[{"href":"https:\/\/milesfortis.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=100614"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/milesfortis.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=100614"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/milesfortis.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=100614"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}