How Is A Gunshot Wound Treated? - Healthline

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HealthlineSubscribeGunshot Wound: First Aid, Recovery, and Outlook

Medically reviewed by Darragh O'Carroll, MD — Written by Daniel Yetman on July 21, 2022

First aid
Hospital treatment
Complications
Recovery
Fatality rates
Outlook

If a person is shot, they need prompt emergency medical attention. After getting to safety and contacting emergency services, you can slow the bleeding by applying pressure until help arrives.

Gunshot wounds are always a medical emergency. The extent of injuries depends on many factors, such as where somebody is shot, the size of the bullets, and the type of gun.

Unfortunately, gun-related injuries aren’t rare in the United States. In 2020, 45,222 firearm-related deaths were reported in the United States, per the Centers for Disease Control and Prevention (CDC). Of these, more than 40 percent were homicides.

If someone’s been shot, it’s critical to call 911 or your local emergency services as soon as it’s safe to do so. Administering first aid can save a person’s life while you wait for an ambulance to arrive. Acting quickly can help slow bleeding and prevent life threatening complications.

Keep reading to learn essential information about first aid, medical treatment, and recovery from gunshot wounds.

Gun violence in the United States

Americans are 25 times more likely to be killed in a gun homicide than people in other high income countries, according to statistics from Giffords, an organization working to end gun violence.

More than 1 million Americans have been shot in the past 10 years, and in 2020, gun-related deaths reached their highest in at least 40 years.

First aid for a gunshot wound

More people experience nonfatal gunshot wounds than fatal ones, according to the CDC. It’s crucial to identify where someone’s been shot and begin first aid while waiting on emergency services.

The first 10 minutes after the injury are often referred to as the platinum 10 minutes. During this time, the person who was shot is at risk of life threatening complications, such as:

airway obstruction
tension pneumothorax (collapsed lung)
bleeding

The leading cause of death in gunshot wounds is bleeding, per 2017 research. According to the American Red Cross, a person can die from severe bleeding in fewer than 5 minutes if untreated.

Here’s what you can do if you’re with somebody who is shot.

Get to safety and call 911

If you’re with somebody who has been shot, it’s crucial that you and the person get to a safe place away from the threat.

In the case of an accidental shooting, this might mean making sure the gun’s safety is on and that the gun is secured. In the case of an intentional shooting, this might mean evacuating the scene.

If you are with an injured person during an active shooter situation, evacuation may not be an option. In this case, the Department of Homeland Security recommends that you attempt to:

hide in a place that’s out of the shooter’s view
silence your phone to avoid detection and remain as quiet as possible
seek an area with a barrier for protection (such as behind a locked office door or a large object)
block a shooter’s potential entry with a barricade, such as stacking furniture
avoid restricting your ability to move in case you need to run or confront

Gunshot wounds always need medical attention to assess their severity and begin treatment. It’s critical that you call 911 or local emergency services as soon as is safe and possible.

While you’re waiting for an ambulance

The quicker a person who has been shot gets to the hospital, the better their chances of surviving. Ideally, they should receive medical attention within the platinum 10 minutes.

Check if the person you’re with is awake and responsive. This involves the tap-shout-tap method. Verbally address the person (“Are you okay?” or “Can you hear me?”), followed by a firm tap to their body, and another verbal cue.

The Red Cross recommends trying this approach for 10 seconds or fewer.

If the person is unresponsive and not breathing, the Red Cross also recommends performing CPR and using an automated external defibrillator (AED) if available.

Managing bleeding

Bleeding is the leading cause of death in people with gunshot wounds. It’s important to apply firm pressure to the wound if the person is bleeding profusely.

If they have a large wound, cover the area with any clean cloth available, such as a piece of clothing. Press down as hard as you can until EMTs arrive to relieve you. It may also be necessary to use a tourniquet to limit blood loss while waiting to get someone to a hospital.

While research is still preliminary, a 2021 study suggests commercially made tourniquets may be able to better control hemorrhage from appendages (arms or legs), reduce the chance of the person needing a blood transfusion, and increase overall likelihood of survival.

These types of tourniquets are pre-made, widely available to order (especially online), and can be added to emergency preparedness kits.

If you are with someone who has been shot and do not have access to a ready-made tourniquet, you can still improvise one. Tourniquets should be used as a first resort when an arm or leg wound is bleeding so much that direct pressure does not stop blood flow.

Wrap and tie a long piece of fabric (such as a shirt or necktie) several inches above the wound as tightly as possible. This is intended to limit arterial blood flow and reduce blood loss.

A homemade tourniquet will never be as effective as a commercially made one, but it can still be a significant first aid tool.

If they’re responsive

If a person who has been shot is responsive and fully awake and doesn’t seem to have life threatening injuries, try to collect as much information from them as you can while waiting for an ambulance. This applies to situations in which you are able to safely make noise, not around an active shooter.

Ask the person who has been shot about any symptoms they are feeling and what allergies, medications, and preexisting medical conditions they may have. Ask about or identify any medical tags they may be wearing. Some people have their medical ID on their phone.

Just because someone is alert and awake after being shot isn’t a guarantee they will remain this way. It’s important you collect identifying information promptly, including contact information for their family or loved ones.

Hospital treatment

Once you or the injured person you’re with reaches the hospital, nurses and doctors will evaluate the injuries and determine what type of medical care is necessary. Treatment depends on the severity and location of the wound and other individual health factors.

Treatment for a gunshot wound might include:

surgery to remove the bullet and fix damaged internal structures
an IV to administer antibiotics, fluids, and other medications
blood transfusion to replace lost blood
sedation or painkillers

Most injured areas

People arriving at emergency rooms with gunshot wounds in the United States most often have injuries to their foot or leg, according to 2015 research.

Here’s a breakdown of types and location of firearm injuries in the United States from 2010 to 2012:

Body part	Unintentional injury	Assault injury
legs and feet	43%	35%
hands or arms	34%	15%
upper trunk	6%	20%
lower trunk	7%	19%
head or neck	10%	11%

Per 2022 research, the most common organs involved in shootings affecting the abdomen are:

small intestines (50%)
large intestines (40%)
liver (40%)
intrabdominal blood vessels (30%)

Specific treatments

Many different types of surgical interventions are used to treat specific injuries caused by gunshots or explosive blasts.

Here’s an overview of which procedures are used in response to certain injuries, per a 2017 research article from Germany:

Type of injury	Treatment
bleeding	aortic clamping
bleeding from large blood vessels	ligature or bypass
injury to liver	packing or compression
bowel damage	staple closure, stoma
artery injury	shunt
vein injury	ligature
pancreas injury	drainage
swelling	laparostomy
broken bones	casting
lung injury	en masse lobectomy
brain swelling	craniectomy

Complications

For each firearm death, there are three disabling injuries in North America.

Survivors of firearm-related injury can experience long-term physical and mental complications such as:

physical disability
memory trouble
emotional disturbances
post-traumatic stress disorder

Specific complications depend on where the wound is and how extensive the injury is. For example, a head wound could cause cognitive and physical symptoms such as:

headaches
sensitivity to light and noise
confusion
memory trouble
balance and motor coordination issues

Infection is a potentially serious complication that can result from the gunshot wound itself or from surgery. It’s important you always take medications as directed by your doctor and follow aftercare instructions precisely to reduce risk of infection.

In rare cases, amputation may be required if a limb is badly damaged. If a bullet has hit your spinal cord, it can result in partial or full paralysis. Organ damage caused by gunshot wounds can also create serious long-term health complications, even if the organ is saved.

Recovery

Recovery from a gunshot wound looks different for every individual case. Some people may have minor wounds that heal in weeks, while others may experience permanent disabilities.

Physical recovery following acute treatment might include:

physical therapy
pain medications
medication to treat other complications resulting from the injury
taking time off work or school

Surviving or witnessing a shooting is traumatizing for most people. Healing requires a mental and emotional component in addition to medical care for the injury itself. People who survive shootings may experience anxiety, panic attacks, and depression among other symptoms.

Talk therapy can help survivors process their thoughts and emotions and develop coping skills. Support groups can provide a safe space to connect with others who have also survived gun violence and work toward personal and collective healing.

Learn more about processing grief after a mass shooting.

If gunshot wounds are extensive or severe, a survivor will likely have to work with a team of healthcare professionals. This may include nurses, doctors, surgeons, and physical therapists, among others.

Fatality rates for gunshot wounds

More people survive being shot than die from it. The survival rate for a gunshot wound depends on factors such as:

how many times a person is shot
whether they are shot at close-range
how quickly they receive treatment
what type of bullets and gun are involved
the location of the injury or injuries

A 2017 study using data from the National Electronic Injury Surveillance System found that survival rates from firearm-related injuries in the United States have remained stable or improved in recent years. From 2003 to 2012 the fatality rate remained constant, at around 22%.

In a 2016 study, researchers examined the survival rate of 413 people with penetrating traumatic brain injury at 2 U.S. trauma centers. The researchers found that the survival rates at hospital discharge and at 6 months were 42.4%.

However, the fatality rate increases when two or more wounds occur or when there are multiple organ injuries.

For this reason, assault rifles like the semiautomatic AR-15 and it’s automatic military counterpart the M16 usually have higher fatality rates than handguns or other firearms. They can hold up to 30 rounds and inflict multiple wounds in rapid succession.

The caliber of a gun (how large a bullet is in diameter) also has a major impact on survivability.

A 2021 study of shooting data from the Boston Police Department found that medium- and large-caliber firearms were more deadly than smaller-caliber guns when used in criminal assaults. The study authors estimated using an equation that if smaller firearms replaced larger ones, this could reduce death rates due to gun violence by nearly 40%.

While survival rates have remained somewhat stable, deaths due to gun violence have risen in recent years. The number of gun-related deaths increased by 13.9% from 2020 to 2019. Gunshot wounds were among the top 5 causes of death for people ages 1 to 44 in the United States in 2020.

Outlook

Gunshot wounds always require immediate medical attention. First aid for gunshot wounds starts with getting the injured person and yourself to safety and calling 911 or local emergency services.

Check to see if the person is awake and responsive, and collect identifying information from them. Use a clean cloth and apply as much pressure as possible to stop bleeding until relieved by emergency personnel.

If the person is bleeding a lot from an arm or leg, try to apply a commercial or homemade tourniquet. CPR or the use of an automated external defibrillator may also be necessary.

Many types of surgeries and other medical treatments are used to treat gunshot wounds. Recovering from being shot may require a hospital stay of days, weeks, or longer. After discharge, a person who is healing a gunshot wound may need medication, physical therapy, and in some cases, further surgery.

Emotional and psychological trauma is common in both shooting witnesses and survivors. It’s important both physical and mental needs are addressed during recovery.

Overall, recovery from a gunshot wound varies substantially depending on the extent and location of injuries. A doctor or care team will work to create a fuller picture of a recovery plan and what to expect at each stage.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Medically reviewed by Darragh O'Carroll, MD — Written by Daniel Yetman on July 21, 2022

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