You’ve just been shot.

There’s no first aid in a gun fight, so you have to win that fight first, then fight for your life.

Based on statistics, the most likely place for your injury is one of your extremities. In one retrospective study of 60 patients more than half of the patients not only had tissue injury, but had fractures as well. Seventy-five percent of these fractures were in the lower extremities and many involved long bones like the femur. Nerve and vascular injuries were common. So, if you’ve been shot, there’s a good chance your arms or legs are compromised.

What will you do?

Do you have an individual first aid kit?

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If you do not have such a kit, why not?  Are you bulletproof?

The most serious and most likely issue with gunshot wound trauma is blood loss.

The human body can only lose about 40% of its blood volume and still survive. So every first aid kit should contain several items to deal with blood loss. The first of these is simply a dressing, like a 4 x 4 gauze, that can be used to stop bleeding via direct pressure.

Another useful adjunct is a clotting agent that can either be poured into a wound or embedded into a dressing. Clotting agents will accelerate the clotting in a large wound.

Pressure bandages that can be tied on, and ace bandages that can be used to increase pressure over a wound are all helpful in managing bleeding.

But if all of those do not work, the one thing you absolutely must have is a tourniquet. Because a tourniquet stops all blood flow below that level, it must be applied carefully and for a short length of time. It is designed to provide a means of controlling life-threatening bleeding, not bleeding that can be controlled through other means. But if you have an arm injury, and need to apply a tourniquet, you have to be able to do it one-handed. Fortunately there are devices designed just for this purpose, and training videos to help you. If you apply one, you need to make sure to note the time it was placed; the medical professionals treating you will want to know.

Controlling bleeding is one primary focus in emergency first aid for a gunshot wound, but it’s certainly not the only thing to focus on.

Medical professionals talk about the ABCs. Airway, breathing and circulation. If you’re breathing, you’re in good shape, unless you’ve suffered a chest wound.

If you have, it can rapidly be life threatening. Entry and exit wounds produce a “sucking” chest wound that allows a lung to deflate and makes it difficult to breathe. Chest seals are useful in this situation and are available on Amazon. You are likely not going to be able to apply these yourself, so you’d best hope someone nearby can apply them for you.

It is imperative that your driver’s license, or your CCW permit contain basic medical information, especially things like allergies, drug sensitivities, and relevant medical histories. Your personal physician’s phone number should be listed. These should be kept right next to your insurance card. If you’re on blood thinners, this information should be noted in big bold print.

Because being shot causes pain and likely shock, you cannot rely on merely taking the items out of your individual first aid kit once you’ve been shot and applying them. You need to practice with them, and train with them. You need to practice putting on the tourniquet. You should not be reading the instructions for a piece of life-saving gear at the moment that you need to deploy it.

If you’ve trained with it, you can put on a tourniquet quickly and safely even if you’re in pain and in shock. If a bystander has a chest wound, having trained with a chest seal could be life-saving for them.

When we train, and when we visualize what happens when the bad guy comes to call, we always see them on the floor bleeding, and us standing tall. But what if that’s not the way it works out? What if we’re both bleeding and on the floor? Training with firearms is more than just training for confrontations and the use of our weapons. It’s training in the aftermath too.

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