Gunshot wounds: Experts reveal life-saving emergency strategies

Gunshot wounds: Experts reveal life-saving emergency strategies

Gunshot injuries are a critical issue in emergency medicine, especially in Germany, where such cases are rare but extremely complex. Medical students Christoph Buchholtz and Dennis Lander draw this insight from their experiences and training. Both are in their 5th semester at the MHB and recently published an article in the specialist magazine “Rettungsdienst”. With the title “Gunshot Injuries: Wound Ballistics and Wounded Care Explained on a Case-Specific Basis” they make an important contribution to raising awareness of this topic. Loud MHB The article deals with the interdisciplinary aspects of gunshot wounds, which are crucial for emergency medical technicians, paramedics, emergency physicians and medical students.

Buchholtz, who worked as an emergency paramedic in the Bundeswehr before studying medicine and took part in the Trauma Fellowship Program in Johannesburg, has extensive practical experience in dealing with such injuries. Lander previously worked as a section assistant in forensic medicine in Saarbrücken. In their article they analyze two exemplary cases, one with a handgun and one with a long gun, and illustrate the differences between these types of weapons.

The differences between long guns and handguns

The article illustrates that long weapons, such as rifles, have higher muzzle energy and often cause serious injuries with exit wounds. In contrast, handguns, such as pistols, typically result in smaller wounds and, less commonly, exit wounds. A crucial factor is the caliber and projectile type, which directly influence injury patterns. These findings are essential because Thieme indicates that German doctors have little experience with gunshot wounds compared to their US colleagues.

There were over 81,000 non-fatal gunshot wounds in the United States in 2014, illustrating the magnitude and problem in the United States. Despite these high numbers, dealing with gunshot wounds in Germany remains a challenge, as they have become more common due to mass shootings in the last 15 years, but are still a rarity. The severity of an injury depends critically on the properties of the projectile and the affected tissue.

Prehospital emergency care

A key concern in emergency treatment of gunshot wounds is rapid hemostasis. The two medical students emphasize the use of the SICK scheme, which provides for a comprehensive risk and hazard assessment: Scene assessment and safety, Impression, Critical bleeding and Kinematics. Prehospital treatment follows the cABCDE scheme, which stipulates that life-threatening problems must be treated as a priority. In addition to saving lives, the focus is also on the rescue workers' personal and protective goals.

Tourniquets and modern hemostatic wound dressings are common aids for hemostasis in the preclinical phase and show promising success. Loud Thieme It is also important to consider all gunshot wounds as contaminated, which often requires antibiotic therapy. In the area of ​​diagnostics, however, the options are limited, which is why personal contact and anamnesis are of particular importance.

Doctors and emergency responders are required to focus on the specific treatment of gunshot wounds, which depends on the type of weapon, the characteristics of the projectile and the mechanism of injury. Open chest injuries must be treated immediately and respiratory management ensured, especially in patients with a Glasgow Coma Scale (GCS) ≤ 8.

The knowledge and experience that Buchholtz and Lander share in their article are crucial to advancing knowledge and practices in German emergency medicine to better respond to gunshot wounds.