HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 14-21
Emergency: Gunshot And Knife Wounds __RN
PURPOSE:
To treat hemorrhage and shock until emergency care is
available.
CONSIDERATIONS:
1. Care of a patient with a gunshot or knife wound is
focused on the prevention and treatment of
hemorrhage, infection, and further damage to
organs and tissues.
2. The patient should not be given anything orally.
3. The knife or bullet should not be removed.
4. Securing all sides of an occlusive dressing may
cause a tension pneumothorax.
EQUIPMENT:
Gloves – if available
Gauze or clean cloth
Thick towel
Tape
Petroleum jelly
PROCEDURE:
1. Call 911.
2. Adhere to Universal Precautions.
3. Explain procedure to patient.
4. To stop bleeding:
a. Apply direct pressure by placing a dressing or
towel directly over the entire area of the wound.
b. Do not disturb blood clots formed on dressing.
Reinforce dressing with additional layers of
gauze or cloth, continuing direct pressure.
Apply pressure bandage.
5. Elevate injured extremity above the level of the
victim's heart.
6. If direct pressure and elevation of the part do not
stop the bleeding, pressure should also be applied
to the artery supplying blood to the area (femoral or
brachial).
7. For a sucking chest wound:
a. Instruct victim to exhale.
b. Apply occlusive dressing with petroleum jelly,
and tape in place on 3 sides. (Or you may use
a plastic bag, plastic wrap, or aluminum foil
folded several times, if sterile occlusive
dressing is not available.) Cover wound with
thick towel, and hold in place to seal it to the
chest.
8. Treat for shock (keep patient warm, lying down, feet
elevated slightly above heart level if possible).
9. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Incident and degree of injury.
b. Treatment provided.
c. Patient's response to treatment.
d. Referral to medical assistance (911).
e. Call to MD.
f. Call to nursing supervisor re: incident.
2. Submit written incident report to nursing supervisor
within 72 hrs.
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