Emergency Care of Gunshot Wounds (3 hours - Basic, Intermediate and Paramedic levels)

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Purpose: To enhance the EMTs knowledge of demographics and statistics, firearms, wounding mechanism, and prehospital care and treatment of gunshot wounds.

Goal: To refresh and update the knowledge base of EMTs pertaining to various gunshot wounds to the body that will enable the EMT to care for such injuries.

1. Introduction (5 minutes)  
2. Demographics and Statistics (10 minutes)
   1. Incidence
   2. Risk groups
   3. Mortality and morbidity  
3. Firearms (20 minutes)
   1. Firearm types
      (rifles, shotguns, pistols, revolvers, semiautomatic, automatic)
   2. Bullet types
      (ball, soft point, hollow point, metal jacket, wad-cutter, slug, shot)
   3. Ballistics
     
4. Wounding Mechanisms (25 minutes)
   1. Blast injury
   2. Cavitation
   3. Crush
   4. Embolization
   5. Fractures
   6. Laceration
   7. Perforation
     
5. Prehospital Treatment of Penetrating Injuries (45 minutes)
   1. Assessment
   2. Airway - special considerations for trauma victims
   3. Breathing
      1. Pneumothorax
      2. Hemothorax
      3. Flail chest
      4. Pulmonary contusion
   4. Circulation
      1. Hemorrhage
      2. Hypovolemia
      3. Cardiac Tamponade
      4. Embolus
   5. Deficits
      1. Nerve damage
      2. Head injuries
      3. Bone and ligament injuries
     
6. Medical Care (20 minutes)
   1. Trauma room
      1. Assessment
      2. ALS priorities (IVs, Intubation)
     
7. Complications (20 minutes)
   1. Compartment syndrome
   2. Hematoma
   3. Infection
   4. Pneumothorax
   5. Peritonitis
   6. Rhabdomyolysis
   7. Organ failure
   8. Functional incapacity
     
8. Medical/Legal Aspects (20 minutes)
   1. Chain of custody
   2. Mandatory reporting
   3. Forensic considerations
   4. Preserving evidence
     
9. Review of Region I protocols (10 minutes)  
10. Questions and Answers (5 minutes)