Clinical Pathways
Clinical Pathways
Gunshot Wounds
Gunshot Wounds

Gunshot Wounds

Tags
Emerg. Med. Practice
Published
April 1, 2023
Author(s)
Drew Clare, MD Samantha Baxley, MD

View The Full Pathway

Action

Perform initial trauma evaluation with ATLS®

Decision

In which area of the body is the wound located?

Background

Patients presenting with GSWs can have injuries that range from minor, lower-acuity wounds to imminently life-threatening wounds. While lower-acuity patients have time for a thorough history and comprehensive physical examination, those with higher-acuity injuries will often have the history and physical examination performed at the same time. Upon arrival, EMS should be allowed to give a succinct report, often including timing of incident, number of wounds, vital signs, treatments/interventions, and any other pertinent information. This can occur while the patient is being moved onto the ED stretcher. At this point, the primary survey of ATLS® should take place: assessment of the airway, breathing, circulation, disability, and exposure of the patient. Exposure is a particularly important part of examining the patient with penetrating trauma in order to identify all wounds, which may be hidden in the perineum and axilla. If there is an abnormality identified in the primary survey that requires intervention, such as a definitive airway or a chest tube, the primary survey should be repeated upon completion of the intervention. Additionally, there are imaging adjuncts to the primary survey, such as x-rays and extended focused assessment with sonography in trauma (E-FAST) examinations.

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Full Gunshot Wounds Pathway
Full Gunshot Wounds Pathway
Head
Head
Neck
Neck
Chest or Abdomen
Chest or Abdomen
Extremeties
Extremeties

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