GSW and Less Lethal munitions

Rubber Bullets: Less Lethal Munitions

Last time we were here, we talked about Chemical Defense. The week we move to things that can make a hole in you. This week its all about GSW (Gun Shot Wounds) and Less Lethal munitions

 

What is the Rubber Bullet

The so called rubber bullet is not non lethal. It is a less lethal bullet. It has and will cause death if not used correctly or with malice. 

A rubber bullet (LL round) is normally blunt to a flat tip. When it hits think of getting hit with a golf ball at close range. It will hurt like hell. Also it will cause massive bruising around the area of impact.

 

 

If fired at close range it will penetrate and act like a low velocity pistol bullet. It’s wound channel is wide and can cause severe damage to tissue, tendons, nerves and blood vessels.

If a person is taking blood thinners rubber bullets can cause severe bleeding under the skin which can be dangerous.

In 2016 a study was performed on the damage caused by rubber bullets. The results were eye opening to say the least. All images in this section are taken from the study

Pattern of rubber bullet injuries in the lower limbs: A report from Kashmir 

One thing noticed was when a LL round was fired at close range its wound channel was much larger than the bullet diameter. It was found that on impact a large portion of these rounds skewed sideways and a few tumbled a few times after impact.

As seen in the above image the wound is oblong, not round as one would expect. This tissue damage is seen though the wound channel.

Should You Remove a Rubber Bullet? Disclaimer

Before we go any further…

Use of the information on this site is AT YOUR OWN RISK, intended solely for self-help, in times of emergency, when medical help is not available, and does not create a doctor-patient relationship. We here can not diagnose, prescribe medication or treatments. We are not doctors, NP’s or PA’s

The information on this site is meant to be used only during times when improvisational, last-ditch efforts are all that is possible. When writing posts, the author often assumes that if anyone uses the advice, the person will have no access to regular medical equipment or supplies. This author always assumes that the person will not have access to professional medical care. DO NOT USE THIS INFORMATION WHEN YOU CAN GET MORE TRADITIONAL OR PROFESSIONAL CARE.

First off, see the disclaimer above. /\

Problems with Removing a Rubber Bullet

With that out of the way, the big question is, “Do I or Do I NOT remove the rubber bullet?”

Blindly probing around in a wound is dangerous. You can cause extreme bleeding by dissecting and/or damaging a blood vessel, such as an artery or a large vein. This can cause your patient to bleed out. It doesn’t take long.

You can also cause permanent and crippling damage to the person. 

In the modern world when a bullet is removed, we take X-rays and CT scans. Ultrasound is also used to guide the surgeon to the object. It is NOT the toss the Bowie Knife on the fire and take a slug of whiskey and start digging.

Even in the worst of times I would usually clean the wound and then pack and dress it and let the docs with a MD degree or who came out of Ft. Sam Houston take out the bullet.

BUT…….

An old friend and mentor of mine who passed away about 15 years ago from pancreatic cancer taught me a lot about surgery. He told me that the best surgical instrument ever made was the index finger. He also said that the sharpest object one should ever put in the human body is, you guessed it, your index finger.

There were (and will be) times when a DUSTOFF was unable to come, or it was not in our best interests to go to a civilian hospital. If it was not in a dangerous area, I would remove one. Notice, I said I would remove one. I was trained in the best facility on the planet for combat medicine. The United States Army Medical Department and School, Fort Sam Houston Texas. as a 91B40.

However that is something that is too involved to cover safely and responsibly in a blog post. You really want to learn? Let’s get a class together and I’ll do a live, in person one. It is dangerous to do. And, without the proper training, you’d be a menace to your patient.

What we will go over is the first aid needed to treat these in the field and let the professionals do the fixing.

Treating a Rubber Round Injury In the Field

In a SHTF situation, the treatment of this is flushing the wound with copious amounts of saline. Water can be used, but an isotonic saline solution is much more effective and a bit less painful than water. As a combat medic, I would flush a wound like this with a mixture of 500cc ( ½ quart) of saline and 30 cc ( 1 ounce) of Betadine. Using a 60 cc syringe or a turkey baster style bulb syringe

This is from a advanced class I taught on gunshot wounds, showing how I flushed the wound track in the tissue, (pork shoulder).

 

Let’s look at some real life wounds from the Kashmir report, linked to above.

LL rounds are NASTY. They HURT, and a lot of people after being shot with one refuse advanced medical care.

So lets talk about GSW care, MINUS the removal.

First you will need a REAL first aid kit. No not the 5.99 one from Walmart. A true blow out kit. These are a 1 time use kit that has only the items you need to stop the bleeding of a GSW (Gun Shot Wound).

This Kit, Everlit Emergency Trauma Kit is a decent kit.  It has everything you need to treat a variety of traumas. This stuff is not cheap. The trauma kit with chest seal will set you back  70 bucks or so. And, it is a one time use.

Yes, there are cheaper. And, there are much more expensive. This set up is a mid-range kit that fills your needs. You will see kits with many different style of tourniquets. This one comes with the industry standard. the Combat Action Tourniquet (CAT). In my opinion there is none better.

Train with Your Kit

So you have this kit. Pop Quiz Medic. What do you do with it?

Grab the Israeli bandage from the kit, or this 6 inch Israeli compression bandage. Open it and practice putting it on.

The kits come with a CAT tourniquet, and it is reusable. But, having 2 is better (remember, 2 is 1 and 1 is none). Here’s an extra CAT Tourniquet.  Practice putting one on.

WARNING: NEVER EVER FULLY TIGHTEN A TOURNIQUET UNLESS IT IS ABSOLUTELY NECESSARY

Wilderness & Battlefield Medic Course Excerpt

The following piece on tourniquet application is an excerpt from my wilderness and battlefield medic class.

Tourniquet Application

Application Site – A tourniquet should be applied approximately 2-3 inches above the hemorrhaging wound. During the Care Under Fire phase, there is no need to expose the site before tourniquet application, it can be applied over the uniform. However, once out of the Care Under Fire Phase, reassess tourniquet application by exposing site. Do NOT place a tourniquet below the knee or elbow or over a joint due to there being two bones, i.e., Tibia/Fibula below the knee, and Radius/Ulna below the elbow, which can splint the hemorrhaging vessel and make it impossible to control the bleed.

Application Tightness– Apply tourniquet tight enough to block arterial flow. Generally, the bigger the limb, the tighter the tourniquet. So, a leg will require more pressure to control bleeding than an arm will. If  the injured limb is still present, check distal pulse to ensure it is occluded.

Other Considerations– It may be necessary to use more than one tourniquet to control severe bleeding. A second tourniquet should be applied just proximal to the first, if needed. Remember  that a tourniquet will be painful for the conscious casualty to tolerate but don’t stop tightening until the hemorrhage is controlled. Pain management should be considered provided the casualty does not have signs of Class III or IV shock. You must document placement of a tourniquet by placing a “T” and the time of application on the casualty’s forehead or other conspicuous spot. After application, do not cover a tourniquet under any condition, leave it exposed to ease monitoring for continued hemorrhage.

Additional Supplies for Your Trauma Kits

SAM Splints

SAM Splint The best instructions on the SAM splint are located here.

QuickClot

This stuff is a life saver. Literally. I could go into the details of its history, but needless to say it has saved many many lives. The key is using it properly

Classes.

Y’all heard me mention classes. I used to teach at a shooting academy a few years ago. And I taught for an Arizona fire arms trainer who is about the best there is. Managing this sort of trauma is not something for a YouTube video or blog post. And know I am not with holding the details to get folks to pay. As I said earlier, if you try mucking around inside the human body, at best you’ll be a menace to the patient. At worst you will KILL him or her. Get the training. If not from me and Freya, then from someone.

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