How to treat a bullet wound
A gunshot wound is a medical emergency, so the first step is always to call the emergency services (999 in the UK, 911 in the US). While you wait, your job is to stop the bleeding: press firmly and directly on the wound with a clean cloth or bandage and keep pressing. Do not remove the bullet or anything stuck in the wound, do not probe it, and keep the person lying down, still and warm. If bleeding from an arm or leg will not stop with pressure, a tourniquet can be used [1][3].
This article sets out first aid for a bullet wound from MedlinePlus, the US National Library of Medicine’s health service, then explains what happens in hospital, drawing on the 2007 Milwaukee Journal Sentinel graphic above. It is general information, not a substitute for emergency care or first aid training.
First aid for a gunshot wound, step by step
- Make sure the scene is safe and call for help. MedlinePlus says to get emergency help if bleeding is severe, if you think there is internal bleeding, or if the person is in shock [1].
- Press directly on the wound. Use a sterile bandage, a clean cloth or a piece of clothing; if nothing else is available, use your hand. Wear gloves if you have them [1].
- Keep pressing until the bleeding stops. Do not lift the cloth to check. If blood soaks through, leave it in place and put another cloth on top [1].
- Do not remove objects or probe the wound. Pulling out an embedded object or digging for a bullet usually causes more bleeding and harm [1].
- Use a tourniquet for life-threatening limb bleeding. If continuous pressure has not stopped extremely severe bleeding from an arm or leg, apply a tourniquet 2 to 3 inches (5 to 7.7 cm) above the wound, not on a joint. Write down or remember the time and tell the responders [1].
- Prevent shock. Lay the person flat, keep the injured part still, raise their feet about 12 inches (30 cm) if there is no head, neck, back or leg injury, and cover them with a coat or blanket [1].
The American College of Surgeons’ Stop the Bleed programme teaches these bleeding control skills in short courses, and notes that bleeding is the number one cause of preventable death after injury [3].
Wounds to the chest, abdomen and neck
Gunshot wounds to the torso and neck are especially dangerous because they can cause severe internal bleeding that is not visible. MedlinePlus warns that abdominal, pelvic, groin, neck and chest wounds can look minor but still lead to shock and death [1]. For these wounds, get medical help immediately, apply gentle pressure, and cover the wound with a moist cloth or bandage. If organs are showing, do not try to push them back in [1].
The Journal Sentinel graphic, based on information from James Feeney of the Medical College of Wisconsin, highlights the same danger areas. Neck wounds need urgent treatment, and the bullet’s entry point may be hard to see. Wounds to the stomach, liver, kidneys and upper intestines involve large blood vessels and are a major emergency that can cause fatal shock. Brain and skull injuries need scans and often surgery to remove damaged tissue, and wounds to the lower intestines or pelvis may need a colostomy or major hip surgery.
Signs of shock and internal bleeding
Watch for signs that the person is going into shock from blood loss: confusion or reduced alertness, clammy skin, dizziness, paleness, a rapid pulse, shortness of breath and weakness [1]. Abdominal pain or swelling, chest pain and changes in skin colour can point to internal bleeding [1]. Tell the emergency services if you see any of these.
How doctors treat a gunshot wound
The graphic sums up hospital treatment in four steps: stop the bleeding and stabilise blood pressure, prevent infection from the bullet and dead tissue, protect nerve tissue from further damage, and remove destroyed tissue while restoring what can be saved. MedlinePlus describes the same work: surgery may be needed to stop bleeding, clean the wound, find and remove bullet and bone fragments, place drains, and remove part or all of a damaged organ [2].
How much damage a bullet does depends on where it hits and on the speed and type of bullet; wounds to the head or torso are likely to cause more damage [2]. The graphic’s comparison of handgun, rifle and shotgun rounds shows why: high-velocity rifle bullets create much larger cavities of damaged tissue than most handgun rounds, and some fragment or tumble inside the body. A bullet that passes through without hitting major organs, blood vessels or bone tends to cause less damage [2].
Doctors do not always remove every bullet. Fragments often cannot be taken out without causing more harm; scar tissue forms around them and may cause ongoing pain [2]. The graphic notes the same debate for bullets lodged in a lung, which some surgeons remove and others leave in place.
Recovery and aftercare
Gunshot wounds can become infected because material and debris are pushed into the wound with the bullet, so antibiotics are often prescribed [2]. MedlinePlus advises keeping the dressing clean and dry, raising the wound above the heart to reduce swelling, washing your hands before and after changing a dressing, and not using alcohol, peroxide, iodine or antibacterial soaps unless your provider says so, because they can damage tissue and slow healing [2].
Recovery is emotional as well as physical. Being shot is traumatic, and fear, anger, nightmares, anxiety or low mood are normal. MedlinePlus advises contacting your provider if these feelings are overwhelming or last more than three weeks, as they may be signs of post-traumatic stress disorder [2].
Questions about treating a bullet wound
How do you stop a bullet wound from bleeding?
Call the emergency services and press directly on the wound with a clean cloth or bandage until the bleeding stops, adding more material on top if blood soaks through. For life-threatening bleeding from a limb that pressure has not stopped, use a tourniquet [1].
Should you remove a bullet from a wound?
No. Do not probe a wound or pull out an embedded object; it usually causes more bleeding and harm [1]. Even in hospital, fragments are often left in place if removing them would cause more damage [2].
How do you clean a gunshot wound?
Do not try to clean a large wound at the scene, as it can cause heavier bleeding [1]. After treatment, follow your care team’s instructions and avoid alcohol, peroxide and iodine unless told otherwise [2].
Can you survive a gunshot wound?
It depends on where the bullet hits and how quickly bleeding is controlled. Wounds that pass through without hitting major organs, blood vessels or bone tend to cause less damage, while wounds to the head or torso are more serious [2]. Bleeding is the leading cause of preventable death after injury, which is why fast bleeding control matters so much [3].
Sources
- MedlinePlus, US National Library of Medicine, Bleeding.
- MedlinePlus, US National Library of Medicine, Gunshot wounds, aftercare.
- American College of Surgeons, ACS Stop the Bleed.
Last reviewed 2 November 2026
