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Gunshot Wound To The Head Or Neck


How are injuries from a gunshot wound (GSW) diagnosed?

A GSW to the head or neck may cause damage to your brain, skull, spine, eyes, or major blood vessels. Your healthcare provider will examine your body to check for injury. He will look to see if there is an entrance and exit wound from the bullet. You may need any of the following tests to diagnose the damage caused by your GSW:

  • An x-ray, ultrasound, CT, or MRI may show damage to the structures in your head or neck. It may also show where the bullet is. You may be given contrast liquid to help your organs or blood vessels show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
  • A neuro exam may show damage to your brain from a GSW to your head. Neuro signs, or neuro checks show healthcare providers how well your brain is working. They will check how your pupils react to light. They may check your memory and how easily you wake up. Your hand grasp and leg strength may also be tested.
  • Blood and urine tests will show infection and kidney function. These tests also give healthcare providers information about your overall condition.
  • An endoscopy may show damage to your esophagus. Damage to your esophagus may be repaired during an endoscopy.
  • A bronchoscopy may show damage to your airways that lead to your lungs. Damage to your airways may be repaired during a bronchoscopy.
  • Surgery may be needed to find damage or find out where your bleeding is coming from. Your healthcare provider may use a laparoscope with small incisions, or make a large incision to check for damage to your organs and blood vessels.

How is a minor GSW treated?

A GSW may be minor if it does not go deep into your skin or damage any of your organs. Your healthcare provider may or not may remove the bullet. He may clean your wound and close it with stitches or staples.

How is a severe GSW treated?

You may need any of the following after a GSW to the head or neck:

  • Medicines may be given to treat pain and prevent infection. You may be given a tetanus shot to prevent an infection with tetanus. Tetanus is a severe infection caused by bacteria found in dirt, manure, and dust. Tell your healthcare provider if you have had the tetanus vaccine or a tetanus booster within the last 5 years. If you have a brain injury, you may be given medicine to prevent a seizure.
  • A blood transfusion may be given if you have bled a lot from your GSW.
  • IV fluids may be given to prevent dehydration and increase your circulation to major organs.
  • A nasogastric tube may be inserted to remove air, fluid, or blood from your stomach. A nasogastric (NG) tube is a long, thin, flexible tube inserted through your nose and down into your stomach or small intestine.
  • A chest tube may be inserted. A chest tube is also known as chest drain or chest drainage tube. It is a plastic tube that is put through the side of your chest. It uses a suction device to remove air, blood, or fluid from around your lungs or heart. A chest tube will help you breathe more easily.
  • An endotracheal tube or tracheostomy tube may be inserted to protect your airway and help you breathe. An endotracheal (ET) tube is a hollow plastic tube that is placed in your trachea through your mouth. A tracheostomy tube is inserted into your trachea through a cut made in your neck. The trachea is also called the windpipe or airway. The ET tube or tracheostomy tube is attached to a machine called a respirator. A respirator gives you oxygen and breathes for you when you cannot breathe on your own.
    Proper Endotracheal Intubation
  • Surgery may be needed to repair damage to organs or blood vessels. It may also be needed to clean your GSW or remove the bullet.

How can I care for myself after a GSW to the head or neck?

  • Perform wound care as directed. Care for your wound as directed. Carefully wash the wound with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Check your wound for signs of infection such as redness, swelling, or pus.
  • Rest for the first 24 hours. Slowly return to your normal activities as directed. You may not be able to play sports or do activities that may result in an injury to your head.
  • Have someone wake you at different times during the night as directed. Have the person ask you a few questions to see if you are thinking clearly. An example would be to ask your name or your address.
  • Get support. It is normal to have difficult and unexpected feelings after being shot. You may have feelings such as anger, depression, fear, or anxiety. You may have nightmares or continue to think about what has happened. Talk to your healthcare provider if you have any of these feelings. Treatments are available to help you.

When should I call 911?

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • Have someone call 911 if you have a seizure or cannot be woken up.
  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.
  • You have trouble breathing.

When should I seek immediate care?

  • Blood soaks through your bandage.
  • You feel a hard lump in your neck.
  • Your wound comes apart.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You vomit blood.
  • You have difficulty swallowing.
  • You feel weak, dizzy, or faint.

When should I contact my healthcare provider?

  • You have a fever.
  • Your wound is red, swollen, or draining pus.
  • You have nausea or are vomiting.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.