Heart Wound
In punctured wounds of the chest the wound should becleansed with an antiseptic solution, then covered with a fairly thick pad of gauze and the chest strapped with overlapping layers of adhesive tape extending around the injured side from the center of the back to the center of the chest. The patient most likely will lie on his injured side, but the head and shoulders should be slightly raised. In punctured wounds involving the heart there is grave danger of immediate death, though some patients survive the injury. If the knife or other instrument is still in the wound, leave it there, as it may be serving the purpose of a plug, preventing fatal or grave hemorrhage. Elevate the head and shoulders and see that the patient is comfortable, then await the doctor. (For wounds of the abdomen, the reader is referred to Abdomen, Wounds of.)
Gunshot wounds may be due to shetgrin, rifle, pistol (re¬volver) , or shrapnel. As the missile enters the body it is likely to carry with it foreign bodies, in the form of pieces of cloth¬ing or dirt, causing infection. The injuries produced within the body are the chief danger in these wounds, though often the missiles penetrate to considerable depth, or even perforate the body, without causing destruction of any vital structure. This accounts for the fact that the initial hemorrhage is rarely of any importance. The wound of exit should be looked for. If found it will be seen to be much greater in extent than the entrance wound, and an ugly laceration. Wounds caused by blank cartridges are burned contusions, deep within which is the wad from the cartridge.