First aid ,CPR after shooting?

[howdy]

Don't forget the #1 thing in EMS is scene safety. I don't see how it is a very safe scene if there has been someone shot and the Police have not secured the area. After the Police get there, I would render aid to the guy I shot but not until the scene was safe. (Paramedic too)

[hheremtp]

Don't forget the #1 thing in EMS is scene safety. I don't see how it is a very safe scene if there has been someone shot and the Police have not secured the area. After the Police get there, I would render aid to the guy I shot but not until the scene was safe. (Paramedic too)

I agree with you on the scene safety issue. The question is, would TDH agree at our hearing to determine weather or not we had a duty to act and would they buy the scene safety argument.

[ninjamedic2293]

1 - Unless someone arrests from hypoxia secondary to a traumatic event CPR will have 0 effect on them. So if they are positioned in such a way as to compromise their airway then repositioning them and performing chest compressions could help. You have evidenced based medicine to back that decision up with the TDSHS. A traumatic arrest is a dead person, they dont come back.

2 - Unless you carry some form of barrier device to protect you TDSHS will have no issue with you not placing yourself in jeopardy of contracting a communicable disease.

3 - If a perp is bleeding out from an extremity wound I am going to do what I can to stop the bleeding. If you carry a firearm you need to carry a tourniquet end of story. Discharging your weapon to stop an imminent threat is completely justified. Not attempting to stop an arterial bleed (when you can safely attempt to control the bleeding) when you have the training and knowledge that failure to do so will kill that person is murder. Perhaps not legally im not sure but definitely morally. If someone's actions require me to respond with deadly force to stop that threat then I am fully prepared to take a life to do so and have no qualms about it. That being said I am not going to purposely kill someone through my actions or inactions when it it possible to avoid that.

4 - Same thing goes for a sucking chest wound, if safe to do so I will cover the wound with a hand (gloved preferably).

Those are the only medical interventions that it is reasonable to assume that you will have the time, capability, and equipment to perform after a shooting. Always carry a firearm and always carry a tourniquet, many fit nicely into a magazine holder.

[davidtx]

[BIG SNIP]
Always carry a firearm and always carry a tourniquet, many fit nicely into a magazine holder.

Was that advice directed at paramedics or at all of us?

[dicion]

Not attempting to stop an arterial bleed (when you can safely attempt to control the bleeding) when you have the training and knowledge that failure to do so will kill that person is murder. Perhaps not legally im not sure but definitely morally.

I'm former military, so I know how to properly use a tourniquet, and can identify an arterial bleed to an extremity. I would assume that I "have the training and knowledge" that you speak of above by this fact.

Yes, I'm going to holster my weapon, get close to, and attempt to assist someone who I just shot because they were trying to kill me...

Of course, since I shot him, he is going to be all nice and happy now, and NOT try to continue to kill me when I get within his arms reaching distance...

I'm sorry, but there is NEVER a time that you can "safely attempt to control the bleeding" on a perp that you just shot. Even if he's unconscious, how do you know he doesn't have a friend outside in a getaway car that will come to investigate when you're busy trying to save the perp's life?

Sorry, but this is the stupidest idea ever. Right up there with Applying Handcuffs, CHL Badge/Sash, and a $200 Upper.
We need to start making a list.

[hheremtp]

Not attempting to stop an arterial bleed (when you can safely attempt to control the bleeding) when you have the training and knowledge that failure to do so will kill that person is murder. Perhaps not legally im not sure but definitely morally.

I'm former military, so I know how to properly use a tourniquet, and can identify an arterial bleed to an extremity. I would assume that I "have the training and knowledge" that you speak of above by this fact.

Yes, I'm going to holster my weapon, get close to, and attempt to assist someone who I just shot because they were trying to kill me...

Of course, since I shot him, he is going to be all nice and happy now, and NOT try to continue to kill me when I get within his arms reaching distance...

I'm sorry, but there is NEVER a time that you can "safely attempt to control the bleeding" on a perp that you just shot. Even if he's unconscious, how do you know he doesn't have a friend outside in a getaway car that will come to investigate when you're busy trying to save the perp's life?

Sorry, but this is the stupidest idea ever. Right up there with Applying Handcuffs, CHL Badge/Sash, and a $200 Upper.
We need to start making a list.

Dicion,

Even though you received medical training in the army you are still considered a lay person in the civilian world. To my knowledge you don't have an EMS/RN/MD certification/license that could be suspended or revoked leading to the loss of your employment and/or career. You as a lay person have no duty to render aid to the person who you just hypothetically shot. It is not that simple for someone who holds a license as a medical professional. While the law may not require medical personnel to render aid; the licensing agency may look at things totally differently when it comes to the obligation to fulfill ones duties as a medical professional. It may seem cut and dry for the non medical professionals, "that guy attacked me, why should I help save him?" but it becomes a real grey area when it comes to us medical professionals. Please don't think that I am trying to imply that medical personnel are superior to anyone else, nor am I trying to be disrespectful of your service to our great nation or the training that you received during that service.

[The Annoyed Man]

1 - Unless someone arrests from hypoxia secondary to a traumatic event CPR will have 0 effect on them. So if they are positioned in such a way as to compromise their airway then repositioning them and performing chest compressions could help. You have evidenced based medicine to back that decision up with the TDSHS. A traumatic arrest is a dead person, they dont come back.

For the most part, yes.

2 - Unless you carry some form of barrier device to protect you TDSHS will have no issue with you not placing yourself in jeopardy of contracting a communicable disease.

Again, correct.

3 - If a perp is bleeding out from an extremity wound I am going to do what I can to stop the bleeding. If you carry a firearm you need to carry a tourniquet end of story. Discharging your weapon to stop an imminent threat is completely justified. Not attempting to stop an arterial bleed (when you can safely attempt to control the bleeding) when you have the training and knowledge that failure to do so will kill that person is murder. Perhaps not legally im not sure but definitely morally. If someone's actions require me to respond with deadly force to stop that threat then I am fully prepared to take a life to do so and have no qualms about it. That being said I am not going to purposely kill someone through my actions or inactions when it it possible to avoid that.

4 - Same thing goes for a sucking chest wound, if safe to do so I will cover the wound with a hand (gloved preferably).

Those are the only medical interventions that it is reasonable to assume that you will have the time, capability, and equipment to perform after a shooting. Always carry a firearm and always carry a tourniquet, many fit nicely into a magazine holder.

Dead, dead, WRONG! I have 6 years of experience working in an ER and have treated hundreds of gunshot patients, and that moral requirement of yours is dangerous, even for a guy like me who has some experience in this area. If I have to shoot somebody, and that person is bleeding out, I am under absolutely no moral compulsion to place myself back into danger by getting close enough to a dangerous attacker to place a tourniquet or cover a sucking chest wound. No Sir. You call the pros — LEOs and EMS — and you let them do their jobs. Period. It is not about vengeance or anything like that. It is about keeping yourself alive and safe, which is why you shot them in the first place.

I will do everything I can to avoid having to shoot someone, including modifying my own natural behavior, eating words I might otherwise speak, being willing to back down from a confrontation, and choosing to avoid going to places that I might otherwise enjoy going to. I am not a naturally violent person. IF I pull the trigger on another human, it is a means of last resort; and IF an attacker presses the attack and shooting them is my last resort, then I owe the gunshot person nothing more than to dial 911 and ask for an ambulance to be sent, in the same phone call I make to report the shooting. That is ALL I owe them, and I am NOT a murderer, and I refuse to accept that label from anyone who thinks that I have a duty to preserve the life of the person I just shot — even if doing so places me back under the same risk of injury that forced me to shoot them in the first place. With all due respect, that would be just irresponsible. I have a wife and son who expect me to come home at night, and my responsibility to them outweighs my responsibility to my assailant a thousand times over. End of story. If a human predator dies of a gunshot wound, the moral responsibility for his death falls squarely on him, and him alone, for making the choice to be a predator.

Sometimes the hyena attacks the water buffalo and the hyena gets killed. Too bad for the hyena.

[dicion]

While the law may not require medical personnel to render aid; the licensing agency may look at things totally differently when it comes to the obligation to fulfill ones duties as a medical professional. It may seem cut and dry for the non medical professionals, "that guy attacked me, why should I help save him?" but it becomes a real grey area when it comes to us medical professionals.

Well, if that's the case, I would say, "Better to be judged by <Insert # of people on the board>, than carried by 6."

I still do not believe that would be true. As said above, security of the scene is the first priority. If you were responding to a shooting as an EMS, you would literally sit there and wait, while the guy was bleeding, until the police secured it, and deemed it safe. Why would this be any different in your own home or anywhere else? Shoot the guy, Call police and EMS, then, once they arrive and deem it safe, by all means, feel free to start assisting the perp at that time if you really want to. Just because you 'arrived' first (Because you were already there) Doesn't get you a pass to not wait for the police. This scenario is no different in that respect than a 3rd party shooting.

I don't see how any board would rule that by not helping him before the scene was secured by police, that you were not doing your job, where, if you WERE on-the-clock, you would be required to wait for the police anyways.

[Bashful]

Dicion,

...To my knowledge you don't have an EMS/RN/MD certification/license that could be suspended or revoked leading to the loss of your employment and/or career. You as a lay person have no duty to render aid to the person who you just hypothetically shot. It is not that simple for someone who holds a license as a medical professional. While the law may not require medical personnel to render aid; the licensing agency may look at things totally differently when it comes to the obligation to fulfill ones duties as a medical professional. It may seem cut and dry for the non medical professionals, "that guy attacked me, why should I help save him?" but it becomes a real grey area when it comes to us medical professionals. Please don't think that I am trying to imply that medical personnel are superior to anyone else, nor am I trying to be disrespectful of your service to our great nation or the training that you received during that service

Wrong... Wrong... Wrong...

You have no legal duty to act unless you are ON DUTY and RESPONDING to that scene. That is Roles and Responsibilities 101. If you are off duty and outside of your jurisdiction, you ARE a lay person in the state's eyes.

The aftermath of a defensive shooting is going to be dynamic, to say the least. My immediate concerns.... are there any more bad guys?... am I injured and can I fix me?... are my family/friends injured?...

The ONLY thing I'm going to be thinking about the BG is if he can get up to try to hurt me again.

[ninjamedic2293]

3 - If a perp is bleeding out from an extremity wound I am going to do what I can to stop the bleeding. If you carry a firearm you need to carry a tourniquet end of story. Discharging your weapon to stop an imminent threat is completely justified. Not attempting to stop an arterial bleed (when you can safely attempt to control the bleeding) when you have the training and knowledge that failure to do so will kill that person is murder. Perhaps not legally im not sure but definitely morally. If someone's actions require me to respond with deadly force to stop that threat then I am fully prepared to take a life to do so and have no qualms about it. That being said I am not going to purposely kill someone through my actions or inactions when it it possible to avoid that.

Dead, dead, WRONG! I have 6 years of experience working in an ER and have treated hundreds of gunshot patients, and that moral requirement of yours is dangerous, even for a guy like me who has some experience in this area. If I have to shoot somebody, and that person is bleeding out, I am under absolutely no moral compulsion to place myself back into danger by getting close enough to a dangerous attacker to place a tourniquet or cover a sucking chest wound. No Sir. You call the pros — LEOs and EMS — and you let them do their jobs. Period. It is not about vengeance or anything like that. It is about keeping yourself alive and safe, which is why you shot them in the first place.

I will do everything I can to avoid having to shoot someone, including modifying my own natural behavior, eating words I might otherwise speak, being willing to back down from a confrontation, and choosing to avoid going to places that I might otherwise enjoy going to. I am not a naturally violent person. IF I pull the trigger on another human, it is a means of last resort; and IF an attacker presses the attack and shooting them is my last resort, then I owe the gunshot person nothing more than to dial 911 and ask for an ambulance to be sent, in the same phone call I make to report the shooting. That is ALL I owe them, and I am NOT a murderer, and I refuse to accept that label from anyone who thinks that I have a duty to preserve the life of the person I just shot — even if doing so places me back under the same risk of injury that forced me to shoot them in the first place. With all due respect, that would be just irresponsible. I have a wife and son who expect me to come home at night, and my responsibility to them outweighs my responsibility to my assailant a thousand times over. End of story. If a human predator dies of a gunshot wound, the moral responsibility for his death falls squarely on him, and him alone, for making the choice to be a predator.

Sometimes the hyena attacks the water buffalo and the hyena gets killed. Too bad for the hyena.

Thats an awful lot of black and white. Perhaps working in an urban environment on the streets my threat and risk analysis leads me to different conclusions than yours. I did specify in my post that I would attempt to help that person "when you can safely attempt to." I carry a tourniquet at all times as I operate under the assumption that if I am forced to discharge my weapon it is highly likely that I will be injured as well, and it would be no consolation to my family that I killed the perp also if I die from a femoral artery transection. Thus I feel that I have a moral obligation, (if it doesn't require me to place myself in grave danger as I too have a responsibility to come home to my family) to attempt to stop that person from dying from a preventable cause. If you feel no moral obligation to do so then thats your business I wont judge you, this is why there is a difference between morals and legalities. I am not labeling you, I am telling you that when I look in the mirror at night I have moral obligations to myself. And I am certainly not a passivist nor hesitant to use deadly force but all the same I am not going to knowingly let someone die when I can reasonably prevent it. To me (again assuming you feel safe and obviously we all have different opinions of what that means) watching someone exsanguinate from an arterial bleed when you have the means to stop it is the same thing as placing another round into that persons head while they lie there. Inaction can produce the same outcome as action. I dont expect you feel that way, its between you and god.

[BIG SNIP]
Always carry a firearm and always carry a tourniquet, many fit nicely into a magazine holder.

Was that advice directed at paramedics or at all of us?

I carry the tourniquet for me (although I wouldn't hesitate to use it for someone else) and encourage others to do the same. It is very likely that if you are forced to discharge your weapon you might be injured as well. The wound will either be severe enough to need a tourniquet or you will be able to wait for EMS to bandage it otherwise. That and covering a sucking chest wound (which can be done without any equipment) are realistically the only important lifesaving measures that will make a difference for a GSW victim short of a trauma surgeon.




I dont think anyone needs to be concerned about losing any sort of medical license following a shooting unless you are convicted of a crime. My actions are based on my opinions of what is right or wrong for me to do assuming I am comfortable that I will meet my obligation to come home to my family at the end of the night. My threat and risk analysis will probably be very skewed from most peoples from working a busy urban ems system where I can have no weapons for protection. And contrary to dicion's opinion of how we operate, we do not (at my agency) routinely wait for the police department or sheriffs department to secure a scene unless there is some extenuating circumstances.

[KD5NRH]

You don't do CPR unless the guy in pulseless and not breathing.

What about the zombies? They're still a threat in that condition.

[The Annoyed Man]

Thats an awful lot of black and white. Perhaps working in an urban environment on the streets my threat and risk analysis leads me to different conclusions than yours.

We'll just have to respectfully agree to disagree. What you refer to as black and white is actually a lot of advance thinking about this possibility, and what my responsibilities ought to be if the worst comes to happen. Also, you might feel more confident about your viewpoint because of age and physical capability. There are a number of us on this board, myself included, who are older and who deal daily with various physical incapacities. If you are young and fit, you have more physical options available to you than if you are approaching 60, have titanium hardware in your body, and limited mobility.

And I want to emphasize, this is NOT a vengeance thing. I would much rather not have to shoot anybody at all. But there are two factors operating here. One is simple self preservation. The other is my responsibility to my family to survive. That total responsibility far outweighs any social responsibility I have to my attacker or his family. Believe me, I've thought long and hard about this.

I did specify in my post that I would attempt to help that person "when you can safely attempt to." I carry a tourniquet at all times as I operate under the assumption that if I am forced to discharge my weapon it is highly likely that I will be injured as well, and it would be no consolation to my family that I killed the perp also if I die from a femoral artery transection. Thus I feel that I have a moral obligation, (if it doesn't require me to place myself in grave danger as I too have a responsibility to come home to my family) to attempt to stop that person from dying from a preventable cause.

And I have a tourniquet too in the event I need one. It's called a gun belt.

If you feel no moral obligation to do so then thats your business I wont judge you, this is why there is a difference between morals and legalities. ...its between you and god

Thank you for not judging. If you've read any of my posts regarding a relationship with God (uppercase "G"), AKA Jesus Christ, you'll know that my faith is a big part of my life. Indeed, it is the only filter through which I am capable of viewing the world. This is the filter through which I've arrived at my conclusions regarding my responsibilities to myself and my family, versus any responsibilities to a wounded attacker.

Too each, his own.

On February 28, 1997, two bank robbers named Larry Phillips, Jr. and Emil Matasareanu armed with automatic weapons tried to hold up a Bank of America in North Hollywood which ended in the well-known shootout with the LAPD. I lived and worked in SoCal at the time, and I was actually on the phone with a vendor as he heard and watched a stream of LAPD squad cars rolling code 3 past his office a few blocks away from the bank, on their way to the scene of the shootout. 3 years later, I worked near the scene, and ate lots of lunches at a Subway shop across the street from that bank branch. Indeed, I used to deposit my paychecks there. To this day, the walls and fences in the neighborhood bear mute testimony to the total number of rounds fired.

Here is the picture of Matasareanu when he was wounded and captured, but very much still alive:


He bled out and died without receiving medical attention, including any tourniquets, from LAPD officers; and according to Wikipedia:

The LAPD was later criticized for not allowing Matasareanu to receive medical attention, to which the department countered by stating that ambulance personnel were following standard procedure in hostile situations by refusing to enter "the hot zone", as Matasareanu was still considered to be dangerous.

Was the behavior of those LAPD officers in close proximity to Matasareanu immoral according your view, meaning, if you were actually in their shoes at the time? Keep in mind that (also according to the Wiki article):

The responding police officers directed their fire at the "center mass" or torsos of Matasareanu and Phillips. Each man was shot and penetrated by at least ten bullets, yet both continued to attack officers.

AND...

Multiple officers and civilians were wounded in the seven to eight minutes spanning from when the shooting began to when Matasareanu entered the robbers' white sedan to make a getaway...

AND...

At least one SWAT officer fired his M16 rifle below the cars and wounded Matasareanu in his unprotected lower legs, and he was soon unable to continue. The police radioed for an ambulance, but Matasareanu, who was cursing and swearing, succumbed to his wounds by the time the ambulance had reached the scene.

Yes, this is an extreme example, but it brings to the fore several points which are very relevant to this discussion:

1. The wounds from which Matasareanu succumbed were to his lower legs, which a non-medical lay person might reasonably believe to be non-fatal. My guess is that one of those rounds nailed his popliteal artery, which could definitely be a fatal wound if not treated. Even so, the officers did not apparently believe that his wounds would be fatal, so they did not apply first aid themselves. Were they in the wrong?

2. EVEN THE PROFESSIONALS considered bringing unarmed paramedics into the scene to be too dangerous to those paramedic crews. This was department policy, and so far as I know, it remains so today. Were they in the wrong?

3. Both Phillips and Matasareanu received multiple gunshot wounds — despite their body armor — and they stayed in the fight until Phillips was killed (by the simultaneous severing of his spinal cord at C1 by a SWAT bullet and a self-inflicted GSW to the brain) and Matasareanu was wounded in the lower legs severely enough to take him down. There was much talk in the press at the time, although it is not mentioned in the the Wiki article, that both men were substantially hopped up on methamphetamines which explained their ability to absorb the hits without going down. This may be the situation if one of us is faced with having to shoot an assailant. He may be high as a kite and not go down with the first hit, or two, or three. That person is extremely dangerous to approach as long as they are conscious, and determining their conscious state may very well place you into grave danger. Matasareanu was taken down by several armed SWAT officers. He was described at the time as "cursing and swearing," and you can see from his picture that he was VERY much still conscious. There can be no doubt that if there had not been several officers there at that point to rush him and cuff him, he would have kept shooting from the prone for as long as his ammo held out.

Again, I realize that this is an extreme example, but the same principles apply. Personally, if it were just me and him, I would have let him lay there without trying to administer any medical aid. I would have called 911 and kept a safe distance, keeping him covered with a firearm until the cops arrived. He was a bad, bad, dangerous man; and any attempt to help him might well have caused the helper's death.

[ninjamedic2293]

The situation chosen is a perfect example of one where the situation isnt safe enough to permit care. There are other situations where you or I might judge it safe each is different.

As to the care or lack thereof, that was over 10 yrs ago in a jurisditiction in which I have little knowledge of. With the current emphasis on active shooter mitigation many agencies are training their medics in care under fire and equipping their personnel with the appropriate equipment to do so. That being said there were multiple officers down at that incident with serious injuries and I can tell you that if there are two people with serious injuries and one is a police officer or firefighter they will be treated first right wrong or indifferent so there is a good chance the outcome would be the same even now days due to lack of personnel.

[Dragonfighter]

While the law may not require medical personnel to render aid; the licensing agency may look at things totally differently when it comes to the obligation to fulfill ones duties as a medical professional. It may seem cut and dry for the non medical professionals, "that guy attacked me, why should I help save him?" but it becomes a real grey area when it comes to us medical professionals.

Well, if that's the case, I would say, "Better to be judged by <Insert # of people on the board>, than carried by 6."

I still do not believe that would be true. As said above, security of the scene is the first priority. If you were responding to a shooting as an EMS, you would literally sit there and wait, while the guy was bleeding, until the police secured it, and deemed it safe. Why would this be any different in your own home or anywhere else? Shoot the guy, Call police and EMS, then, once they arrive and deem it safe, by all means, feel free to start assisting the perp at that time if you really want to. Just because you 'arrived' first (Because you were already there) Doesn't get you a pass to not wait for the police. This scenario is no different in that respect than a 3rd party shooting.

I can't count the number of times I've taken away a gun or worked with one pointed at me by getting there first. That was a different time, younger and faster...and not so fat. I agree with TAM, if I am forced to shoot someone to survive an attack, why would I endanger myself by rendering aid beyond the call to 9-1-1?

A word about CPR:

A witnessed medical arrest (or unknown time of arrest) is a compressions only protocol now. The thinking being that residual oxygen in the blood will perfuse the tissues enough to stem off brain death for the few minutes it takes EMS to arrive. Oxygen exchange from mouth to mouth or other ventilation simply is not that effective when compared to compressions only. Definitive ventilation (intubation, oxygenated air via bag or positive pressure mask) is the only means by which a reasonable O2 saturation can be hoped for. In adult CPR, ventricular fibrillation is the cause in the vast majority of cases and defibrillation, early and aggressively is the fix. That's why publically accessible AEDs are a good thing.

Trauma CPR:

When you poke holes in someone and they arrest there are several causes to consider. The body is a closed circuit with fluid exchange on a molecular level. There is a pump, control circuits, plumbing and a gas exchange system that must operate within parameters to keep you alive much less conscious. As these systems are compromised the body will shut down in regression to attempt to preserve life.

Leakage - Sanguinary depletion (leaking pipes) is the most common cause. Hypovolemic shock can only be treated by first plugging the leak, then replacing the volume. CPR in this case is an act of desperation as there is simply not enough "stuff" to push around. EMS can abate the fluid loss, replace the volume with salt water, ventilate and manually work the pump while hoping for the best but time critical definitive care is the only hope. That's why in metropolitan systems, trauma (not arrested) will go to nearest trauma center while trauma CPRs go to the nearest hospital period regardless of capabilities. CPR due to leakage has a dismal survival rate. Secondary to that is in many cases, the pipeline is irreparably damaged and emergency workers often get to watch a life slip away while they are helpless to stop it.

Pump Damage - A hole in the pump is a major problem but remarkably, the body will try to stave off the imminent death by spasmodic contractions of the muscles surrounding the wound and stemming leakage. That said, the wiring can be damaged and there is of course the likely hood of catastrophic damage. There is a lot of important stuff and sometimes the body's own protections will backfire. The pericardium can fill with blood for instance and strangle the heart. If the cause is the pump and CPR is the result, the outlook is grim but ironically not as much so as the simple plumbing failure. I have seen a man revived after the ER doc use a cardiac needle to enter the pericardium and pull the blood off. I have also seen a man shot with a .45 (presumably FMJ) which turned out to have a hole (through and through) in the right ventricle (which is critical but not as bad as the left ventricle) conscious and talking all the way to a hospital and later out and alive.

Gas Exchange System - Poking wholes in this area is bad, real bad, but it is also survivable. Tension pneumo-thorax is one of the deadliest consequences of this kind of damage. It results from what we call in the vernacular a "sucking chest wound" more precisely a perforated chest wound. What occurs is the lung deflates and fills the pleural space with air, every time the person inhales the negative pressure created by the diaphragm "sucks" air into the void space but it does not let it out readily. So pressure increases, the lungs displace and cannot fill adequately and the heart cannot keep up the work load and the person suffocates. As severe as this is a temporary treatment can be affected by placing a one-way valve dressing (usually a make shift using a venti-cover or dressing packaging) and needle decompression.
Hemo-thorax works much the same way except the void is filling with blood. Sitting the patient up and poking wholes is about the only thing you can do in the field, but the bleeding is internal and must be abated surgically.
Then there is bleeding into the lungs themselves resulting in drowning. Ironically with quick intervention there is a decent chance of success even in CPRs (know time of arrest and mitigation methods used).

Circuitry - The control center and wiring can be switched off or disconnected and the pump, plumbing and ventilation system will continue to operate for a brief time and slowly they will degrade and shut off. CPR here is useful only to provide a viable organ donor to the emergency room.

Short story is this, a trauma CPR has little chance of success in the field, time to definitive care is the only mitigating factor. Someone who is leaking but not dead is still a danger. Activate 9-1-1 and stay clear...keep safe.

[The Annoyed Man]

I have also seen a man shot with a .45 (presumably FMJ) which turned out to have a hole (through and through) in the right ventricle (which is critical but not as bad as the left ventricle) conscious and talking all the way to a hospital and later out and alive.

[/quote]
I've seen exactly the same thing, except the bullet was 9mm. Patient was stabilized, operated on, and then transferred to the hospital wing of L.A. County Jail. He had a second GSW in his arm. 2 weeks later, he was back out on the street.

He (and his partner) had been shot by a clerk at Gerlock's liquor store during a holdup attempt. One of the responding officers who was there in the ER asked the doctor if he could go in the room and get a deathbed statement from him. The doctor said, "He's not dying now, but if you go in and tell him you want a deathbed statement, it may get him worked up enough to kill him." The cop said, "...and your point would be...?"