A 54-year-old male accidentally shot himself in the leg while cleaning his gun. Your assessment reveals a small entrance wound to the medial aspect of his right leg. The exit wound is on the opposite side of the leg and is actively bleeding. The patient complains of numbness and tingling in his right foot. You should:

• A. Gently manipulate the injured leg until the numbness dissipates.
• B. Control the bleeding and cover the wound with a sterile dressing.
• C. Assess distal pulses as well as sensory and motor functions.
• D. Manually stabilize the leg above and below the site of injury.

Answer: (B)

In trauma care, stopping life-threatening bleeding comes first. When a gunshot wound is actively bleeding, the immediate priority is to apply direct pressure and cover the wound with a sterile dressing to control blood loss and reduce infection risk. The numbness and tingling raise concern for possible nerve injury, so neurovascular assessment is important, but it should follow the control of bleeding. Gently manipulating the leg could worsen bleeding and tissue damage, and while checking distal pulses and sensation is useful, it isn’t the first step when hemorrhage is ongoing. Stabilizing the leg is helpful, but again, only after bleeding has been controlled. Therefore, the best action is to control the bleeding and cover the wound with a sterile dressing.