Kenosha guy shot in arm: wound and TQ use

Chuckman

Senior Member
Joined
Dec 17, 2016
Messages
19,493
Location
North Durham
Rating - 100%
20   0   0
By now everyone has seen all the pics of the guy shot in the bicep (Kenosha). From a self-aid/buddy aid perspective, what can we ascertain about the injury and the treatment?

First, we know the wound was caused by a 5.56/.223 at close range. We also know that it was basically a grazing injury and not a "through-and-through". If it WAS a "through-and-through," (i.e., perforating) his entire humerus, bicep, tricep, and deltoid would have been shattered and shredded given the range, and an enormous exit wound. Also look at pics below, you can see the furrow running perpendicular to the axis of the arm (especially pic 2). Varmint rounds and higher (and even smaller-caliber rounds) will perforate at this range; of course, the smaller the bullet, the smaller the exit would (excluding things like hollow point, etc.).

Based on pre-TQ pictures, does he need a tourniquet? How do you treat it? Based on the pictures, he does NOT need a tourniquet. While there is indeed ample bleeding, he still has a humerus against which to apply direct pressure, and it is a perfect wound to pack. Also note that he can still grip his pistol. I won't say that with a more traumatic perforating injury with the humerus/bicep/tricep you can't do this, but it's a lot less likely.

But, he did choose to either self-apply the TQ (or have someone else do it). Did he do it correctly? As evidenced by the pics, he did not. If you look the TQ looks like it is simply laying on the bicep. A TQ that is appropriately/correctly applied will look like it's squeezing the bicep in half (see pic 4 & 5). For effective TQ use, the outcome is stop the bleeding, but you do that by encircling and compressing all the vessels by 'squeezing the container' to stop the flow.

Does this would take you out of the fight? It depends. It sure did with this fella! But it doesn't have to. If you put on the TQ you are effectively eliminating that arm from the fight, but that location is perfect for self-application (if you need it), transition to weak arm/off arm, and drive on! This is basic TCCC training.

How would Chuckman do this, if this was Chuckman? A handful of 4x4s and/or kerlix/kling into the wound, and an Israeli (or OLAES/kling) dressing around it and that's it. Transition to my weak hand where my evidence of lack of training of shooting weak-handed would be evident.

I hope this information has been helpful. If you have any insight, questions, comments, or shade to throw my way, let me know!


upload_2020-9-2_13-47-54.jpeg

5f46213189aff80028ab7f21


DGebqiu.jpg


U8X8wlBv-O5CroQqN-nU9WbSslDTN_Zn4kZ7hGIFKaTG_YJSYFcGzU41xm4RLoRMDoTRteUjwiN19MXdb3NVbM6qjO-KAzJljQ2iyA


1604JEMSlfe-p02.jpg
 
I hope he gets a staffinfection. Sorry not sorry.
when I went through trauma training the TQ was put as high up on the appendages as possible, don’t know what the current standard is.
 
I hope he gets a staffinfection. Sorry not sorry.
when I went through trauma training the TQ was put as high up on the appendages as possible, don’t know what the current standard is.

The position is OK; much higher, and he would have been near his axilla (underarm), and that would have been a challenging location. Still, he coulda moved it up an inch or so.

He'll die from infection or tetanus before blood loss.
 
Besides a tq taking that arm out of the fight, what's the downside of applying one correctly in this case? In the middle of a firefight, whether its self aid or buddy aid, I'm not sure I want to take the time to try and apply a pressure bandage and take the risk of it not doing the job, with the look of the particular wound.

Looks like I need to push self aid izzy wraps with the boys as tq is most often pushed soon us.. ;)

Edit: It is also clear I need more anatomy knowledge.
 
Last edited:
Thanks for the insight. My thoughts were between IBD and TQ when I first saw this wound in photos. Glad to know I wouldn't have been wrong if I chose IBD.
 
does seem to be a loose TQ, but i have very little experience applying them outside of a stop the bleed class. I doubt that would have induced the kind of numbness needed to really occlude deep vessels.
My guess is that the TQ was put on as a safeguard in case the brachial or any of its immediate offshoots were damaged. Doesn't seem to be a terrible bit of insurance given how messy the wound was and the most recent understanding that a TQ for an hour or two isn't going to cause permanent damage.
 
Besides a tq taking that arm out of the fight, what's the downside of applying one correctly in this case? In the middle of a firefight, whether its self aid or buddy aid, I'm not sure I want to take the time to try and apply a pressure bandage and take the risk of it not doing the job, with the look of the particular wound.
Taking the arm out of the fight wasn't an issue anymore because he ran away screaming instead of trying to continue the fight. There was no fight anymore.
Looks like he was ready to kill for his cause, but not die for it.
 
Besides a tq taking that arm out of the fight, what's the downside of applying one correctly in this case? In the middle of a firefight, whether its self aid or buddy aid, I'm not sure I want to take the time to try and apply a pressure bandage and take the risk of it not doing the job, with the look of the particular wound.

Looks like I need to push self aid izzy wraps with the boys as tq is most often pushed soon us.. ;)

Edit: It is also clear I need more anatomy knowledge.
My take on this is the pressure bandage (IBD) can be backed off a few wraps, redeploy them above the wound then use the attachment bar to twist the wraps tighter (ala TQ) and refasten it down. That's a quick and dirty I'd sure be tempted to try. Now wait for the expert to chime in.
 
Besides a tq taking that arm out of the fight, what's the downside of applying one correctly in this case? In the middle of a firefight, whether its self aid or buddy aid, I'm not sure I want to take the time to try and apply a pressure bandage and take the risk of it not doing the job, with the look of the particular wound.

Looks like I need to push self aid izzy wraps with the boys as tq is most often pushed soon us.. ;)

Edit: It is also clear I need more anatomy knowledge.

There's no downside, really, especially how he applied it since it really wasn't tight enough to do anything any way. It takes a bit more time and purposeful thought to throw a kerlix in and wrap it than to toss on a TQ for self-aid. For buddy aid one is as easy as the other. In all honesty, even if you do nothing, you will probably be OK until you get to a hospital (excluding, of course, an austere environment where an ED is more than a day away).
 
does seem to be a loose TQ, but i have very little experience applying them outside of a stop the bleed class. I doubt that would have induced the kind of numbness needed to really occlude deep vessels.
My guess is that the TQ was put on as a safeguard in case the brachial or any of its immediate offshoots were damaged. Doesn't seem to be a terrible bit of insurance given how messy the wound was and the most recent understanding that a TQ for an hour or two isn't going to cause permanent damage.

It's either bleeding to the point it needs one, or it isn't. An injury requiring a tourniquet needs it now, not just in case.

In a decision-making algorithm, does he need it? No. Does having it on change anything? No. You can conclude that by having it, it is rational 'better safe than sorry', especially for people who are not used to wounds. What a lay person would do vice a medical provider might be different, as is what a novice provider might do versus someone who has been in the game a while.

Like anything in life there is rarely a 100% definitive "in all cases" scenario, which is why this is a great lesson.
 
I recall one article that he asked for MEDIC, he talked another person on how to apply his TQ. Interesting he could not let go of the Glock.

We had a guy at my p/t Home Depot job, he would keep his arm outside of the 'cab' of the lift machine, he had long arms, would laugh at us when we asked him to keep his arm inside. He had his arm up against a diagonal brace for the overhead metal safety grid. One day he is going down the aisle and hits one of the many wooden drop bin displays we had back in the day, plexiglass on top. He hit his arm real good, he tried to backup the machine but due to the pressure on his arm being wedged between the machine and the wood, he ended up moving the machine forward and he cut into his arm from half way above his wrist to all the way up 8 inches past his elbow. So much blood, he screamed for help, our receiving guy was in Iraq twice and knew what to do to get the bleeding under control.
22 operations to save his arm over a year.
 
@Chuckman :

My read right down the line. I'm glad to have my assessment confirmed by someone far more knowledgeable than I.
 
My first views of pictures, it looked like an entrance wound where his fingers are on the underside of his forearm. Looked like the round entered on the underside, traversed up and between the bones and blew out at the elbow. Took out the bicep and the muscles on top of his forearm; the muscles on the bottom still attached contracted thus not dropping the pistol.

No tq needed, but these goofs have been known to put a tq on a shallow wound from a rubber bullet...
 
Last edited:
I think if he had just sprayed his arm with his saline spray he was carrying around he would have been able to stay in the fight.
 
@Chuckman I don't know what's correct, but am keeping my eyes open for an anticipated stop the bleed class :p

I recall one article that he asked for MEDIC, he talked another person on how to apply his TQ. Interesting he could not let go of the Glock.

We had a guy at my p/t Home Depot job, he would keep his arm outside of the 'cab' of the lift machine, he had long arms, would laugh at us when we asked him to keep his arm inside. He had his arm up against a diagonal brace for the overhead metal safety grid. One day he is going down the aisle and hits one of the many wooden drop bin displays we had back in the day, plexiglass on top. He hit his arm real good, he tried to backup the machine but due to the pressure on his arm being wedged between the machine and the wood, he ended up moving the machine forward and he cut into his arm from half way above his wrist to all the way up 8 inches past his elbow. So much blood, he screamed for help, our receiving guy was in Iraq twice and knew what to do to get the bleeding under control.
22 operations to save his arm over a year.
That HD had more lift accidents than all the others in eastern NC combined, I used to do the lift accident reports.
 
Last edited:
I learned that a bicep appears to be a very dark red meat, like a raccoon. Not a meat that looks tasty, but probably would keep my dogs alive so they could acquire me some white meat, like pork or rabbit.
 
Well, he ain't bleeding much, so the tourniquet is either doing its job, or the vessels clamped down themselves.
We use CATs at work, had a gunshot this morning, looked like a 9mm/38 size hole, right in the side of the left thigh. I put one on but it was too little too late, he had bled out by then. We worked him, so did the ER for a bit, but they finally called it.
I also think that wound on the convicted felon holding that handgun is the exit wound, he probably has a small hole on the other side of his arm. 5.56 rounds will take a chunk of meat with them, and shatter the hell out of bones going through an arm, hydro-static shock, cavitation, velocity, all that stuff. I've seen one that was almost identical to his, just a little higher up on the arm, big girl, the entrance was 22 size, the exit would probably hold a baseball. 5.56 is a nasty little round.
 
After multiple "combat medic" classes I'm an expert and I can tell you with certainty that is a sucking chest wound and needs a flap of MRE plastic and some 100 mph tape.

Carry on.
 
  • Like
Reactions: JT
Well, he ain't bleeding much, so the tourniquet is either doing its job, or the vessels clamped down themselves.
We use CATs at work, had a gunshot this morning, looked like a 9mm/38 size hole, right in the side of the left thigh. I put one on but it was too little too late, he had bled out by then. We worked him, so did the ER for a bit, but they finally called it.
I also think that wound on the convicted felon holding that handgun is the exit wound, he probably has a small hole on the other side of his arm. 5.56 rounds will take a chunk of meat with them, and shatter the hell out of bones going through an arm, hydro-static shock, cavitation, velocity, all that stuff. I've seen one that was almost identical to his, just a little higher up on the arm, big girl, the entrance was 22 size, the exit would probably hold a baseball. 5.56 is a nasty little round.

It's a wound channel. Saw that frequently overseas. A 5.56 at less than 10 feet perforating an upper arm at 3,200 ft/sec would have utterly destroyed his arm.

I HATE thigh wounds...those things bleed out, quick-like.
 
"Lone Survivor" of Kenosha shootings running his mouth off with his lawyer at his side. Says he has a concealed permit, he is a felon according to several reports.
https://www.cbsnews.com/news/kenosha-protest-shooting-survivor-gaige-grosskreutz-kyle-rittenhouse/

He said he used his own medic bag to apply a tourniquet to his arm before police drove him to the hospital.
"That was a grievous wound. Had I not had my training and proper equipment ... to treat a gunshot wound, I might not be here doing this interview," he said.
He's still being treated by doctors in the same hospital where Blake is convalescing from his wounds.
"I'm missing 90% of my bicep," Grosskreutz said. "I'm in constant pain, like, excruciating pain, pain that doesn't go away," he said.
 
Last edited:
Back
Top Bottom