When assessing a gunshot wound, which of the following should you routinely check?

• A. Evaluate pulses proximal to the wound
• B. Apply ice directly to the wound
• C. Determine why the patient was shot
• D. Look for the presence of an exit wound

Answer: (D)

When a gunshot wound is present, you routinely look for an exit wound because the bullet can travel through the body and injure structures far from the entry site. Finding an exit wound helps you map the trajectory and raises suspicion for damage to internal organs, blood vessels, or other tissues that wouldn’t be evident from the entry wound alone. This information guides your assessment, helps you estimate the extent of injury, and informs transport decisions and potential need for advanced imaging or treatment. The other options aren’t part of the standard immediate assessment: applying ice directly to a wound isn’t recommended, determining why the patient was shot isn’t part of on-scene care, and while you monitor perfusion, the emphasis here is on identifying the exit wound to understand possible injuries.