Q&A: Nailed It

If a character is stabbed and pinned through the hands (like a crucifixion), could they wrench themselves free without bleeding out? I realize they’d be most likely be permanently disabled if they survive, I just want to make sure that “if” is workable.

So, there’s a small historical footnote worth knowing: In Roman crucifixion, the nail would be driven through the wrist, not the hand. The reason being that the hand isn’t structurally sound enough to support the body’s weight.

As for wrenching yourself free from actual crucifixion? Probably not. Someone subjected to that would normally take days to expire. Factor in the blood loss from getting nailed up there in the first place, and being able to break yourself free seems pretty far fetched.

It’s worth noting, there’s very little archaeological data on crucifixions, and only one set of crucified remains dating to the Roman Empire has every been discovered. This leaves us with religious and contemporary documents. Given the time involved, there’s some uncertainty in the details. For example: The size, design and metallurgical makeup of the nails.

If you’re talking about a situation like the character’s hand being mangled by a normal carpentry nail, that’s a little different. The Ulnar Artery loops across the hand, forming the Superficial Palmal Arch, which connects with the Radial Artery. So, damaging this must be bad, right?

Yes, and no. You can bleed to death from tearing the Ulnar artery (or the arch.) This is still an important conduit for blood through the forearm, and no arterial wound is safe. The Radial artery is the one most frequently severed when someone attempts to slit their wrists. So, yes, it is possible to bleed out this way. It’s also extremely unlikely, baring other factors, like a compromised clotting factor, immersion in water, or continued aggravation of the wound. In most cases, your body will clamp down on the damaged artery halting the loss of blood. In fact, emergency first aid for a ruptured artery in the wrist or hand is to keep pressure on the damaged tissue for roughly 5 to 15 minutes, until clotting commences. Depending on the circumstances you could be looking at over an hour before cardiovascular collapse from this injury (if it’s going to happen at all.) So, yeah, you can, theoretically, bleed to death from this, but it’s not going to be fast. Regardless, you can bleed to death from this, so don’t screw around with it.

So how does this happen? The nail goes through, and then you tear it out between the webbing of the fingers. That forces you to sever the Superficial Palmal Arch, causing arterial bleeding. If you’re just yanking your hand off the surface, from whatever it was nailed into, and the nail didn’t damage the arteries, you’ll bleed, but you won’t die from bloodloss.  It doesn’t really matter whether this pulls the nail through your hand or you keep the as a souvenir and implausible, improvised, punch dagger. Additionally, depending on your personal physiology, and the exact point of contact, it’s possible the nail will penetrate outside the Arch, and pulling your hand free, though the webbing, will damage tissue, but won’t be life threatening.

Now, the bad news. If your holding your hand on a surface, someone stabs through it with a knife, and the blade perpendicular to your arm, there’s a real risk the blade itself will sever the Palmal Arch. Again, by itself, this is unlikely to be lethal, but it is something that needs to be taken seriously.

Also, until the wound has clotted, bandaging these wounds will require some real skill. It’s far easier to keep pressure on the wounds by hand (insert a bandage between your hand and the wound when possible), until the initial bleed ends. If the bandage soaks through, then apply a tourniquet. Don’t just slap a bandaid on top and call it good. Also, simply. tightly wrapping a bandage around the hand will not apply pressure where you want it.

This is in contrast to arterial damage near the torso, including in the arm pits and groin, which can result in death from blood loss in under two minutes. It’s an artery, but size and volume moved matters.

One fun detail, if your character takes a fairly normal sized carpentry nail to the hand, assuming it doesn’t specifically pierce anything vital, it can do minimal damage. Obviously, nicking a nerve is permanent. This is in contrast to taking a knife to the hand, where the size of the blade means that it will probably hit something vital.

The puncture wound will suck, and in a modern setting, they’ll need a tetanus booster, and probably an antibiotic, in addition to basic wound care. Surgery can repair non-nerve damage, though the hand won’t be exactly the same again. But this is not something that will your character in the scene.

As always, please remember I’m not a professional hand stabber, so don’t take this as medical advice, aside from, you know, the first aid: keep pressure on bleeding wound that spurts in time with your pulse. Also, as someone who is not a doctor, I recommend you don’t get stabbed through the hand. I hear not healthy.

-Starke

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