Tag Archives: blood loss

Would actual sword fights end with a lot of cuts on both combatants or is it more of a “you get tagged first and your out” kind of deal?


This one can really go either way, depending on injuries
sustained. So, let’s parse this out a bit, because I might not have been really
clear about this in the past.

Shallow nicks won’t do much. You’ll lose blood, but not at an
appreciable rate. You’ve almost certainly sustained a few of these in your
life. From a writing perspective these are basically cosmetic. From a medical
perspective they’re not much more. A sword or knife can absolutely inflict

There are rare circumstances where these immediately
relevant. Cuts to the forehead can cause blood to get in the victim’s eyes. In
combat, this is a debilitating situation. Blood that gets onto the palm can
make it more difficult to grasp objects or weapons. (Fresh blood is quite
slick. As it dries it will become sticky, so the effect is reversed at that

When you’re talking about lots of cuts, then you’re probably
talking about this kind of injury. Individually these aren’t dangerous, but if
they start stacking up, blood loss is cumulative, so they can potentially
become life threatening, but that’s not a likely outcome for a duel.

Incidentally, if you’re writing a scene where characters are
dueling to first blood, then these cuts qualify. In fact, that’s what the
duelists will aim for. It’s the easiest kind of injury to sustain, and if the
participants don’t want to kill one
another, this is the safest route to victory.

When I’ve been talking about injuries that create a decisive
advantage, I’m talking about deeper cuts; ones that open up veins or debilitate
limbs. Injuries where bloodloss will lead to impairment and death.

In a duel, these will kill you. When I say things like, “with
first blood, the clock is ticking, and your character will die if they don’t
find a way to turn the fight around,” I’m talking about these deeper injuries.
A person can survive a few shallow cuts without much ill effect, and in most
cases can survive quite a few without aid. Deep cuts are immediately dangerous.

Here’s the problem with this: I’m talking about these like
they’re two separate kinds of wounds; they’re really not. They’re both cuts. If
we’re being technical, the deeper variety are “lacerations.” But, that makes it
sound like there’s a clean delineation between these injuries which simply
doesn’t exist.

So, I’m going to step back and put this in abstract terms, as
they apply to characters for a moment.

Characters can suffer “cosmetic injuries.” These will result
in bleeding. As I mentioned earlier, blood After the fight is over, they’ll
hurt. Unless your character is getting covered in these things, they’ll never
kill them. These can be sustained anywhere, but when you’re talking about
strikes to the forearm (except along the inner arm) or to the face, bone will
usually stop the strike before it gets to deep.

Characters can suffer “wounds.” These will result in a lot of
bleeding, way too much bleeding. These, “start the clock.” Without medical
attention, even just self inflicted first aid, these will kill your character.
Usually these are sustained to limbs or the torso. Places where you can get
fairly deep without striking bone.

In the real world, blood loss will impair the fighter, slowing
them down, confusing them, making combat more difficult. This means their
defense (if they have one) will suffer, and it will be far easier for their
opponent to get through it with a kill strike. A blade through the throat or
chest, for instance. This isn’t always true in fiction, but it’s a function of
how the human body works that’s worth remembering.

If you’re asking, “is it plausible for a character to win a
swordfight with lots of tiny cuts?” Yes. If you’re asking, “is it plausible for
a character die in a swordfight with one or two deep, lethal wounds, and to be
otherwise untouched?” Again, yes. It really depends on the circumstances of the

I hope that clears things up some, and am genuinely sorry if
I’ve confused any of you by glazing over this. That one’s my mistake.


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In film often when characters get stabbed/assaulted they can often continue to fight or don’t pass out immediately. How does adrenaline or shock factor into the physical reaction, especially when the character isn’t a cop or military and isn’t accustomed to being in these violent situations. How long would they be able to function before they crash? Is it possible to run away or even fight?

Taking these questions in reverse order: Yeah, kinda,
sometimes, and it varies wildly, based on the injuries sustained. Also, it’s
not the adrenaline crash that kills you.

Adrenaline rushes mean that you’re often unaware of injuries
sustained in the moment. I’ve never been fully certain if adrenaline actually
dulls the pain response, or if it simply causes your brain to ignore it. Either
way, while you’re under an adrenaline rush you can suffer injuries and be
unaware of them. It’s why you’ll sometimes see characters (and, for that
matter, real people, with prior experience) checking themselves for injuries
after combat (or any other traumatic event). It is entirely possible to be wounded
and have no idea it’s happened until you’re trying to figure out where all that
blood is coming from.

Depending on what you’ve just been through, coming down off
an adrenaline rush can be deeply unpleasant. Your brain is sure something’s
fucked up, but it can’t pin down exactly what or where, so it’s going to take
that out on you, and everything aches. Adrenaline crashes won’t kill you. (There
may be some weird outliers here for people with heart conditions, but, in
general.) A crash may make you wish you were dead, or make you want to throw up on
people, but it’s not lethal.

In the moment an
adrenaline means that you can suffer (fairly severe) injuries and keep on
fighting. If the injury doesn’t outright disable a limb, you can keep using it,
even if that’s a very bad idea. Getting stabbed or shot is no guarantee that
someone will sit down and peacefully bleed to death. Actually, shooting someone
is a pretty good way to ensure they won’t sit down and bleed to death without

When you’re trying to figure out how long it will take
someone to die, you’re actually asking about how fast someone bleeds out. This
relates directly to the injuries sustained. Someone who’s had a knife driven
into their neck isn’t going to keep fighting. Someone who had it run through
their bicep or buried in their shoulder blade, probably can.

We’ve covered blood loss before (and I strongly recommend you take a look at that tag, if you haven’t), but that’s the real factor
here that controls if someone can fight. If they still have enough blood in
their body to function. Lose too much, your ability to fight is impaired, and
you’ll eventually fall unconscious and die.

Blood loss is why concepts like, “first blood,” are important
in duels. Once that happens, the clock is ticking for that
character; the longer the fight goes, the more their ability will decay, and
unless they find a way to turn it around, they will die. (Even if they manage to prevail, they may still die without medical attention.)

Fighting through a stab wound is a fantastically bad idea.
Engaging in any physically strenuous activity that raises your heart rate, (for
example: fighting someone, or running away), will speed up blood loss, meaning impairment
kicks in sooner. Still, the point of adrenaline is to keep you functional after
sustaining an injury, so that you can survive.

If someone suffers an injury which disables them in some way,
such as breaking an arm, there’s no powering through that. Adrenaline won’t let
you override shattered bones. The biomechanical pulley system of muscles and
tendons simply doesn’t work with broken bones.

So, the short answer is, “yeah, kinda.” You can keep fighting
after being attacked. So far as it goes, there’s plenty of cases where someone
took a stray bullet and kept on fighting, only to bleed to death later.


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do you have any comparisons on how big a knife has to be to do x amount of damage and the type of the blade? (I don’t really know if that made much sense)

It doesn’t really work like that.

Damage as a value is something you see in games because it’s an easy to
articulate abstraction. “You have a knife it does five points of damage. You
have a character, they have fifteen hit points.” That’s very easy to calculate,
and you’re looking at 3 attacks before the character expires.

What knives, and most weapons, actually do is tear apart tissue. It’s not
that your liver takes X amount of damage, it’s “did the knife pierce it? Is it
now bleeding?”

For games, that’s a bit daunting. It’s a lot easier to say a character can
take a fixed amount of damage before they expire, then tell the players to work
within that limit. At that point, it’s a natural fit to say that weapons have
fixed damage values. You can then modify these two elements to create a sense
of verisimilitude. It’s not how the world actually
works, but it feels good and creates a legitimate tensions for the

The closest you get to a hit point style calculation in the real world is, “how
fast are you loosing blood?” Usually, that’s what will kill you. At that point,
the only real distinguishing element is how big a hole did your weapon make. It
doesn’t have to be very big to get the job done. Bigger holes, or more holes
will get the job done faster.

The size and shape of a knife isn’t about how much damage it does, but how
you can use it. Anything over three inches is long enough to kill you. Larger
knives allow for different strike patterns. At a slightly abstract level, with
larger knives you’re trading speed and agility for mass. So, you use them in
different ways, prioritize different targets, and fight at different ranges.
Small knives are usable at zero range, while large knives (like machetes or bayonets)
actually have a minimum effective range, like swords and other “full sized”
melee weapons.

There is a purpose to the hitpoint abstraction, even in your writing, so
long as you keep in mind that it’s an artificial system. As we’ve said, many
times before, combat takes a toll on its participants. HP can be a legitimate
way of pacing your fight scenes, so long as it’s not information you’re putting
directly in front of your audience.

You never want to say, my character took X damage from that attack, but if
you’re actually writing about how your character narrowly avoided a blow that
caught and tore their jacket, or how they skinned a knuckle.

If you honestly have a hard time pacing fight scenes, giving your characters
a fixed value representing their health, stamina, and general good luck keeping
them out of harm, and then chipping away at it isn’t the worst possible exercise.
So long as you don’t turn around and then simply relate a turn by turn
breakdown of who slapped whom around, you may find it helpful in gauging how
fast your fight scenes should play out.

But if you’re close enough to use them, knives will absolutely ruin somebody’s


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Hey there. Went through some of your old asks to see if you’d talked about this before, but couldn’t find anything. My question is this: I’ve got a character who’s arm has been cut clean off at the shoulder (through some kind of magical, incredibly sharp sword). He’s got access to essentially modern-day medicine. How long will it take for him to bleed out/reach the point where doctors can’t save him?

At a wild guess, I’d think somewhere south of five minutes. The way you would calculate a concrete number is to divide ~2.25 liters by the volume of blood lost per second. That should give you the answer of roughly how many seconds your character can survive. Again, if it’s over 300, I’d be surprised.

There’s a minor issue in that calculation; the blood loss wouldn’t be completely
linear, and if you really wanted to do the math and get it just right,
you could use their blood pressure, and use that to get the volume of
the first couple spurts. Remembering that blood pressure drops as you spray blood all over the place like a broken lawn sprinkler; but even at low pressure, a wound like that is going to loose blood fast.

This is also why I can’t tell you exactly how fast your character will be losing blood. The answer there is “very,” but that doesn’t really help for a calculator.

That 2.25l value is actually an average. The real target is the victim losing ~40% of their total blood. For an average adult male, that’s going to be 2.24l. But, because all of these values are relative to the size of the victim, the time to bleed out shouldn’t be affected by this. There are a lot of medical conditions that can affect bleed times, and recovery. But, I’m willing to go out on a limb and say, at these volumes, none of them will really matter much.

The Wikipedia article on Bleeding should cover you for identifying the symptoms. It has (at the time of writing this), a copy of the four hemorrhage stages. The very short version is that the victim will become cold and clammy, disoriented and confused, unconscious, and dead, in roughly that order.


Does a person die immediately when they’re shot once, or do they have to be shot multiple times? Because I’ve seen in movies and books that a character is shot once in a not-that-important place, and they immediately collapse. Yet I’ve seen news articles that describe a person getting shot multiple times yet they still manage to get away.

Keeping in mind, the usual disclaimer about not being a doctor; my medical knowledge being limited, and I’m going to be simplifying some of this a lot?

In general? No. Gunshot victims usually die from blood loss. This can happen pretty quickly, or it can take awhile, it all depends on what the bullet damages. But, it’s not usually an instantaneous process.

I could swear we reblogged an infographic on blood loss symptoms by volume, but all I can find right now is this.

If a bullet nicks or severs an artery, this will result in rapid blood loss and death. We’re still talking about at least a couple minutes before death. With non-vital areas, where there’s only soft tissue damage, you could be talking about bleeding out for hours.

If the bullet damages internal organs, then things get a little messier. If the bullet manages to destroy something you actually need, like the brain or heart, then you’re going to die.

That’s the simple part… here’s the part that’s slightly outside my expertise. Hydrostatic shock is where a gunshot strikes someone, and kinetic force from the gunshot is transmitted through the fluid in their body to injure other organs. I’ve seen the discussion go back and forth over the years, some people insist that hydrostatic shock can rupture internal organs and cause people to suffer lethal injuries from relatively minor wounds, and there is some support to the idea that hydrostatic shock result in minor hemorrhaging. The other side of the argument is that, while the shock wave does occur, it isn’t actually life threatening. (There’s also a contingent who’ve been waging an edit war on the wiki page claiming that hydrostatic shock doesn’t exist at all.)

The actual hydrostatic shock wave increases the more a bullet disrupts the tissue. So .45 hollow points will produce more shock than a jacketed 9mm. These can result in minor brain hemorrhaging, but this usually comes up in autopsies, meaning they probably died from getting shot, and it turns out there was additional trauma that went undiagnosed.

If I’m sounding like I don’t know if this is relevant or not, it’s because I don’t. Ignoring specialized hydrostatic shock rounds (again, like hollow points, high explosive rounds, or anti-materiel rifles), I’m not sure if hydrostatic shock actually kills people, or just slaps an extra layer of damage on an already life threatening injury.