Tag Archives: starke is still not a doctor

If a knife was laying on the ground for a few seconds, and someone was stabbed/cut with it, would it become infected?

From the very specific way you phrased that? Maybe. The injury could become infected, but the whole thing about it being on the ground is kind of a red herring. That is to say, it doesn’t really matter.

Any knife that hasn’t been fully, carefully, cleaned, can be a potential vector for infection. Post injury, clothing, ambient debris, and even improperly sterilized bandages can result in infections.

There’s actually a small irony in that infections for gunshot wounds come from the stuff being forced into the wound after the injury, not from the bullet itself.

Dropping the knife on the ground, getting dirt or grass smeared on it could result in the blade carrying more bacteria, but, unless it was sterilized before the fight, that would already be the case. I’m not sure how the odds work out on it picking up bacteria, but, it kind of doesn’t matter.

Outside of some specific situations, backtracking and figuring out exactly where an infection came from is wasted energy.

So, you have a character that’s stabbed. The wound could become infected. Without access to proper medical care that could kill them. It doesn’t really mater if the knife has been dropped or not. It doesn’t matter if the bacteria came from the knife, or the victim’s shirt, or their own hand, when they grab the wound because, “surprise, you just got stabbed.”

The one time you do need to track down the source of an infection is when it’s a persistent, recurring issue. Cases where you have a colony of legionnaires’ disease or staph in a hospital, for instance. You see patients getting sick from it regularly, but the vector ends up being in the hospital itself. Another example would be commercial food contamination, such as an E. coli outbreak. But, when it’s a single infection, tracking the vector isn’t usually a priority.

-Starke

One of my characters gets pinned to the wall via a knife through her hand. But after that, the only treatment she can get in her situation is to stop the bleeding and wrap the wound up. Would she have somehow been able to coax mobility back into the fingers whose connectors(? don’t know the official name haha) in the palm without professional help? And how long would jarring that area cause pain/numbness?

If the blade penetrates between the metacarpal bones, and doesn’t displace them, then wrapping it will work as emergency first aid… provided she’s getting more help later on. Also, the knife, bandage, and possibly the wall, are all potential vectors for infection, so she’s going to need to treat her bandage with an antiseptic.

Generally speaking, ligaments connect bones to one another, while tendons connect muscles to bone. Severing or tearing either of those is a permanent injury that will require surgery to repair. Though, just taking a knife through the palm (between the metacarpal bones) won’t necessarily nick one.

If I recall correctly there is a string of tendons (juncturae tendinum) that bridge the second through fifth metacarpals for each finger, and that could be injured, but it might be possible to actually miss it, depending on the size and placement of the blade. It can also result in some truly disturbing looking injuries, if torn.

A tendon or ligament injury isn’t one you can just walk off. Anyone who’s experienced a sprained ankle first hand can tell you that. If they’re torn, you can’t “coax mobility” into it. This would be like trying to get a door working after you pulled the pins from the hinges. The pieces are still there, but they aren’t mechanically connected the way they need to be.

…seriously, don’t google these kinds of injuries unless you have a strong stomach or a high tolerance for really disturbing looking hands.

That said, the injuries that are likely to tear ligaments, would also probably amputate the finger, at least partially. So this is a somewhat less likely outcome, unless the blade connects across a knuckle. Fortunately, (thought, it might not feel like it at the time) fingers are one of those very rare cases where you’ve got convenient spares available.

With knife injuries, it’s usually a good idea to avoid moving and stressing the wound. It’s possible to cause more damage. This is also true of bone fractures (which is a real possibility if you’ve just taken a knife through the hand). Also, in a similar vein, if you’ve been stabbed, pulling the knife out is usually a bad idea, because it will further aggravate the wound and result in increased bleeding. (There are situations where this isn’t the case, such as where the blade is interfering with applying aid, but those are the exceptions, not the rule.)

Where I’ve experienced issues, fighting to get finger mobility back, has actually been in staff training. Blows to the knuckles are unavoidable. The staff creates a rough structure that (partially) protects against breaking your fingers when struck, but it does nothing for the bruising, which makes moving them after getting hit, much harder. Also it hurts like hell. Your hands provide absolutely critical tactile information to the brain, unfortunately, this remains true when the information being fed back is how much that hurt.

The stiffness lasts for a few minutes, and it’s actually something you can acclimate to from experience. The pain lasts a bit longer, I want to say 15-30 minutes, but I never actually timed it, and it’s been nearly 20 years since the last time I had someone clock my knuckles with a staff.

A similar injury could be suffered if your character is holding onto a ladder, pipe, or even a D-Cell Maglight, and takes a blow to the hand hard enough to raise a bruise.

-Starke

Hi! Sorry if this is a dumb question but I have a character who is shot at, her head being grazed by the bullet. In order for that to happen as realistically as possible, what would the circumstances have to be? Does the gunshot have to come from a distance? Would she lose consciousness? Would there be lots of blood? What kind of wound would she have and how would it get treated after? That’s more than one question haha. Any information would be of great help!

The circumstances would have to be that the bullet missed. It’s not really any more complicated than that. You put a round in the general vicinity of someone, and didn’t quite connect, but you still tore up some tissue on the way through.

This can just be the result of poor aim, situations where a character is just pointing a gun rather than actually aiming it. Though, someone who doesn’t know what they’re doing and is trying to aim could also result in a glancing blow. Or, if both the shooter and the victim are moving, then hitting a target accurately is a lot harder, and a glancing blow like that is certainly possible. I don’t want to say, “more likely,” because it’s not really a common outcome.

There’s a slightly rarer situation where a shot directed at the head will skate across the skull, it’s one of those “the world is a weird place sometimes” kind of fluke things, but it does happen, rarely.

Range only makes a glancing shot less likely, but it also reduces the chances of getting hit, so, not really a concern.

In general, she probably wouldn’t lose consciousness. At least not from blood loss. Having a panic attack because someone just shot her in across the head isn’t out of the question.

Honestly, I’m not certain about how much blood. Glancing wounds will result in a disproportionate amount of blood for the severity of the wound, but it shouldn’t be life threatening. So, someplace between, “more than you want to see,” and, “not enough to kill you.”

It’s also worth pointing out that this kind of injury is rare enough that my writer’s guide to forensics has nothing on the subject, so I’m kind of flying blind here.

This probably would result in a long, shallow gash and not much else, which means it would need to be treated like any minor open wound. That is to say: disinfect (with peroxide, or alcohol), staunch the bleeding with gauze (ideally with antiseptic ointment added to the bandages, once treatment gets that far), and if the bleeding persists, get someone to sew your character up.

If this happens to you? Go to the ER. This is about as non-lethal as gunshot wounds get, but that doesn’t mean you should mess around with it, also douse whatever you cram in there with either alcohol or peroxide first, you do not want to mess with an infection if you don’t have to, and impromptu bandages are as good a vector as anything.

If the bullet takes off her ear, or part of it, that would probably require reconstructive surgery. Even if it doesn’t, she’ll probably end up with a nasty scar as a result.

Sorry, the wound info is a little more speculative than I’d like, but I don’t have anything solid on hand, so I’m having to do it mostly off the top of my head… so to speak.

-Starke

This may seem a silly question, but I can’t find my answer through online searches. When someone breaks their back (spinal cord broken), will they still be able to scream? Pain-wise, what does someone feel, if anything? My character is healed with magic, but between the time his back is broken and he’s healed is what I’m having problems with figuring out…. I’d prefer this be answered privately, but if you feel this may help someone else, I don’t mind it being publicly answered.

This is actually going to need to be public, because, I’m not a doctor, so there’s a higher chance of me screwing up the medical questions, which means having someone who’s more familiar with the subject checking our work is a bonus.

In general we don’t do private answers beyond a paragraph or two, simply because if the information has the potential of being useful to more than just the person writing the ask. Especially with stuff like this, where it’s not just you.

Also, again, the major disclaimer is, damage to the nervous system is a little more advanced than any of the actual first aid training I got in Scouts.

The basic idea is your nervous system is the means your brain has for relaying information and instruction to your body and back. When you damage it, the information just stops going (both ways). You can no longer instruct parts of your body to function, and they can’t feed back any sensory information. All of this kind of “flows downstream,” so, if you sever the spinal column, everything past that is just gone.

This manifests as numbness, rather than specific pain. This is where the, “I can’t feel my legs/arms/whatever” cliche actually applies. Nerves can get nicked, I knew someone that had a nerve in his arm damaged by an Emerald Tree Boa. The resulting injury left him with a numb patch in the center of his palm.

The brain can interpret no nerve data as painful. However, this tends to happen with phantom limb syndrome, rather than just nerve damage. If you can actually look at the affected area, and confirm that no, nothing’s gone horribly wrong, then the pain dissipates.

But, again, this one’s a little outside my area of expertise, so I could be wrong here.

-Starke

how hard of a punch would it take to split knuckles? to break bones? and what would be the effect of them, respectively, on the target?

I realize this won’t be exactly quantitative, but, not a lot. A normal punch to anything other than soft tissue can easily cause tearing to the knuckles. This can be your opponent’s face, or just a heavy canvas punching bag. This is part of why things like boxing handwraps exist.

Breaking bones, well, breaking your own bones is disturbingly easy as well. Unless my memory is off, there’s 27 bones in the human hand, and none of them are particularly well suited to suffering direct abuse. An improperly clenched fist can result in injuries ranging from dislocated joints to multiple breaks. Handwraps help to stabilize the fingers, and reduce the risk of breakage, while boxing gloves provide the hands with limited armor.

The entire point of boxing gloves is to protect the fighter’s hands, not to protect their opponent. The extra padding means they’re not going to be as prone to breaking bones in their own hands, or cutting their knuckles. The other side of this is, it makes it easier and safer to break your opponent’s skull with your fists. Something that normally wouldn’t be viable, because you’d turn your own hands into hamburger in the process.

There’s a real irony when it comes to professional boxing. When the gloves were first introduced, body shots were the norm, and the gloves were supposed to make the sport safer. What ended up happening was they made head shots safer, increasing their frequency, and in turn, made head injuries more common, reducing the overall safety of the sport. But, at least they made boxer’s fractures less common.

Tearing your knuckles is… basically aesthetic. Unless your character suffers from anemia, or if they’re dealing with a situation where they’re exposed to a potential infection, and they can’t have their hands treated, anyway. It’s unpleasant, but if it’s a choice between comfort and being horribly murdered, a little pain probably isn’t too high a price to pay.

You’re looking at using a disinfectant and bandaging the injuries. Literally, it’s safer than getting scratched by a cat.

Now, if they’re also being exposed to a blood borne pathogen in the process, that could be an issue, but that should be somewhat obvious.

Anyway, boxer’s fractures are unpleasant. This is where you have direct force against the knuckle, and it breaks the fourth or fifth metacarpal bone. The fourth metacarpal is the first bone you probably associate as your finger. The fifth metacarpal is the bone that runs to your knuckle through your hand.

In either case, you need to immobilize the broken bone, seek medical attention, and expect to need three to four months before you can use that hand again. Breaking the fifth metacarpal can easily end up requiring surgery to realign the bone. Ignoring this and trying to continue using the hand can easily result in more damage to the surrounding tissue.

If you’re wanting more information on that, then you’re in luck, because boxer’s fractures are a semi-common sport injury, so there is an absolute wealth of information out there on the subject.

Breaking your opponent’s bones is going to vary wildly based on what was broken.

-Starke

One of my characters is a high ranking officer in her army who primarily uses melee weapons, and has one of her arms cut off. How would this affect her during battle and daily life?

How would having their arms cut off affect their ability to fight? Yeah, you kind of need those. Without them, you really can’t. I’m sure there’s a few exceptions out there, like the one armed MMA fighter, who’s name is escaping me at the moment. But, cutting off her arms is going to be the end of her military career. She’ll be packed up and shipped home to a hospital, and her combat days will be over.

Obviously, if this is a science fiction setting, and we’re talking about cybernetic augmentation to replace the lost limbs, that’s not going to apply. The same is true if it’s a high magic fantasy setting where she can have living arms of wood grafted onto her, or whatever. But, any historical setting, and even modern day, that’s not an option.

In daily life? You can look at actual amputees, and see how they function. I know I’ve seen a couple pretty good documentaries on the subject over the years, but I can’t identify any off hand. If that’s not an option, just take a day and be very conscious of everything you do with your arms and hands. Then realize your character probably can’t do any of them without prosthetics. That means no opening doors, no feeding themselves, nothing.

Prosthetics make that a little easier, and there are some people out there who can do fantastic things with theirs. Which could, with time and practice, allow her to feed herself, open doors, and operate in civilian life to some extent. But, how does this affect her ability to fight? She can’t.

Also, you’re not going to have a military officer that uses melee weapons. That just doesn’t happen, for basically the same reason you won’t find a bayonet charge on a modern battlefield. People have guns, and it turns out, you can use guns to kill people at slightly longer than arm’s reach. Meaning your “high ranking” whatever won’t be wading into battle and belting out, “drive me closer, I want to hit them with my sword!”

Also, high ranking personnel don’t actually see combat, if they can help it. If you’ve proved yourself valuable enough to be promoted, there are far more expendable soldiers available to take your place in the fray.

Someone in a command position may be technically replaceable, but, their loss would be disproportionally disruptive to any ongoing conflict. There’s a lot of truth to the whole “cut off the head and the snake dies” cliche when it comes to crippling a large military force. Without someone to tell the grunts where to go or what to do, they’re just so many tons of meat. And, that’s what rank ultimately means. It’s an indication of how far up the chain of command your character is.

Unless they’re in something like the Imperium of Man’s Astra Militarum, you’re not going to see someone waving swords around on the battlefield, and you’re not going to see high ranking officers wading into combat. They have a job to do, and it doesn’t involve getting waxed by the first enemy sniper they can find.

-Starke

@kalany, So, turns out, I did misread the question. Mea culpa, for what little that’s worth. Unfortunately, it doesn’t really change much about the answer. If their character is still engaged in front line combat, they’re going to need both arms to function. You can’t just lop one off and call it cool.

You need two functioning limbs (not counting legs) to fight something with two functioning limbs (again, not counting legs). You need two functioning limbs to operate a rifle. You can’t one hand them. You need two functioning limbs to reload any firearm. And, of course, saying, “but I wanted to hit them with a sword,” just isn’t a valid tactic in the 21st century.

Now, if their character was already a flag officer (an Admiral or General), who wasn’t involved in combat… just forget that whole melee thing, then wandering around with one arm isn’t unprecedented. There are examples like Lord Nelson, who continued belting out orders after he’d lost his arm, and I think his eye. But, as I said above, these are people telling others where to fight, not doing it personally. After all, the art of command is delegation, not demonstration.

-Starke

if i’ll hit someone with something heavy in head in order to make them unconscious (nevermind if i succed or not) is there a possibility to make them some damage to brain? and what exactly would happen?

Well, by definition you’re trying to inflict brain damage. Knocking someone out through blunt force is a concussion. The entire point is to damage the brain enough to get it to say, “nope, I need a break now.”

That is assuming you don’t outright kill them. The difference between hitting someone hard enough to annoy them, hard enough to knock them unconscious for a few seconds is… actually, no, there isn’t a difference on your end. It’s all in how their brain and skull decide to interact with one another.

-Starke

EDIT: There’s also this post from last year.

I know either of you two aren’t doctors, but let’s say the majority of someone’s blood vessels, excluding major arteries, either in an arm or a leg, are “shattered”, for lack of a better word. Would they bleed out if there are lacerations on the skin? How bad would the internal bleeding be? What are the long term effects of it? Would they go into shock?

Yeah, they’d bleed out all right. So, when we talk about blood loss from arterial injuries being dangerous, the issue is the speed the volume is lost at, not that the artery itself is somehow special. Rupture enough veins in the legs and they will bleed to death. It might take a few minutes longer, but it will kill them.

I’m inclined to say it would actually be more dangerous than an arterial injury. In that case, if you can get medical attention there’s one injury they need to deal with. The situation you’re describing would result in hundreds of simultaneous injuries that are dangerous as a whole, but treating them individually would be extremely time consuming, and by the time they were done your character would have bled to death.

Also, yes. Hypovolemic shock is a function of the body shutting down from blood loss. If you start losing a lot of blood you will go into shock and die.

-Starke

When you are running away from someone / something, and you finally feel safe and the adrenaline starts to leave you, would it be realistic to pass out? From all the panic and other emotions you kept repressed so you could escape?

No. Flushing adrenaline can make you shaky, but it won’t cause you to simply keel over without warning unless there’s something seriously, medically, wrong.

Also, adrenaline doesn’t suppress panic. Keeping a clear goal in mind, and working towards that can, but adrenaline does nothing for panic. Also, panic can’t make you pass out. Except in rare cases where it could cause a heart attack, stroke, or similar “f— this I’m out” for the victim’s body.

Now, adrenaline can reduce or delay your pain response. That is to say, you can be seriously injured and not know it because of the adrenaline rush. Which could result in someone passing out after the adrenaline rush. But, that would be because they are bleeding to death, and not because they panicked or because the adrenaline did it to them.

-Starke

Not the sort of thing you get back up from unless you happen to be called Phineas Gage.

Though, from what I’ve read, his friends disputed that the man who got up was still Phineas.

Which kind of illustrates the point I was making. Sticking a blade into someone’s brain and stirring might not kill them, but it will seriously mess them up, and I just don’t know what that will do to them.

-Starke