Treatment of a stabwound

Nivarion · Jun 7, 2011

It seems that while I know plenty about how to kill people, I don't know squat about putting them back together.

I have a character who's been stabbed. The blade went in under the last rib on the left side, and angled up enough to hit a lung and puncture the diaphragm.

There is an experience battlefield medic on hand, and he's the only medical help around. What would he try to do to save her? The technology is late renascence, however he's been exposed to 20th century medical philosophy. (it makes more sense in context.)

If it helps any, the blade was not long enough to reach the other lung or heart.

GeorgeK · Jun 8, 2011

There is a finite probability that that would heal. It's not a zero. Pop a lung and you have a pneumothorax. A small pneumo can heal provided it's small enough that it doesn't get worse or become a tension pneumo. Theoretically if your blade tract happened when the patient was contorted, then when they are not contorted the tract might act like a flap valve and prevent a tension pneumothorax. Note: heavy on the theory, light on the probability. Stuff like that happens, just normally not to the good guys.

The good news is that since it is not modern, there are no CT's or even surgical exploration to definitively say what was cut. You could simply have your medic agonizing over what might be wrong and all he'd really know is the location of the wound.

areteus · Jun 8, 2011

In an immediate triage situation with no hope of getting him into surgery anytime soon, changes are all he can do is put pressure on the wound and cover it with a clean bandage to prevent shock due to blood loss and infection. The time to look for problems like pneumothorax is after the battle... and as stated above, he has no way of knowing anyway...

Trouble is, in this environment his 20th century knowledge is not going to help him much. As well as the lack of diagnostic equipment (as above) he won't have access to antibiotics or the ability to transfuse blood safely. He can't even really guarantee a sterile surgery (I think the renaissance was the time of physicians swilling out wounds with salt water or gin...). Since the two main killers on the battlefield up until the Crimean and Boer wars were infection and blood loss he needs to find a way to deal with both those problems.

Steve Collins · Jun 8, 2011

If the lung was punctured you'd cover it with plastic or polythene taped on three sides.

areteus · Jun 8, 2011

In the renaissance? No plastic... perhaps you'd use oiled cloth but not sure what else would work to seal a wound to the chest that had punctured the lung...

Nivarion · Jun 8, 2011

Thanks for the answers guys. I always love asking questions here.

Steve Collins said:
If the lung was punctured you'd cover it with plastic or polythene taped on three sides.

Would covering it with some sterilized leather work? pour some boiling water over it and slap that thing on there.

areteus said:
Trouble is, in this environment his 20th century knowledge is not going to help him much. As well as the lack of diagnostic equipment (as above) he won't have access to antibiotics or the ability to transfuse blood safely. He can't even really guarantee a sterile surgery (I think the renaissance was the time of physicians swilling out wounds with salt water or gin...). Since the two main killers on the battlefield up until the Crimean and Boer wars were infection and blood loss he needs to find a way to deal with both those problems.

This whole world got a good dosing of 20th century medical knowledge. Most apothecary's would have some penecillin on hand, but not a lot.

The blood transfusion thing will probably be bad. That bit of knowledge is lost in this world, and she's very small. (seven year old.)

GeorgeK said:
There is a finite probability that that would heal. It's not a zero.

So there's a chance that she'd live fine, but its pretty slim?

And I've also picked up, he'll pretty much just have to pull the dagger out, cover it with bandages and hope for the best. Is that right?

And finally, what are the chances of paralysis of the diaphragm? I've heard of that happening when a knife goes through a significant portion of it. Are there chances she would start breathing again if it happened?

Would it make sense for him to set people to breathing for her?

Steve Collins · Jun 8, 2011

In the renaissance? No plastic... perhaps you'd use oiled cloth but not sure what else would work to seal a wound to the chest that had punctured the lung...

Doh! Sorry, it would have helped had I read the thread properly.

Would covering it with some sterilized leather work? pour some boiling water over it and slap that thing on there.

I guess anything like that would work ,providing it was flexible, all it does is seals the chest when the patient breathes in.

Nivarion · Jun 8, 2011

Steve Collins said:
In the renaissance? No plastic... perhaps you'd use oiled cloth but not sure what else would work to seal a wound to the chest that had punctured the lung...

Doh! Sorry, it would have helped had I read the thread properly.

Would covering it with some sterilized leather work? pour some boiling water over it and slap that thing on there.

I guess anything like that would work ,providing it was flexible, all it does is seals the chest when the patient breathes in.

I guess something else I should ask on this is, How much will a coat of short fur mess with this?

Hehe. Fantasy creature with highly similar to human biology here.

Steve Collins · Jun 9, 2011

The seal would need to be as airtight as it could be so I guess if a patch of fur was cut away around the wound area this would suffice.

Nivarion · Jun 9, 2011

Steve Collins said:
The seal would need to be as airtight as it could be so I guess if a patch of fur was cut away around the wound area this would suffice.

About what I figured.

And that's all I needed for this scene. Thank yall greatly. Rep points for everyone.

Treatment of a stabwound

Nivarion

Brony level >9000

GeorgeK

ever seeking

areteus

Steve Collins

areteus

Nivarion

Brony level >9000

Steve Collins

Nivarion

Brony level >9000

Steve Collins

Nivarion

Brony level >9000