Knife Wound

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Becca_H

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My MC's forearm receives a nasty slice from a scary-looking knife. It doesn't penetrate directly through, merely skims through the skin in the upper arm.

I need her unconscious from it (because it's so much easier to move a character against her will when she can't complain). Is this realistic, either through blood loss or pain or something else?

What would she need in the hospital? Just stitches? How long would they keep her in for?

Also, she's 16, accompanied by her father. Would the hospital ask any probing questions as to how she got hurt? If her dad just said, "She dropped a knife while cooking," would that be sufficient? Ideally I don't need anyone probing into her life or how she received the injury.

Also: She's not insured. Roughly how much would it cost her father?
 

FabricatedParadise

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What would she need in the hospital? Just stitches? How long would they keep her in for?

Also, she's 16, accompanied by her father. Would the hospital ask any probing questions as to how she got hurt? If her dad just said, "She dropped a knife while cooking," would that be sufficient? Ideally I don't need anyone probing into her life or how she received the injury.

Also: She's not insured. Roughly how much would it cost her father?

I'm not sure how things work there, but I can tell you from personal experience that hospitals here will DEFINITELY ask questions when a child comes in injured and the explanation is sketchy. And they have a protocol they have to follow, even if the "injury" is a rash (as in my case), they do head CT's, full skeletal x-rays, make the parent meet with social workers, etc.

As for insurance. Here an Emergency Room visit will easily run you hundreds of dollars just for the basics. If they do the investigative things like CT scans and X-rays, you're looking at many thousands of dollars.

Edit: Oh but you don't have to pay right then. They bill you.

But that's just here in the US. I see you're in the UK, so your story is probably set there. Which would make my information useless lol :)
 
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FabricatedParadise

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In regards to your other questions, I'm not a medical professional so I can't say for sure but:

I do personally know people who faint at the sight of blood or from pain. My aunt fainted (twice) while she was getting her ears pierced, but that was more from anxiety than the actual pain.

If the wound is only through skin, they'd probably just clean it and do stitches and bandage, tell her to keep it clean and dry, etc. or I would assume that to be the case.
 

Williebee

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The wound, as described would be unlikely to make her unconscious. She might faint, if she is the fainting sort, but that's not going to last long. If the cut didn't hit anything vital then blood will well up and run in rivulets. How much is decided by how deep.

And yeah, the hospital, by law is going to ask some questions, probably will try to ask of both dad and the girl separately.
 
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Piper Brooks

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In my years working in an ambulance, I never saw someone unconscious from a superficial wound. If it were deep and in the right place, there could be enough blood loss to lead to unconsciousness, but I don't think that would be likely if the knife just skimmed through.
Now, bloody wounds can look awfully scary, and can lead to hysterics, and fainting could happen if she us someone who faints at the sight of blood.
As for finding out how a teenager got cut like that--we would have asked questions and not hesitated to notify police. Reporting child abuse is required. The father brushing it off by saying something so implausible, would have been a red flag. I would think he would need to come up with a solid story to defray suspicion.
 

Bracken

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It's in the US, don't worry :)

Thanks for your help!


In the US, emergency rooms can't refuse you, whether or not you have money, insurance, or even ID.
Take it from me, I was uninsured for fifteen years, and on the few occasions I got really sick, I'd just go to the ER.
You can always just say, "I'm uninsured, I don't have any money with me, I don't have ID with me today, my name is _______ (fake name) and my address is _______ (fake address). Just bill me."
Or, alternately, give your real name and address, and they will bill you. And then you can either pay it, or not. If you don't pay, they can't refuse you service the next time.

Anyone who doesn't believe this is free to go try it.

An uninsured minor, however, would probably have Medicaid if her parents couldn't afford to insure her. Also, each state has a special low-cost or sliding-scale option for insuring the children of the working-class poor, who make a little too much to qualify for Medicaid.
It's really not realistic that a minor in her father's care would simply have no insurance, unless he lost his job and health insurance benefits the month before and hasn't had time to apply for Medicaid or CHIP yet.

As far as the knife wound; I don't see why it would render her unconscious, unless she passed out from emotional shock or something.
It's really not that easy to make the average person pass out (and stay out long enough to be transported to ER).
A superficial knife wouldn't be painful enough to do it (trust me; I've endured natural childbirth without any painkillers, not to mention stitches in my chin, a broken arm, and two kidney infections, and not come close to passing out, although I might've wished I could).
I don't think she'd lose enough blood to pass out, either.

It really doesn't ring true, given the injury you describe, that she'd pass out at all. People endure terrible trauma every day. Car accidents, etc. Unless it's head trauma, they do not typically lose consciousness unless they are actually near death (from blood loss, etc). This knife wound doesn't sound anywhere near serious enough to make a person lose consciousness.

She'd probably get a tetanus shot and some stitches (they might use tape or glue instead, depending upon the depth of the cut).

Child Protective Services would probably get involved.
A social worker would almost certainly speak to her alone, out of her father's presence.
Nothing her father had to say would make any difference; only she would be able to convince them that abuse/assault had not occurred. If she denied it and stuck to the "dropped a kitchen knife" story, they'd probably be forced to accept it even if they suspected it wasn't true, because of her age. If she was seven or eight, they might remove her from her father's custody regardless of what she said, but at sixteen they probably wouldn't, if he and she both denied any problem and if their stories were consistent.
 
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Becca_H

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Thanks for the replies so far.

Ideally, I need police/child services far, far away from these two. With the characters the way they are, there's no chance in hell of them collaborating on a story. The only reason she faints is she wouldn't go to the hospital otherwise.

Is there any way I can stop them appearing? Be it improve the cover story, change the injury, etc? (I did believe a falling knife is believable, considering some people hang them on hooks, even though a drawer is a better place.)

The father didn't cause the injury. He knows who did, but due to his daughter being in trouble with the law (and him for that matter, and several other people), he wants to gloss over everything and fix it himself.

Also, she's definitely not insured, and the dad is the type of person who insists on paying his bills. Can anyone suggest an approximate cost of treatment?
 

glutton

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Thanks for the replies so far.

Ideally, I need police/child services far, far away from these two. With the characters the way they are, there's no chance in hell of them collaborating on a story. The only reason she faints is she wouldn't go to the hospital otherwise.

Is there any way I can stop them appearing? Be it improve the cover story, change the injury, etc? (I did believe a falling knife is believable, considering some people hang them on hooks, even though a drawer is a better place.)

The father didn't cause the injury. He knows who did, but due to his daughter being in trouble with the law (and him for that matter, and several other people), he wants to gloss over everything and fix it himself.

Also, she's definitely not insured, and the dad is the type of person who insists on paying his bills. Can anyone suggest an approximate cost of treatment?

Is there any reason you can't just have her skip the hospital visit altogether, or is it important to the story?
 

glutton

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It's pretty crucial to the story.

Maybe have it get a little infected after some attempt at at-home treatment and she gets scared enough to go? Better that than having her faint and stay out long enough to be taken there IMO.
 

Bracken

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Also, she's definitely not insured, and the dad is the type of person who insists on paying his bills. Can anyone suggest an approximate cost of treatment?
It's extremely variable.
Do a google search for the term "cost of stitches emergency room" and you'll see what I mean.
If I were you, I'd just pick a number between 500 and 1500, and that's a reasonable estimate as to what it would cost.

Emergency rooms usually offer a discount to uninsured people who are willing or able to pay the full amount at the time of treatment, rather than being billed. I guess they figure a bird in hand is worth two in the bush.

I've had them offer to cut my bill in half if I could pay it all at the time of treatment (not that I could ever afford to).

So... why don't you say the bill was 798 dollars, and they knocked 30% off that, since dad was willing to pay immediately?

That's realistic enough.
 

jamiehall

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If you need the character unconscious from a cause other than panic fainting, you would need more than the kind of knife wound you described.

Perhaps a knife wound while in the middle of a prolonged exposure to very cold weather? Or some kind of pre-existing medical condition? You're looking for something which, when combined with a knife wound, would put incredible stress on the body to cause the unconsciousness.

A badly infected knife wound could eventually cause unconsciousness, but that would take lots of time.
 

sheadakota

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Becca its your story so write what you want, but the scenario as described is not very realiztic- A superficial cut on her arm (and that is eaxactly what you described- a slice that only penetrates the skin) will in all reality not even need stitches- the falling knife will never be believed- ER personal are actually trained on how different weapons wound and weather that wound could be accidental or an attack- a falling knife would not create a slice- but rather a puncture wound followed at the best by a superficial cut where the arm was quicklt drawn back- it would not create an injury that needs stitches and unless your character is a total wuss she would not be unconcious from this injury due to lack of blood- Child and youth would most definitely be called in on this if they think the kid or dad is trying to cover something up-
IMO if you need the kid in the ER, you need a better scenario.
 
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sheadakota

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It's extremely variable.
Do a google search for the term "cost of stitches emergency room" and you'll see what I mean.
If I were you, I'd just pick a number between 500 and 1500, and that's a reasonable estimate as to what it would cost.

Emergency rooms usually offer a discount to uninsured people who are willing or able to pay the full amount at the time of treatment, rather than being billed. I guess they figure a bird in hand is worth two in the bush.

I've had them offer to cut my bill in half if I could pay it all at the time of treatment (not that I could ever afford to).

So... why don't you say the bill was 798 dollars, and they knocked 30% off that, since dad was willing to pay immediately?

That's realistic enough.
ERs are not going to barter payment with you - that would be left to billing and it isn't going to happen the night of your visit.
 

Bracken

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ERs are not going to barter payment with you - that would be left to billing and it isn't going to happen the night of your visit.


Excuse me? Are you calling me a liar?
You certainly do go to billing on the night (or day) of your visit.
They don't let you out of there without forcing you to sit down at a desk with the billing dept and making a payment plan.
Hell, the ER here, the exit door is locked and there's a security guard, and the people behind the desk have to buzz you out, and they will not do so without directing you to the billing department first.

I was just there a couple of months ago (threatened miscarriage; luckily, it didn't happen. I'm insured now, but the same deal still applies- they want me to pay the part that my insurance doesn't cover).

First thing they do is show you a paper and say:

"This is how much you owe for the treatment you received here today. If you can pay the entire amount today, we can take this amount off (usually 25-30%; sometimes more), and you'll only pay this much (they show you a smaller figure)."

You: "I can't pay that today."

Them: "Well, how much can you pay today?"

You: "Nothing. I don't have any money with me today."

Them: "Okay, fill out this paperwork and we'll bill you."

______________________

For fifteen years I was uninsured, and used the ER as my primary care physician.
Can you imagine how many ER visits that amounts to?
I think I know whereof I speak, here.
Now that I'm insured, I still use the ER... but only for emergencies.

Would you like the phone number of the ER I use, so you can discuss with them how and when they handle their billing, whether they let patients out the door without discussing payment and having them sign a payment agreement, and what sort of discount they offer if a patient (insured OR uninsured) is willing to pay the amount they owe in full at the time of treatment?

After you discuss that with them, you can come back here and apologize to me for shooting your mouth off without knowing what you're talking about.
 
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sheadakota

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Excuse me? Are you calling me a liar?
You certainly do go to billing on the night (or day) of your visit.
They don't let you out of there without forcing you to sit down at a desk with the billing dept and making a payment plan.
Hell, the ER here, the exit door is locked and there's a security guard, and the people behind the desk have to buzz you out, and they will not do so without directing you to the billing department first.

I was just there a couple of months ago (threatened miscarriage; luckily, it didn't happen. I'm insured now, but the same deal still applies- they want me to pay the part that my insurance doesn't cover).

First thing they do is show you a paper and say:

"This is how much you owe for the treatment you received here today. If you can pay the entire amount today, we can take this amount off (usually 25-30%; sometimes more), and you'll only pay this much (they show you a smaller figure)."

You: "I can't pay that today."

Them: "Well, how much can you pay today?"

You: "Nothing. I don't have any money with me today."

Them: "Okay, fill out this paperwork and we'll bill you."

______________________

For fifteen years I was uninsured, and used the ER as my primary care physician.
Can you imagine how many ER visits that amounts to?
I think I know whereof I speak, here.
Now that I'm insured, I still use the ER... but only for emergencies.

Would you like the phone number of the ER I use, so you can discuss with them how and when they handle their billing, whether they let patients out the door without discussing payment, and what sort of discount they offer if a patient (insured OR uninsured) is willing to pay the amount they owe in full at the time of treatment?

After you discuss that with them, you can come back here and apologize to me for shooting your mouth off without knowing what you're talking about.
Wow - easy there- I'm not calling anyone anything- My hospital is obviously different from the one you were at so I should have added that caveat- Peace
 

Bracken

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Wow - easy there- I'm not calling anyone anything- My hospital is obviously different from the one you were at so I should have added that caveat- Peace


Peace, then.

Really, though, you (and the thread-starter) ought to call around to some ERs and ask some questions, do some research, if you're not simply willing to take an internet stranger's word for it.
I don't blame you if you're not, but seriously, people, do a little research before you just run around claiming people are lying.

I stated my basis for having this knowledge (15 years of being uninsured and having to use the ER every time I got sick).
So it's not like you're simply accusing me of being wrong, or misinformed, or mistaken.
Your clear implication was that I was being dishonest.
 

Stacia Kane

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Just as an FYI, my mother has been an emergency room nurse for over twenty years, in hospitals both public and private. I can't speak for all of them, but I know in at least a couple of them you certainly did not speak to billing before they let you leave; you got a bill and a phone call within a few days of your visit. (ETA: Just remembered that in one of them you did speak to someone in Billing before you were seen if there was time, but they didn't ask for payment at that time if you were uninsured or for your copay if you weren't; you again got a bill within a week or so. That was at North Broward Hospital in Ft. Lauderdale; I visited there a few times both insured and uninsured, and never once wrote a check at the time of my visit, it was always a bill that came later.)

That was definitely the case for me, when I had a medication-induced seizure in October of last year (that was North Fulton Hospital in Alpharetta GA). The ambulance took me to the ER, I was there for an hour or two, they discharged me, and I left, without a word about billing or payment (I'm not sure those departments were even open at the time of my visit, since I know at one of the hospitals where she worked--Mount Sinai on Miami Beach--the billing/payments people worked a straight 9-5 M-F schedule). The phone calls from the hospital started three days later, I believe, and the bill for the ambulance arrived separately.


Different hospitals have different policies.
 
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Bracken

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Here, you don't leave the hospital without making a payment plan and signing it.
If you're going to be billed rather than pay at the time of treatment, you have to decide how much you want them to bill you each month. There's a minimum they won't go below- maybe 40 dollars a month- but I don't know how they figure it. It may be a percentage of the total bill.

But no, they don't let you walk out the door without either paying or making a payment plan and signing it. Which is not to say you have to pay; just that you have to sign an agreement. If you can't pay, you can't. They have no recourse, except to screw up your credit. They can't refuse you treatment the next time.
Many poor and indigent people routinely use the ER, and never pay a cent. A lot of times, they give fake names and addresses to billing.

There are both private and public hospitals in most large cities, and I'm sure they're run differently. Public hospitals see far more indigent and uninsured people.
The hospital I am referring to, however, is a private, for-profit hospital. It is part of the Columbia/HCA group, the largest group of private hospitals in the United States.
I am not sure if their billing policy is standard and across the board for all their hospitals or not. It seems like it would be.
 
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Stacia Kane

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Here, you don't leave the hospital without making a payment plan and signing it.

And that's fine, that's the policy there. It is absolutely not the case for every hospital.


If you're going to be billed rather than pay at the time of treatment, you have to decide how much you want them to bill you each month. There's a minimum they won't go below- maybe 40 dollars a month- but I don't know how they figure it. It may be a percentage of the total bill.

Also not the case at every hospital. My late FIL was treated (again at North Broward) for prostate cancer, and his payment plan worked out to less than $40/month. I remember my mother telling me about conversations with the people in billing at one of the other hospitals where they told her about people on $5/month billing cycles.



But no, they don't let you walk out the door without either paying or making a payment plan and signing it.

Again, at your local hospital. Not at every hospital.


Which is not to say you have to pay; just that you have to sign an agreement. If you can't pay, you can't. They have no recourse, except to screw up your credit. They can't refuse you treatment the next time.


100% true. They can't refuse you treatment if you can't pay at that time, either, at least not in the state of Florida; it's the law.


Many poor and indigent people routinely use the ER, and never pay a cent. A lot of times, they give fake names and addresses to billing.

Also 100% true.
 

Canotila

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When I was 18 I took an art class at the local community college. Long story short, you always cut away from yourself. I ended up with a half inch deep cut that went lengthwise along my wrist, it sliced the artery.

Now, I'm one of those people that faints at blood, needles, etc. Somehow I didn't faint, managed to tape paper towels around my wrist and drove myself to the ER.

They put in 9-11ish stitches and called it good. A social worker did come in and I spent a good 20 minutes or so trying to convince her that no, I wasn't suicidal. And no, I wasn't in fear for my safety because of anybody else.

In all, it cost me about $550 for the visit. That was without local anesthetic though. I asked the doc to skip it because my arm felt numb from the adrenalin anyway and I didn't have insurance. She was fine with that and it didn't hurt.
 

Silver King

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Excuse me? Are you calling me a liar?
She did no such thing, and you know it.
...After you discuss that with them, you can come back here and apologize to me for shooting your mouth off without knowing what you're talking about.
You need to take it easy and stop mistreating people who don't agree with you, and who are otherwise trying to be helpful. If you're having a bad day or week or month, try not to post here during that time to save the rest of us from whatever anguish you're dealing with at the moment.
 

Bracken

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She did no such thing, and you know it.

You need to take it easy and stop mistreating people who don't agree with you, and who are otherwise trying to be helpful. If you're having a bad day or week or month, try not to post here during that time to save the rest of us from whatever anguish you're dealing with at the moment.


When someone solicits my opinion, and I say, "In my experience, here's how it works and this is what my experience is based on", and then somebody else barges in with, "No, that certainly is not how it works", well, yes, in fact that person is calling me a liar.
The fact that there may be a hospital in the United States, or even a number of hospitals, where things work a different way in no way negates the information I gave, and in no way justifies someone coming along and saying, "No, what you said is not how it is."
I can, in fact, prove that it is, if need be.
I can prove that billing at my hospital works exactly as I stated in my post, if necessary.
I just find the presumption uncalled for.
 
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