Hand injuries and shock

Basenjichaos · Mar 23, 2015

I have a scene I'm considering in which a WIP (I assume that means woman in peril) uses part of a broken beer bottle to free her hands, which are taped behind her. Being diabolical, I have decided that one of her hobbies is piano playing, because I'd like to give her a radial nerve injury (I believe that is the nerve that control three of the fingers on the hand).

I know it would be painful, but she has everything to lose and is therefore pretty damn motivated. There a painfully loud Bruce Willis movie playing (I figure the end of any Die Hard movie on surround sound would mask any noises of pain), and she is gagged, so hopefully it's believable that any noises she makes would be unheard.

Further, I don't want her to hit an artery, because this occurs outside the city limits and there's 20-30 minute delay in medical assistance arriving (which I can adjust if need be). I do want her to bleed enough to put her in shock. She's pretty dehydrated and has obviously been in a bad situation for 3-5 days.

So my questions are:

1. Does this sound plausible?
2. Has anyone had radial nerve injuries of the hand, and what were your experiences/frustrations with treatment and healing?
3. Would this bleed enough to put her into shock, but not kill her immediately? (My plan is for her to be able to use that broken bottle to stab someone with it, before a her friend can call help for her).
4. Any and all input is happily accepted!

King Neptune · Mar 23, 2015

I don't know about the nerve damage, but the rest is plausible, especially since she is playing with broken glass. With broken glass there can be as much or as little damage as you want. One minor problem is that most beer bottles aren't any good for stabbing these day, but old-fashioned multi-trip reusables are still adequate; the others are too weak.

Siri Kirpal · Mar 23, 2015

Sat Nam! (Literally "Truth Name"--a Sikh greeting)

In case you were serious and not joking, WIP stands for Work in Process.

Blessings,

Siri Kirpal

asroc · Mar 23, 2015

Basenjichaos said:
2. Has anyone had radial nerve injuries of the hand, and what were your experiences/frustrations with treatment and healing?

I believe you're thinking of the median nerve. The radial nerve controls all fingers, but only the extensor muscles and those are all located in the forearm, not the hand. The parts of the radial nerve that actually make it to the hand innervate part the skin.
The median nerve controls the palmar side of the thumb, index and middle finger and half the ring finger (roughly. The median nerve and the ulnar nerve share a few muscles). If you injure it close to the hand you'll primarily have problems with your thumb because the muscles will atrophy. You'll also have trouble feeling sensations in that half of the hand.

Basenjichaos said:
3. Would this bleed enough to put her into shock, but not kill her immediately? (My plan is for her to be able to use that broken bottle to stab someone with it, before a her friend can call help for her).

Weill, it's not entirely impossible... It's quite common for people who unsuccessfully tried to commit suicide to damage their median nerve and there may be signs of shock (although if she doesn't injure the artery at all, then not really.) Unless she's a hemophiliac or really gets in there good and deep it probably won't kill her.

growingupblessings · Mar 26, 2015

The dehydration alone (assuming it has been significant over the past 3 days) would be enough to put this patient at a realistic risk for hypovolemic shock - her blood pressure would be already be dangerously low. You don't need her to bleed too much, if at all.

The hypotension (related to dehydration, not blood loss) which is what I think your realistic event is probably hinged on if I'm understanding you correctly, is going to be a struggle for your character. She is going to be feeling like heck. Her awareness of her extremities will be greatly diminished. She is going to be weak, dizzy, and exhausted. Having her accidentally cut her wrist would be totally believable as a result.

In a state of even severe dehydration without the presence of shock, she's going to have a hard time finding the energy and control of her body to walk, let alone fight somebody. Maybe she could stab a sleeping guy with the bottle?

Perks · Mar 26, 2015

Don't know if it helps at all, but I cut my hand very badly on an industrial meat slicer, although there was no significant permanent impairment to the finger that got got.

Because it was so quick and clean, there was no pain at all at first. In fact, it kind of felt like shock because the knowledge of the injury seemed to erase the pain of it -- almost immediately. I never made more than an initial hiss.

Even when my boss ran my hand under the water, I braced for pain, but none came. I was white, sweaty, and shaking, but in no pain.

It was several hours before I got into a hospital and when they jabbed a needlefull of somethingorother up into the meat of the injury, well, then I nearly hit the ceiling.

_Sian_ · Mar 27, 2015

To pipe in about the dehydration - how your character (I'm presuming she's young and relatively healthy) would react to a moderate amount of blood loss is going to change depending on the condition she's in before said blood loss.

How dehydrated is pretty dehydrated? That's really what it hinges on. If she hasn't had water for like two or three days she's going to have trouble staying awake, never mind figuring out the opportune moment to cut herself free.

If they have been giving her water, and she just feels thirsty, then maybe make the tiredness the confusing factor that makes her cut herself? Tiredness can be defeated by a rush of adrenaline. Sever dehydration - not so much.

But yeah, if she's a health young woman and just relatively thirsty, as opposed to clinically dehydrated, I see no issue with her bleeding so much that she'd suffer from a clinical form of shock. If it was the artery that she cut by accident, that would be more of an issue, but I'm sure there are ways to give yourself nerve damage without slicing open an artery.

Hand injuries and shock

Basenjichaos

King Neptune

Siri Kirpal

Swan in Process

asroc

Alex

growingupblessings

Drinking lots of coffee

Perks

delicate #!&@*#! flower

_Sian_

Ooooh, pretty lights and sirens :D