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There's only one injury you can really do there that's life threatening, straight slit along the length of the arm (crosswise is not generally deadly). I don't know the name of the artery, but Google is a writer's friend, it's easy enough to look it up. So first off, the girl attempting suicide needs to have researched this, most 13 year-olds haven't been around enough to know how to slit their wrists "properly".

Second, google "first aid for slit wrist" and look at the suicide attempt answers, the first answer on Yahoo Answers seems pretty complete to me. https://answers.yahoo.com/question/index?qid=20091206230808AAES6JE

I live 20 miles from the closest hospital.

At the wrist there is both the radial and ulnar arteries as well as tiny branches. The radial and ulnar arteries actually connect in the fingers in most people so even if one were to be severed and between that and compression which is the short term solution to such bleeding resulted in occlusion of one of the arteries, perfusion of the hand should still be maintained. So gangrene is not a likely issue. If one were to cut deep enough to sever one of those two main arteries there is a good chance that they will also sever one or more tendons that flex the fingers. They may even sever one of the main nearby nerves, so partial hand paralysis may be noted. Repairing arteries, nerves or tendons is not something that can be done at the scene. That will require an OR and trained surgeon in that respective specialty. At the scene, all that can really be done is to bind the wounds to control bleeding. People do die from severing radial or ulnar arteries, it's just that most suicide attempts don't cut deep enough to actually sever them. Instead they cut the skin and the tiny vessels, not the main ones.

Also ER doctors generally don't have, "bags." Almost no physicians do anymore. Those who do are doing rounds at places other than a hospital or urgent care facility where all the supplies they might need are provided. You may find in a rural area a primary care physician who might also work in an ER but in addition to that does house calls or may do rounds once a week at a low care nursing home.

In my area (rural and 30 miles to the nearest hospital) EMT and Paramedics are going to be on the scene not a doctor. We do have 1 doctor that still makes housecalls but that's very rare and he does this for home bound patients only.

Here when an emergency call comes in, it's usually the police department and fire department who are called in first to access and stabilize the scene. The EMT/Paramedics will only be allowed in when the scene is considered safe. All police and fire department personnel have medical training. Enough to possibly start treatment and to properly inform the medical team what is going on. They do have some supplies such as pressure bandages.

Once the medical team is on scene their job is to stabilize the patient then get to the hospital. Depending on the situation one of the firefighters or police might be needed to assist on the truck depending on if the medical team is a 2 man or 3 man. Sometimes you do need an extra set of hands even if it just for reassurance of the patient. Anymore, parents, friends and family are NOT allowed to ride on the truck unless it's a young patient.

With this type of injury they will assess the injury, try to stop the bleeding, load the patient and go. Treatment will depend on the team and how much training they have. EMT level 1 can only do minor treatments. Level 2 can do higher level treatments such as put in a breathing tube. Paramedics can start and IV and distribute medication.

I used to be an EMT and in an area with a higher than normal amount of medical doctors. I had two calls where the doctor was a neighbor and showed up before I got there. First thing, as George said, they don't have bags. Second is they let me do my thing and stepped back. My job as an EMT is to get the patient to the hospital where they actually have equipment and lots of trained personal. Smart doctors understand that, know that we know what we've got on the ambulance, and by and large, leave us alone.

For an EMT, this is simple. Secure airway, apply pressure to the wound to control bleeding, large bore IV if there's a paramedic, O2, and prepare for the crash. Then get to the hospital as soon as possible. Race is between whether we get to the hospital first or the patient bleeds out first.

Suicide is not an issue for the EMT, other than the patient might be refusing treatment.

As patient bleeds out, lower and lower level of consciousness. All we can do is slow the bleeding as best we can. And tell the driver to "GO!"

Best of luck,

Jim Clark-Dawe

I can't think of anything outside of a hospital where a Neurosurgeon would be able to show off his or her skills, other than being able to diagnose something.

In the case of slit wrists, basic treatment is take a clean t-shirt, wrap around wrist as tightly as possible, then duct tape in place. No tourniquet. Worst case is death or loss of hand. Loss of hand beats death, so constricting blood flow to the hand is not a major problem. (You don't want to, but you've got to stop the blood flow.)(Blood flow loss to the hand may require an amputation down the road. Beats being dead.)

There's no way to stitch this in the field. If you're going to stop the bleeding, you're going to pull the slit together through a bandage and pressure.

Here's Wikipidea on hypovolemia -- https://en.wikipedia.org/wiki/Hypovolemia It has a good description of the stages.

The crash is the patient, and is when he goes unconscious, with no breathing and/or heart activity. CPR is rather useless as there's nothing to push, defib doesn't do much because there''s no blood to work with. If you can get your patient stable, you've got a bit of time. But if the bleeding isn't controlled, you've got to get them to the hospital as fast as possible. Hospital is notified and a surgeon is waiting in the ER.

Best of luck,

Jim Clark-Dawe

If you need a bag, have a neighbor who is a combat medic or corpsman show up or your basic prepper. They'll almost always have a go bag of medical gear, similar to what a paramedic might have.

20 minutes is a short distance in most areas. And Jack was correct. Pressure to the wound or tourniquet (pretty rare nowdays but still works) and transport. Radial artery is a good choice, but it's rarely deadly for the aforementioned reasons.

What do you need for the story? That would be the key to figuring the best wound and needed response to make your story work.

Jeff

You're talking about a survivalist bag, not a jump kit. If your neurosurgeon is a survivalist, he would have such a bag.

Depends upon how bad your patient is going down the tubes, but basically:

gauze -- lots of it over the wound
tape -- holds the gauze in place and applies pressure
O2 -- helps to delay the consequences of the blood not having as much oxygen as normal volume
IV -- if qualified, an IV with large bore
airway management tool -- depends upon training

It's not a lot that you need, and parts can be easily supplied/substituted by most people

Best of luck,

Jim Clark-Dawe