Blood loss / suicide attempt / recovery

There's not one answer to these many questions. Extent of injuries, state law, and hospital policy might factor in.

This is a sensitive subject, and I'd encourage any author to do some basic reading/research on the the subject before writing about it. Though I wasn't able to tell from your question, perhaps you've done that.

You might want to find some survivors stories to give yourself some context. You should be able to google and find them.

If your kid literally cuts his wrists, then it's very likely that someone can find him in time to save him. Most people are hesitant to cut their own skin, even if they think they want to. They cut shallow, and get a lot of blood, so they think they've done enough. Your guy might not even black out.

(long-term cutters cut into their skin like this on a regular basis without loss of consciousness)

The amount of blood loss you're talking about is going to be in the 30%-40% blood volume range, and that's *a lot* of blood, like half a gallon. This is where transfusions become necessary.

Once you're over 40%, then you've got your victim going into shock because there's not enough blood circulating to keep all the body functions going. The body puts itself into hibernation mode (aka, passing out) to conserve energy and survive.

Your guy would have to cut into the vein to bleed that much.

Also, once taken to the hospital and stabilized, his parents aren't going to be with him. He'll be on suicide watch in the psych ward. After a few days, they can see him, and they might get to visit him while he's unconscious in the ICU, but once he's lucid, doctors will want to talk to him without outside influences.

leahutinet said:

Pardon this morbid post, but there's something I really need to know for my story. One of my characters (male, 17) tries to kill himself by slitting his wrists in the bathtub (I warned you).

So not morbid compared to so much asked here, heh. Also, you know that's really, really hard to do and a kind of fiction-y way to attempt to kill oneself, yes? I mean people do it in fiction, and people certainly have done it irl, but it's very unlikely to be successful. Slitting wrists horizontally (I suppose that depends on the way someone is holding his or her arm -- parallel to the bottoms of the fingers or palm) won't kill you, almost certainly. It will do very little but hurt. Cutting the other way, parallel to the forearm itself, is a better bet, but you have to hit the blood vessels and it's harder to do than you'd think, and said vessels aren't super large.

Someone finds him and calls 911 just in time, and he's taken to the hospital. I want him to survive but I need to know how long it takes for the doctors to take care of him, and how long do his parents need to wait before seeing him, so I need to know whether there's surgery, how long it takes, how long it takes for his blood to come back and when he can be transferred somewhere where his parents can see him, even if he isn't conscious yet. I planned the story like this: the guy tries to kill himself, is saved just in time and taken to the hospital, the doctors take care of him, and then his parents stay with him but they don't know whether he's going to survive or not. Is it believable? I can change a few things but just tell me if I need to change everything, I'm not a medical expert.
If you have any questions, feel free to ask them.

Also, if you could tell me how long it takes for him to recover, like when he can start walking again, when he can go back to school, etc. Thanks!

Click to expand...

I'm just going to presume he tries the more likely-to-succeed way and actually hits stuff and is there for a good long time and does lose some blood, though I don't know how likely it'd be he'd lose enough to be in a lot of danger. You probably want GeorgeK or Terz. Someone should probably start walking as soon as possible... as to the whole consciousness thing, ask George or T?

As to the transfer, if he's conscious, he's going to be assessed by psychologists/psychiatrists in the hospital and either moved onto a psych unit or referred to care once discharged, depending on their assessment of the suicidal intent, the current mental status, underlying mental illnesses, etc., etc. How that shakes out will inform whether/when he goes home, to school and the like.

Why did he try to kill himself, was he depressed, was he serious, does he have any mental illnesses or disorders, was this in response to something specific, is he already under the care of a psych*, is he on any medication, that sort of thing.

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

I've never attempted that. But I did lose one quarter of my blood as a result of a tonsillectomy from hell, back when they couldn't cauterize the severed blood veins.

I was more or less ambulatory within hours. Did not need a transfusion, but they ordered a pint, because they thought they'd need it. I got dizzy very easily. Had very little energy for two weeks. Was cleared to go back to school after two weeks, but was not allowed any strenuous exercise for a month or two after that. The doctor (my pediatrician, not the ENT) checked my blood count two or three times a week, by drawing blood from my fingertips. I thought it was weird that he was drawing blood, when I had so little to spare.

Hope that helps.

Blessings,

Siri Kirpal

Figure 3 weeks per pint of blood lost, if there are no transfusions. A good recovery requires iron supplements and orange juice (Vit. C). This assumes the patient is generally healthy and is not depressed or suffering for chronic fatigue syndrome.

With 40% blood loss he will be unconscious until heart rate and blood pressure return approximately to normal. If he's given a transfusion, then recovery will be quicker, assuming no other problems were created by the blood loss (e.g. coma).

While I was in Vietnam I was called over to the hospital because they needed my blood type. I went over and it was a multiple gunshot wound patient just leaking blood everywhere. I was the first donor to arrive and they just hooked me up to him, directly. There was no measurement of my blood volume given, just a stopwatch. After 25 minutes another donor arrived (I have a rare blood type) and they kicked me off the bed and hooked up the new donor. I was flying medevac (dustoff) as the medic and I asked how long I had to rest since I was on first up. They told me to drink the orange juice they had for me and I was good to go. Half an hour later I was flying at 3,000 feet going in for a combat pickup. I don't recall any "effects" from the transfusion.

By the way, the patient lived.


Good luck!
DrDoc

As soon as he gets fluid resuscitation which would bring up his blood pressure, he should regain consciousness whether it is blood or another fluid. He might be very tired and weak until the red cells are replaced because he'd be hypoxic but he wouldn't necessarily be unconscious. He might however, be confused until the hypoxia was resolved.

You might research Class IV hemorrhage (loss of >40%). You'll find a wealth of information.

Can't speak to blood loss, but can speak to the suicide attempt stuff. I was hospitalized repeatedly for suicide attempts as a teen (ugh) and some of those experiences apply here.

So, the questions you're asking depend HUGELY on the individual hospital, the character's state of mind when he wakes, and state law. Family will be with him in the ICU; mental health professionals will ask them to leave during assessments (interminable and repeated Q&A sessions where the psychologist/therapist/social worker asks a long list of questions about depression/substance use/self harm/thoughts of harming others/etc) but otherwise they're welcome, in my experience. Same as with any injury. In a psych ward, family or friends can visit during visiting hours, and he can call them on the phone if he has a phone card.

"Suicide watch" is a pretty vague term. In the ICU, there will be nurses around more or less all the time, and the patient will be in bed, so there doesn't need to be any specific "watch" happening (I expect the nurses are aware, but I was never treated specifically differently at the ICU stage). If you're talking about within a psych ward, everyone in a psych ward is assumed to be potentially suicidal all the time. Nobody gets to keep their belt.

Basically, while the patient is in the ICU, unless they're actively psychotic or otherwise dangerous (sounds like your protag is just depressed) they are treated like any other injured patient. Once they're in the psych ward, they're treated like any other crazy person.

Exception: I was in one hospital where after the ICU but before any question of discharge/psych ward, while I was recovering in a single room, they had a staff member assigned to sit with me around the clock and just keep an eye on my mental health. That was an excellent hospital, however. When I was completely physically recovered (after several days), they did a psych eval on me, and since I REALLY did not want to go into the psych ward, I smiled prettily and asked to go home and they were fine with that. Psych wards have very little space and aren't there to make you happy and well again, they're just a box to stick you in to keep you alive for a few days while they get your meds sorted. If you aren't in immediate danger of killing yourself or someone else, they'll send you home.

By comparison, the worst hospital I went to had me in ICU for a few hours and then sent me to the psych ward while still unconscious. I woke up alone and too dizzy to walk, in a single room with a shower. Huge variations in how much care a hospital puts in to its patients.

There are some more layers with voluntary/involuntary commitment. Short version: Big hospitals usually have a psychiatric unit of their own, which is for short-term care. They'll have a Pediatric Psychiatric Unit and an Adult and Geriatric Psychiatric Unit, or some similar name; your protag will be in with the kids and teens if he does get sent to the psych ward. If you're the kind of sick that never gets better, they send you off to the state hospital. Otherwise, they sort out your meds and boot you out as soon as you answer "nah" to "anything fun planned for the weekend like for example suicide?" If you try to kill yourself but are like, "that was a poor life choice, not doing that again," they'll probably just send you home from the medical part of the hospital if you seem pretty stable. If you seem like a risk to yourself or others, they'll put you in the psych ward to sort out your meds; if you don't want to stay voluntarily, they can hold you for 72 hours (depends on the state I think) but then have to get a court order to hold you longer.

Let me know if there's any more info that might be helpful.