Untreated lacerations and related questions

i know someone who had almost that exact scenario happen in a crash. he was partially ejected and smacked his head on the side of the car. he was not renderred unconscious but was quite loopy after and he did have a concussion. he however was not lacerated from the head banging.

and when i was little, i flew into the windshield of our car (i was unbuckled) when we had a head-on accident. i shattered the windshield to a zillion pieces but had not one cut on my head.
so yes your scenario is possible.

Scalp wounds bleed like crazy from the smallest cuts, there is good blood perfusion there. You likely wouldn't have a risk of bleeding out from a small laceration. Untreated, you could have a scar. It could end up in place were the hair hides it (but not for someone like me) anyway. If the wound is kept clean, there are probably little downside risks in delay of treatment. Possible infection, a mess to clean up...

Sports trainers and the like keep tampons on hand for nose bleeds. The idea isn't terribly uncommon so that your readers shouldn't see it as pratical.

Tornadoboy said:

I've got a character whom has her head banged off a side window in a car crash and is knocked unconcious for maybe 10 or 15 minutes, would it be plausible for a person to take such a blow to the head and not receive a laceration deep enough to require stitches? She is going to be trapped (though not in the car) with my male protagonist for 5 or 6 days by a blizzard, they won't have access to medical care and I figure if I give her a cut too deep it could be too much of a distraction for the reader, having an otherwise attractive character with a seeping cut on the side of her head through the whole scenario might be realistic but a little too disgusting.
And alternatively, if I DID decide give her a deep enough laceration to require maybe 2 or three stitches what kind of complications would arise from not treating it within that time period? While they don't have access to real medical supplies they will manage to keep it clean and bandaged with relatively clean materials, perhaps even boiling then drying them out before applying. When they did reach a hospital would they have to treat it differently than a fresh wound?
I'm also debating whether or not to have the window break when she hits it, I don't want her hurt too badly but having her knocked out works pretty good for the scene.
Any help will be appreciated!

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Unfortunately, I have a bit more experience with serious automobile accident injuries than I ever wanted. So...

I don't believe someone could hit a side window hard enough to knock themselves out for such a relatively long period of time. During a car crash years ago I slammed my head through the drivers side window. I didn't lose consciousness at all nor did I sustain any deep cuts from the glass, but for approximately a year after the accident I was pulling microscopically tiny shards of glass out of the side of my face. (So glad I was wearing glasses so my eyes were relatively protected.)

You might want to have your character hit the pillar that supports the car doors. It's close to the front-seat occupants heads and it's made of steel, plus the seat belt adjustment mechanism can leave a nasty head laceration on a side impact, if you want to go that route.

It would also seem to me that your character's biggest problem is not the laceration ( that will bleed like hell initially but eventually scab over in about an hour) but the obvious concussion and highly probable internal injuries. People die from those all the time if they go untreated. A sign of concussion is confusion and exhaustion. My husband and I were completely messed up after our crash, broken bones, shredded cartilage, internal bleeding, but the only outward sign of injury was my husband's cut finger from where he stuck his hand through the windshield. It took 10 surgeries and 3 years to put him back together again. Go to webmd.com for all the indicators of concussion.

Good luck in your research.
c.

I was a passenger in a car going 50-55 mph on an icy road that T-intersected with another road. The driver was unfamiliar with the road and didn't realize it ended in a "T". At the last second, he tried to make a left hand turn - but there was no way in hell he was going to make it. The car slid sideways through the intersection, ripped out two small trees in the parkway and struck a hundred feet or so of metal guardrail that ran perpendicular to the road (it was used as a buffer between a gas station and a railroad track which is why it wasn't parallel to the street). The car hit the end of the guardrail hard enough to tear it (all 100 feet) out of the cement. I smacked the right side of my head against the side window on impact. The window did not break and I don't believe I lost consciousness but I did suffer from a fairly severe concussion (and headache), whiplash, dislocated vertebra in my neck and back, torn muscles in my neck and back (involving months of rehab), a dislocated shoulder, and the displacement of the cartilage disc that sits between the mandible and the temporal bone of my jaw which resulted in my jaw being locked open later that night.

Lots of bruises, no lacerations.

Good luck with your WIP.

Every first aid course I've ever had talked about using sanitary napkins for lacerations and/or tampons for bleeding noses. This is not an original idea and definitely could, in my opinion, be used. When you have an emergency, you use what you have on hand, and since sanitary napkins are designed to absorb blood, it's obvious to me that they'd be useful in those situations.

I cut my hand fairly severely when I was in high school by accidently jamming a piece of metal through the meaty part between my thumb and first finger (yes, large quantities of alcohol were involved!) I used a sanitary napkin to stop the bleeding, so I wouldn't worry about people thinking you ripped it off from Mr. King. It's a very practical solution.

And as far as lacerations go, a small one would bleed very heavily and not necessarily require stitches, though it would be unbelievably tender and sore and a knock on the head that rendered her unconcious for that long would surely also cause a fairly bad concussion. That would be a much bigger concern than a cut. Her head would be pounding for several days, if the swelling in her brain didn't kill her! Okay, I'm being a little sarcastic there but the resulting concussion from a blow that hard could be very serious.

Hi there. I am a paramedic and have responded to more car crashes over the years than I care to admit.

Tornadoboy said:

I've got a character whom has her head banged off a side window in a car crash and is knocked unconcious for maybe 10 or 15 minutes, would it be plausible for a person to take such a blow to the head and not receive a laceration deep enough to require stitches?

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Yes, in fact, more often than not, people bang their heads in crashes and don't break the skin at all. Exceptions would be hitting/starring the windshield, getting cut by your own glasses (which happens a lot), airbag abrasions, etc. If that happens, it will bleed like crazy for a while (the scalp is very vascular), but direct pressure should stop it eventually.

As for being unconscious for 10-15 minutes from such a thing, it almost never happens. Sorry. You may be a little loopy, or black out for a second, but the side-window probably isn't gonna do much unless it's a seriously hard blow. Then you should probably be less worried about bleeding, and more worried about the conscussion.

And from personal experience, when I was 16 I was hit on the drivers side by a car doing about 60 and knocked my head into the side-window. Other than getting my bell rung, I didn't black out a bit.

Tornadoboy said:

And alternatively, if I DID decide give her a deep enough laceration to require maybe 2 or three stitches what kind of complications would arise from not treating it within that time period? While they don't have access to real medical supplies they will manage to keep it clean and bandaged with relatively clean materials, perhaps even boiling then drying them out before applying. When they did reach a hospital would they have to treat it differently than a fresh wound?

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What everyone else said. Plus, although infection might be a problem, scalp and facial wounds just don't get infected as easily as wounds on other parts of the body.

Tornadoboy said:

I'm also debating whether or not to have the window break when she hits it, I don't want her hurt too badly but having her knocked out works pretty good for the scene.

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A head probably won't break a side-window, not without help. A head can easily crack/star a windshield though, so you may want to rework your accident?

And remember, there are always exceptions to the rule, and your mileage may vary.

Hope this helped,
Audrey

quidscribis said:

Every first aid course I've ever had talked about using sanitary napkins for lacerations and/or tampons for bleeding noses. This is not an original idea and definitely could, in my opinion, be used. When you have an emergency, you use what you have on hand, and since sanitary napkins are designed to absorb blood, it's obvious to me that they'd be useful in those situations.

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I doubt this will make any difference but here's a historical look at the sanitary napkin. Sanitary napkins in disposable, paper and cotton form, did not exist until the first World War. Nurses began using bandage pads - like an now old-fashioned sanitary napkin that fit into a belt (younger gals won't have a clue what I'm talking about) - during their menses. After the war, companies like Kotex came out with a version of the same to mass market.

So the idea of using sanitary napkins as bandages is quite plausible since sanitary napkins as we know them evolved FROM bandages!

As for lacerations, when I was in a car crash, I had many multiple small cuts which bled a lot but did not require stitches. Each was tiny but bled a great deal. Most were on my left arm which I used to cover my face on impact - I was the passenger.

I have experience with hitting my head hard enough to sustain a pretty good concussion, but no cutting or bleeding. I didn't hit a hard object. I hit the airbag.

Don't discount how hard a small female who sits very close to the dash hits the airbag. This is why children are not supposed to ride in the front. It can kill them.

I smacked the airbag hard enough for a bruised nose and two black eyes and a concussion. I didn't pass out, but I was very confused afterwards because of the head injury. THings took on a very dreamy quality. I wasn't making sense to the people I spoke to.

Other consequences were: My knees were cut and severely bruised from the car pushing inward. The next day was the bad part. I was stiff and sore and had a seat belt shaped bruise across my chest. My body had jerked so hard against the SB that the belt's edge actually cut my neck. I could hardly move for about two days. Fortunately, I avoided major injury. The car's safety devices really did work.

If you want to know more about hitting an airbag: taste, smell, feel, etc. I remember it vividly and don't mind sharing.

I think it's worth mentioning that windsheilds and side windows are generally made of very different types of glass on most cars from the 1960's onward. Both are designed to reduce the chance of getting serious lacerations. The side windows will be tempered glass. You can slam into tempered glass very hard without breaking it, hard enough to get a concussion with no cuts. This is much stronger than normal glass.

One of my professors in college demonstrated how strong it was by walking on a sheet of tempered glass supported by a pair of 2x4's. The glass sagged under his weight but did not break. He then gave the glass a gentle tap on the side with a hammer, and it just about exploded into tiny pieces, demonstrating that tempered glass does not have the same strength in all directions, and when it breaks, the entire sheet breaks into tiny bits that are hopefully less likely to cut people than standard glass shards. Tempered glass will not crack like normal glass - it's either intact or the entire sheet goes.

Windshields, by contrast, are made of laminated glass. This is just as fragile as normal glass, but there are layers of plastic inside it. If you shatter this, the fragments all stay in place. You can touch a shattered windshield and not cut yourself, although if you are thrown against one you may get a cut. The reason they do not use tempered glass on the windshield is that laminated glass is "softer" if you hit it with your head and less likely to give you severe brain damage.