View Full Version : Collapsed lung/sword wound questions

06-12-2007, 10:27 PM
I've got a character who's supposed to be killed by a swordsman, but the guy is only pretending to be on the bad guy's side and pulls his punch, so to speak. Instead of killing the MC he only pretends to give a deathblow and leaves him for dead. The MC is still going to be pretty badly injured, but not in a way that's life-threatening as long as he gets medical aid pretty soon.

Would a punctured/collapsed lung and broken ribs be a reasonable outcome? The swordsman is an expert and would know how to avoid striking a vital organ, but he's going to want it to look realistic to the non-soldier who's watching. I haven't detailed what kind of sword he's using (the MC doesn't know anything about weapons).

Also, if anyone's suffered a similar injury (presumably not from a sword fight!), I'd appreciate knowing how it feels and how long you took to recover, and what kind of medical attention you needed. Thanks!

06-12-2007, 11:14 PM
A dear suffering an arrow to the lung is pretty similar, I think, so maybe this will help. The lung collapses as air leaks into the thoracic cavity, blood starts to fill the lung and the cavity. It becomes harder and harder to breath. Should blood fill both lungs, the animal will suffocate.

However, the neat thing is when the animal takes off, there is a pink frothy spray every time it coughs, the oxygen rich blood turns it bright red. there are also vast leakings of blood, and the more the deer exerts itself, the more blood there is. It is assumed that a double lung hit is going to be a mortal wound. If you're going to have a character injured in a lung, it can't be a massive injury, I wouldn't think, and I bet placement of the injury would dictate the severity of the would, I.E., high up in the lung would cause the lung to fill with blood faster, but I really don't know for sure.

06-13-2007, 12:51 AM
Oh, thanks, that gives me some good ideas. Icky, but useful. :)

Plot Device
06-13-2007, 01:24 AM
I'm told one lung is larger in humans than the other. So make his injured lung be the smaller of the two. I think the left one is the smaller--not sure. It's all a matter of fitting the lungs AND the heart AND a few other organs all in the upper chest cavity like a jigsaw puzzle. So God or Nature or the Circle of Life or whatever saw fit to make one lung smaller than the other.

And my first aid training class showed us a video of a guy with a punctured lung--pink frothy foam was bubbling out of his mouth from his lungs. Yuck.

06-13-2007, 02:28 AM
OKay well I was an army medic and here's what little I know about collapsed lungs but maybe it will help.

Collapsed lungs are survivable BUT if it goes untreated air fills the cavity surrounding the chest wall (im not TOTALL educated so any nurses feel free to correct me if im wrong)and can collapse the good lung with the obvious result of both lungs being collapsed - death.

A wound that causes a collapsed lung will generally hiss and froth a pink bubbly blood from the site. The trick in treating the wound in the field, was to take a bandage lay it over the site leaving one side of the flap open so that when the patient breathes, the flap sucks in keeping air from flowing into the chest cavity but on exhale the flap releases allowing air to escape.

I hope this helps...remember im only an ex medic and this is purely a combat treatment strategy NOT a long term solution. I am honestly not entirely sure if this treatment in and of itself,if maintained, could allow someone to survive without proper intervention...(which involves a really painful procedure of shoving a hard plastic tube through the intercostal spaces. I've seen that done. Made me hurt for the patient!)

06-13-2007, 02:37 AM
Ooh, I really feel sorry for my MC. It sounds like this is a worse complication than I thought. On the other hand, that makes for great tension in the story, as long as his recovery is believable.

Thanks for the details, everyone! Keep 'em coming!

06-13-2007, 06:36 PM
A lung that totally collapses after a penetrating wound to the chest (called a tension pneumothorax) is difficult to survive (but not impossible) without treatment, which consists of sticking a tube through the chest wall to suck out the air, allowing the lung to re-expand. The reason it is so deadly is not just the effect on the lungs. The space between the lung and the chest wall (the pleural space) is normally under negative pressure. When something like a sword breaks the seal to the pleural space, outside air rushes in with each breath, compressing not only the lung but also the heart. It is the sudden decrease in heart function (called tamponade) that is most lethal.

All that said, you can still do whatever you want with your character because the lung collapse doesn't need to be total--partial collapse is not uncommon. The worst chest wounds are "sucking," communicating with the outside world with each breath (and pulling in more air each time), but some close off themselves. When they do seal off (or if someone covers the hole), the progressive bad effects of the tension pneumothorax are less. Of course this is largely a matter of luck, and your expert swordsman would really need to be expert to cause a predictably lesser, non-lethal injury. You still can rely on the amazing (and amazingly unpredictable) ability of a healthy young male's body to sustain major trauma and recover.

The symptoms of someone with a partially collapsed lung would be difficulty breathing. He may or may not cough up pink froth or frank blood.

I do this kind of thing for a living. Hope this helps.

06-14-2007, 01:42 AM
I do this kind of thing for a living. Hope this helps.

Absolutely! Thanks! I wrote the scene last night and from your description it sounds like I've described it pretty accurately. And he does get medical attention pretty quickly, and he is young and healthy, so I figure it won't seem unrealistic to readers with medical knowledge.

06-16-2007, 06:53 AM
I had a Spontaneous pneumothorax with pleural effusion a couple of years ago. I remember it vividly. If you would like to hear details about how it felt, and how i recovered, feel free to PM me...

06-16-2007, 06:54 AM
By the way, I was in my mid to early twenties at the time. I thought I was young and healthy...

09-17-2010, 11:48 PM
Thanks for sharing this info :) Very useful for my poor young, healthy fit male who has a sword pierce his lung ;)

09-17-2010, 11:58 PM
To make it more survivable and just as believable as a deadly wound you could have the stab from the side and have it behind the lungs, either inside the ribcage or between ribs and shoulder blades. There would be plenty of blood, and it would be within a couple of inches of hitting the heart.

Smiling Ted
09-18-2010, 06:17 AM
Does your world have magic or 19th Century medical knowledge?

09-18-2010, 05:09 PM
oooh, thanks Peter, incidently he was stabbed from the side.

Ted its a medieval/magical blend allowing for a little 21st century medical knowledge, ;) However, I proably do need to know a little about recovery and treatment! (I've read the previous posts but if anyone has extra to add it would be much apprecited.) :)

Smiling Ted
09-18-2010, 07:28 PM
oooh, thanks Peter, incidently he was stabbed from the side.

Ted its a medieval/magical blend allowing for a little 21st century medical knowledge, ;) However, I proably do need to know a little about recovery and treatment! (I've read the previous posts but if anyone has extra to add it would be much apprecited.) :)

The key word here is "sepsis." Until the 19th century, virtually any wound could be fatal because of infection.

09-19-2010, 06:34 PM
Some pneumothoraces (small ones, where the source that caused it is gone) will heal with rest. This would be more believable with a stab wound from a thin narrow blade like a rapier (or a needle when a central line is placed) as opposed to a hack from an ax. It would not be unusual for the skin around the source of the lung wound to develop "crepitence". (Little air bubbles in the skin that look and sound when you press on them, like there is rice crispies under the skin) In a pneomothorax that will heal without intervention you might see the crepitence form over an hour or two in association with dyspnea on exertion (DOE) and then gradually fade. The DOE may take a few days to mostly subside and then gradually fade over a few weeks. I'd also expect that the area involved with crepitence would be smaller than about the surface area of your hand. IF it keeps spreading then that is one that will probably require a chest tube.

09-20-2010, 01:03 PM
The lung has two wings, left and right, which are completely independent. I had a spontaneous pneumothorax and my left lung has collapsed completely, and I had almost no problem with breathing. I had some pains arising from the ribcage (due to their slightly changed position).