I'm writing a scene, and I need to know if it's plausible.
So here's the setup... I have a victim that has a depressed fracture of the occipital bone (just noticeable to the touch) from falling into the corner of a piece of furniture after being shoved forcefully. As he tried to defend himself with vertigo, he was startled and manged to fall on a large chef's knife, penetrating his right/left lumbar region but more medial than lateral. (I'm not very specific on the location.)
His attacker (Long story short, it's a stalker fan in love with a rock star, the victim from above, that has kidnapped and is holding said rock star captive.) tries to save him. He gives the victim an overdose of morphine combined with a heavy dose of unidentified sedatives so he can sew him up. (The sedatives have been shown in the story to be able to render the victim practically unconscious at the drug's peak with a half-life of about six to seven hours. I don't even know if there is such a drug.) On top of a head injury and blood loss from the stab wound (which I, again, have been less than specific but said enough to know he's lost two, maybe three, pints), stalker fan is pretty much killing his rock star, but hey, stalker fan isn't a doctor he's a recovering druggie. Oh, and rock star's a little guy, about 5'4" and 140lbs.) Where I left the story off at is rock star is unconscious with slow, shallow breathing, and stalker fan has sewn his wounds closed with fishing line.
Now that I have lost everyone's attention, I get to my question. I want to know if this is plausible scenario. Rock star is never going to wake up. About seven hours after the injuries (six since the drugs were on board), rock star is going to seize. About three hours, give or take, later, rock star is going to go into respiratory distress. Stalker fan will be asleep, so no one is going to resuscitate him. Stalker fan wakes up next to a dead, cooling rock star.
I'm really stretching that timeline, I know. And forgive me if my jargon is off a little; I studied nursing for a while long ago but gave it up for engineering graphics which I gave up for writing.
So, anyone? Is this a plausible scenario?
To sum up: yes.
Now I'm going to go on a long, nerdy rant and give you information you might or might not know that could be beneficial to helping you write the scene. I'm a huge neurology nerd, so the head injury pleases me, but more on that later. I'm sure you know a good portion of this, because you were a nursing student, but I'm going to try to write this so that all of our readers might benefit. I mean no insult to anyone's intellect.
Make sure that the knife misses the lumbar arteries, otherwise he'll bleed out PDQ. (I'd have to look at the scene ver batim, but if you're still writing/editing, just make sure that you have it blocked out (imagined and mapped) well in your mind.) Especially ensure you miss the aorta. (Which I'm sure you know.
)
As far as the skull fracture, what you're most likely looking at is called a basilar skull fracture. These can be nasty, but they give you an awesome visual, because they may present with Battle's Signs - a bruising around the eye sockets and over the mastoid process (behind the ear).
NERD BIT: If you're feeling particularly nerdy or want to look this up in-depth, Battle's Signs are technically two discreet signs - Periorbital Ecchymosis, or Raccoon Eyes, and ecchymosis of the mastoid process, or Battle's Sign. In much of minor medical education, they are clumped together. You will also see a CSF halo - put a piece of gauze to some blood coming from their ears, and it will absorb the blood, but also some very light yellow/clear/kind of fluorescent liquid - that's CSF. It comes in a lot of subtly different colors depending on what's wrong with your patient, but it's always beautiful, especially when backlit. If they ever let you into a neurosurgical ICU, ask to see someone who has shunt just so that you can see it, because description rather escapes me.
Our regularly scheduled programming: Other fun things that you'll get from this as an author is the ability to let your character bleed from his ears without actually having been hit on the ears. And boy can people with head injuries vomit like nothing you've ever seen.
Now here's the bit where my dealing with emergencies makes me a little useless, and for which I will add a disclaimer: every patient that I have seen with a basilar skull fracture has been very, very unconscious. They don't always have to be unconscious, and I've confirmed with a couple of colleagues that it's quite possible for them to have their wits about them. I just happen to be a magnet for patients who are particularly not-all-that-well-off.
The biggest concern I would have with a basilar skull fracture is regulation of basic bodily functions - heart rate (I've seen a lot of VTach with these fractures), blood pressure (which you treat secondarily and which varies depending on how bad the patient is), and... you guessed it. Breathing.
Infection is a bit of a concern with these kinds of fractures (as meningitis can occur), but we typically don't immediately start on antibiotics.
As far as the drug which is administered: what you're describing sounds like a benzodiazepine. It's a sedative which won't knock someone out per se, but will definitely relax them. (It will be beneficial to sleep, but it's not like propofol, which'll knock everyone out rapidly. You can remain conscious while on them.) I'd head for the Ativan (Lorazepam). It's rather marvelous, and lasts 6 hours.
Now, the great thing about benzodiazepines is that along with relaxing you, in some cases even enough to perform simple surgical procedures (they have a secondary benefit in that typically people won't remember anything when they're on them), they are also used in the management of... You guessed it, seizures. So if you give a high enough dose and don't taper down, especially on a head injury (which can have the effect of lowering your seizure threshold)... Voila.
Now the exciting bit. People are always shown sewing people up on the television and in movies... And they're usually very wrong. Because the typical suture (because in medicine, we can't say 'stitch' or 'stitch job') uses a very specific type of needle: that is, a curved one. Straight needle, you would need to pull skin up and stitch through it (very bad form, leaves a heckuva scar, looks terrible, and is often difficult to do with people who are in shape, like rock stars).
I'm not going to go into how it's normally done, because let's face it, your villain won't know any of that. But I will note that performing stitches with a straight needle will be: 1. awkward. 2. possibly difficult (I say possibly, because honestly, I've never tried it - I've always used the curved ones). 3. ugly.
So, I would mention him having difficulty, and maybe say something halfway through about how it always seemed easier in the movies, because it won't be a fun experience. (Not that it would anyway, I suppose...)
Also useful to note: between the two wounds, his head is going to bleed a lot more. A
lot. Normally, when I see head injuries, there's a hematoma (a lump on their head), but if you're going for depressed, and you're going for blood loss, I assume that you're making the wound bleed. There's very little you could do descriptively to exaggerate that bleeding from what it would be in real life. These guys redefine bleeding.
But what kills your character, in the end, is probably related to CSF. CSF stands for cerebrospinal fluid, and the pressure that it needs to maintain has a narrower margin than blood pressure. So, one of two things happens: 1. Increased Intracranial Pressure (Higher CSF pressure), which is what I'm more used to dealing with. 2. Decreased ICP (because he's losing CSF, possibly through the ears and nose). Here's the fun bit: they present very similarly. Symptoms might include headache, spectacular vomiting with no nausea, one pupil being bigger than the other (he wouldn't be conscious for that), high blood pressure and slow heart rate (usually occurring together), and irregular breathing (fast then slow then fast then slow then...).
If you need additional information, feel free to ask. If you want to do your own research, I recommend Medscape. If you ever need an account to access something, send me a PM and we'll see if we can't get you some information.