Okay, so I'm not being very nice to one of my characters. He's in a fight and gets stabbed with the sharp end of a broken metal cane (probably a little thicker than an umbrella handle, and has a sharp, jagged end where the metal's been broken) and is then left lying in the cold for a while before his friends get to him and take him to hospital. The character is about 20/21 years old, male, generally healthy, quite slim build. Questions: First of all, where should the stab wound be? I want it to be somewhere that's going to cause him to bleed out quite fast, so he's unconscious when his friends get to him and he's on the brink of death by the time he arrives at the hospital, but with surgery and (most likely) a transfusion or two, he'll survive. I'm thinking it'd be somewhere in the abdomen, but I'm not 100% sure where would cause that kind of bleeding (the research I've done so far has told me more about organ damage rather than the rate of blood loss). Any ideas would be very welcome! Secondly, how would hypothermia affect the rate of blood loss, and how would the blood loss affect the rate at which he becomes hypothermic? He'll be lying on a frozen/icy ground, wearing a t-shirt and long sleeved shirt, but no jacket or coat, so I'm wondering how long I can realistically leave him lying there without killing him. Thirdly, when his friends get him to the hospital (he doesn't arrive in an ambulance, but they've called ahead to let the hospital know the situation), how would the treatment go? I'm guessing he'd need fluids to sort out the blood loss until he gets into surgery, but I'm not sure how the hypothermia would factor into everything, and what the post-surgery treatment would be. Also, depending on where the wound ends up being, what kind of internal damage and complications could there be, given the weapon he was stabbed with? Lastly, how long would his recovery be? How long would he spend unconscious after surgery, how long would it be before he's able to sit up/stand up, and when would he be allowed to leave the hospital? I know it'll take several days, but I don't quite know what's a realistic time frame. Also, what sort of follow-on treatment would he need, in terms of recovering from the blood loss and looking after the healing stab wound? I hope all of that makes sense. Thanks in advance for any help/advice!
To start off, If you want hemorrhaging that doesn't involve any organ damage, stay away from the abdomen. The subclavian artery is the major blood vessel for your upper extremities. If that were to be punctured, (especially with a jagged cutting instrument) your victim could slip into hypovolemic shock quite quickly. Look up images of the subclavian artery to get an idea of how it runs behind the collar bone. It's protected, but if stabbed at the right angle, it can be hit. The hypothermia is a 50/50 proposition. It could potentially be the reason your victim lives, but the studies are still ongoing. Hypothermia causes peripheral blood vessels to constrict so that blood flow stays centered toward your core organs. Induced Hypothermia is being studied as a possible treatment for trauma and cardiac arrest patients. It wouldn't be unrealistic to use that. (It might be thrashed by a surgeon who disagrees with the studies, but what do they know, right?) You should probably have your character go to a hospital in a moderately sized city that has at least a level II Trauma Center. Otherwise he would need to be stabilized and then transferred to a hospital capable of doing the surgery. For an injury such as his, with a call in ahead of time, a hospital would most likely have a trauma team on standby. He would get blood right away instead of a fluid bolus and from here, I can be of no more assistance. If you need more info, I will ask around the next time I get a chance. It might be a couple of days though. Hope this helps. Good Luck!!
Hi! Thanks so much for the info! With the stab wound, I don't mind there being some kind of organ damage, as long as it's something he can pretty much fully recover from (though I imagine there'd be some kind of lasting pain from that type of injury anyway?). I'm just not sure what areas of the abdomen would give that kind of blood loss - I don't particularly want to sever an artery, as I want him to have maybe about an hour(ish) before he gets to hospital (the actual amount of time is flexible, but I don't want it to be, like, 10 minutes). Also, I don't think I mentioned this before, but the weapon has been taken out of the wound. I know that will majorly affect the rate of blood loss - hence not wanting to go for an artery that'll have him bleed out in seconds!
