Author Question: Exsanguination

Heather S. asks:

I came across your website while browsing for some information for a project. I am currently a nursing student and am doing a project on arterial bleeding. I am trying to find specific exsanguination times for the major artieries in the body. I have had no luck after searching online and multiple medical books. I just need a simple answer, i.e carotid artery 2-20 minutes. I have a few times, however, I feel that they are inaccurate. Please see below:

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Carotid - 2-20 min

Brachial - 5-60 min

Femoral - 5-60 min

Aorta - 1-2 min

Popliteal - 5-60 min

I would greatly appreciate your help as it seems you are extremely interested in medicine. This might go on to help your other readers as I came across the questions dated January 12, 2012 where you discuss exsanguination. Thank you!

Jordyn Says:

Your question is not an easy one.

Any major artery (and the ones listed are major) that is completely severed will likely lead to the patient's death in less than five minutes. I saw a demonstration once where a physician simulated this happening.

He took a 2 Liter bottle (an empty pop bottle) and filled it with water. He drilled a hole into it (to simulate arterial severing) and then squeezed it at a regular rate to simulate the heart pumping. That bottle was empty in a matter of three minutes. Yes, we timed it.He said the diameter of the hole he drilled equated to the popliteal artery which is behind your knee.

However, the injury may not be a complete separation which is why you have the varying time lengths. Of course, if the person gets some type of medical treatment (like a pressure dressing that stems the bleeding) they may last a lot longer as well.

I know this answer isn't a clear cut answer but in medicine . . . they usually aren't.

Heather's Follow-up Question:

Could I say the smallest time is the fastest time to bleed out without medical attention and the longest time is a small bleed from an artery?

Jordyn Says: Yes, this is reasonable. 

Injured Characters: Start From "The End"

I just returned from teaching at Colorado Christian Writers Conference up in Estes Park, CO. Not only is it a beautiful spot-- being up in the mountains is stunning!-- but it's also a conference close to my heart. It was this conference in 2006 where I became firm in my decision to seek publication and so much has happened in the last seven years. If you haven't considered this conference-- do so! You get FOUR appointments. It's the only conference I know that guarantees that.

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While there, I taught my Medical Pitfalls lecture for authors where I teach you to maim, injure and kill your FICTIONAL characters the right way. Several people made appointments with me just to figure out the right way to do it.

It was awesome.

After doing this service for writers for almost three years, I've noticed a definite trend. People have an idea of how they want to injure the character but don't necessarily like the end result. For instance, they'll give me an injury and then want the character to be hospitalized for several days. However, often times the injury is not severe enough for the character to even be in the hospital. Sad part of today's medical enviroment is you have to be pretty sick to gain admission.

Other issue is the opposite. The author has given the character a devastating injury but wants them to be semi-fuctional in the proceeding days. Well, maybe in a fantasy world where they can heal themselves would this work but otherwise . . . no.

My suggestion for all writers/authors is to think of your character's end point by asking yourself a couple of questions.

1. Why am I injuring/killing this character?
2. Do I want them to be functioning in the next couple of scenes/days/weeks/months? If so, how well? Fully? Partially? With great incapacitation?
3. Do I want my character to be in the hospital? If so, for how long? Keep in mind the longer a person is in the hospital the more issues physically they will have-- particularly with muscle atrophy, loss of strength, and potential for infection. The longer they are in the hospital the more likely they will need rehab.
4. Do I want this character's injury to have surgery?

Let me give an example of how I as a medical consultant for writers can help knowing the end point first.

Example A:

Author: I want a pediatric patient to have what the parents think is a fracture that sends them to the ER but I don't want it to be a big deal. I'm using the ER visit as a moment for them to come together as parents in concern for their child to maybe remember some of the reasons why they came together. However, I don't want the child to really have injury. Be fine. Able to play and be normal by the end of the ER visit.

Impossible? Why, no, actually.

Injury: A nursemaid's elbow. A nursemaid's elbow is a dislocation at the elbow caused by pulling or tugging of a child's arm-- say to prevent them from darting into traffic. It is a VERY common injury among toddlers and parents feel very guilty when they bring them to the ER because they think they've broken their child's arm. Not even an x-ray is required for diagnoses. A simple maneuver will pop the arm back into place and the child is happy and on their way with no restrictions. Back to normal life.

However, let's take the other end.

Example B:

Author: I want a child to be injured in a fall. I want it to require surgery. Maybe a few days in the hospital.

Injury: Hmm... ideas? I have the perfect one. A supracondylar fracture. This fracture is just above the elbow. Any fall-- generally onto the elbow can cause it. Other than a Type I-- they generally require surgery to fix. Give a surgical complication-- and your child character is in the hospital.

See how knowing the end point is helpful? So-- consider this when you consult a medical expert for your writing. It will also open up possibilities you didn't think of.

Author Question: Ankle Injury

Elaine Asks:

I have a medical question on my WIP that I was wondering if you can help me with. I have a 72-year-old woman who falls and hurts her ankle. It swells and throbs and her family brings her to the ER. From my research I gather that she can have a sprain as opposed to a break. I need her to be somewhat mobile because she needs to rush to a caving site where her son is trapped. Is it feasible to think that she can use crutches, can drive, pushing aside that she'll pay a price afterwards? Any suggestions?

Jordyn Says:

Ankles are 95% of the time sprained and not broken. So yes, this is feasible. If you want her driving-- I'd probably injure the left foot so there wouldn't be major difficulties with driving. Crutches/air splint/or ace wrap for 7-10 days and then re-evaluate after that if her pain is not improved.

Here's a link that pertains to your question: http://jordynredwood.blogspot.com/2011/07/welcome-dr-frank-edwards.html

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Elaine Stock is a former RWA member and has presented several writing workshops. Presently involved in ACFW, she was a 2011 semi-finalist in the prestigious Genesis Contest in the contemporary fiction division. She is also active on several social networking groups. Her first short story was published on Christian Fiction Online Magazine. New to the blogging world, Elaine started a blog this past April, Everyone’s Story. Since then, the blog has been graced by an awesome international viewership that totally pings her heart. Everyone’s Story features weekly interviews and reflections from published authors, unpublished writers…and just about anyone who wants to share a motivating story with others that may lift their spirit. She has also been the guest of several other blogs, helping to further grow her presence on-line.

She and her husband make their home in an 1851 Rutland Railroad Station they painfully but lovingly restored.

Winner!

Hello Redwood's Fans!

How has everyone's week gone?

Mine . . . amazing.

I got to spend the week up in Estes Park and it was GORGEOUS except for one brief sleet storm. You know it is Colorado and for some reason this year the state does not want to give up winter.

I was part of the faculty for the Colorado Christian Writers Conference. If you want a smaller, amazing conference this is one to book for next year. I got to take a suspense class from Bill Myers and he was awesome. Hope you'll check out his books sometime. 

The WINNER of Lynette Eason's latest novel When A Secret Kills is Kristie Porter!

Congratulations, Kristie, and I'll be e-mailing you shortly on how to claim your prize.

A big THANK YOU to Lynette for coming and visiting Redwood's. It's always an honor to have you.

What amazing thing happened to you this week?

Jordyn