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Upper Torso Stab Wound?
Rabbit
inanimaterabbit wrote in little_details

I need help with character being stabbed in the upper torso or perhaps the side, depending on your answers.

I have a character being beaten, then stabbed, then the assailant runs away. He is about six feet tall and an athlete in modern day US. He would be found within 15-30 minutes of being hurt. I don't want the wound to be fatal or even critical, but enough that he may pass out from blood loss and need surgery. So where's a good spot? Below the ribs, in between, etc? The knife would be 4+ inches. If the wound fits this criteria, how long would a full recovery take? I can't find anything about recovery time for stab wounds except for very serious ones. I have found some okay descriptions of the pain and feeling of being stabbed, such as shock preventing people from even realizing it first, but extra detail would be greatly appreciated.

If this doesn't jive medically I will change the circumstances.

--

I have searched Google for: "stab wound," "stab wound recovery," "stab wound recovery time," "stab wound pain," "chest wound recovery" with all different kinds of combinations and synonyms. All I find are news articles about specific people being stabbed with no descriptions of the feeling of being stabbed or the actual recovery time, articles on first-aid for a stab wound, or case studies that are not about the right area and full of jargon.
 
I did find two somewhat helpful descriptions of the pain. I also searched for a similar question in this community under many different tags, but almost everything about stabbing had to do with stomach wounds.

Thank you!




Chest wounds bleed pretty quickly, but they do so internally, making them almost more fatal than other types of stab wounds. If someone is stabbed anywhere in the heart, what usually happens is that either the lining of the heart or the chest cavity itself fills with blood. This can kill the person in anywhere from 10-15 seconds to a couple of minutes. A stab to the lung (i.e. the rib area) would be very painful, but not necessarily painful. The only concern your guy would have is if his lung deflated or if blood from the surrounding area got into his lung. As you were saying with anything below the ribs (i.e. abdominal wounds), that's arguably the worst place to get stabbed because it takes about 40-45 minutes for that kind of wound to bleed out provided the aorta wasn't nicked.

Now you said that you wanted it to be a 4 inch knife. That might cause some problems in terms of how seriously you want this guy to be hurt. Keep in mind that your torso is pretty jam-packed with organs and blood vessels. Four inches would more than likely end up putting the guy in critical condition, maybe even kill him. Anywhere your guy got stabbed would result in pretty organ damage and a few sliced arteries, plus there are the muscles that would get damaged in the process. That's really the only thing that would maybe not be plausible in this scenario. Four inches could work, it just depends on the location of the wound.

As to recovery time, that's a bit more fluid. There's no hard and fast rule about how long it takes to recover from a stab wound, so you can really make it up here. You said the guy is biggish and athletic, so chances are he was already in good physical condition. It would still take him about a week or two to recover, and even then he'd still have limited mobility as his muscles healed plus a lot of pain.

I tell you all this, but then again there are other people who get stabbed multiple times all over their bodies and walk away not too much worse for the wear. When it comes to stuff like this, you really can take quite a bit of creative license. I doubt (hopefully!) that many of your readers will have been stabbed or known someone who has been stabbed who could argue with you. But even if they did have a totally different experience (maybe they were stabbed in the heart and lived to tell the tale), that doesn't necessarily make whatever scenario you cook up any less authentic. Like I said, everyone is different.

Sort of depends where in the chest someone gets stabbed how much they'll actually bleed. If it's out laterally, they don't bleed that much. You'll get a bit of bleeding from the intercostal muscles that usually stops, and collapsed lung, and it's treatable with a chest tube - and I've seen folks do fine even if it took a little while to get them to the hospital. Up high underneath the collarbones and around the shoulders, you've got the subclavian vessels to worry about, and in the central chest you've got the heart, the great vessels, the bronchi, the esophagus to worry about - but lateral chest and a four inch knife? Shouldn't be a major issue. Chest tube for a few days in the hospital, and that'd be it.

The vast majority of penetrating chest injuries don't require anything other than a chest tube to treat.

Thanks to both you and surgicalsteel for your great, detailed answers. It looks as though my scenario is implausible. I'm thinking of changing it to either:

- A shorter knife that glances off a rib and lightly lacerates the lung.

- Removing the stab entirely and making the beating more severe.

Basically I'm going to do more research, but I'm looking for a recovery anywhere between 4-8 weeks. It can still be painful for him to do physical activity, but I need him to be capable of it.

(Also baba you're right, I don't think my readers would know if I wasn't completely accurate in this area, but I want the details first. ...Then I can fudge them a little.)

I've been looking into this question as well (albeit with a near-through-and-through crossbow bolt and not a knife).

I've gone for bolt embedded up to the fletching between two of the lower ribs on the right side, puncturing the edge of the liver. The liver is very vascular and bleeds a lot but with a narrow wound tract, limited movement and medical attention within the course of an hour or so it should be very survivable from my understanding, and the liver can also function even if a section is damaged so long as... you know, the whole thing hasn't been macerated. (but if a doctor/nurse can correct me it would be helpful for me as well!)

I've left the bolt in place to limit blood loss until the other characters can work out what the frig to do, but I'm dealing with an ~18th century setting and none of my characters being medical personnel of any kind.

oops, that was me. No idea why LJ signed me out!!!

The liver actually has pretty amazing regenerative properties - damage it, and as long as you don't go below a critical threshold of functional liver tissue, it'll grow back. The injury you've described should be survivable - as long as you haven't hit any major vessels in the liver, it'll likely bleed for a bit, then clot will sort of fill the arrow tract and it'll stop. I'd tell a patient with that sort of injury to try and avoid heavy lifting and contact sports for about six weeks.

Thank you for this idea. I did a little research on liver lacerations and found that while full recovery and survival are likely, it could be 3-4 months before the injured person could return to vigorous physical activity, which for the purposes of my story won't work.

(Not sure if this would apply to your specific case)

I was stabbed in my liver. Miserable but not fatal. Nice scars from surgery though.

*points up to response to baba_o_reily *

Lateral chest - out toward the side. Right side's less tricky than the left. At or slightly below the level of the nipple. Most likely he'll end up with a collapsed lung which can be treated with a chest tube to re-inflate it. In the hospital 2-3 days, and I'd usually tell a patient to avoid contact sports, heavy lifting, or flying in an airplane for 6 weeks. After that - he'd likely be relatively pain free, but there may be random little movements for several months that'd give him a twinge of pain and remind him that yes, he really was stabbed.

Agreed here. If you want something serious but not particularly life-threatening, I think you can get away with a 4" knife wound to the right chest, treated with a chest tube and no surgery. Left side is possible too, as long as it avoids the heart.

Personally, I think you can get away with a stab wound like this easier than a more severe beating (as you mention above). As long as the knife hits lung tissue and no other organs or major vessels, the treatment is pretty simple and recovery fairly short (as surgicalsteel details). A more "severe" beating might actually end up with even more damage, as your character would probably be taking blows to more organs and would probably end up with some organs injured that might need greater intervention than a chest tube (diaphragm injury, liver injury, kidney injury, spleen injury, even a bruised heart, head injury, facial fractures, etc. etc), including complicated surgeries and/or longer recovery times. If you want this fairly simple, I'd personally stick with a mild beating that results in superficial bruising and the stab wound that causes a collapsed lung and minimal bleeding.

Agreed on the beating - I've seen people in the ICU for a couple of months after a severe enough beating.

Okay, thanks, that's the scenario I'll go with. All of you have been a great help.

This helps me with a piece I'm doing, however, I'd like a little bit more information if at all possible.

Location: *In* the ICU ward at a hospital
Who: Police officer gets stabbed while apprehending a suspect trying to get hold of a patient in the ICU

The officer gets stabbed by a rogue SWAT member but the officer is wearing a kevlar vest. How much protection would the vest offer, if any?

The guys would be facing each other, with the knife in the right hand (left side of officer). The guy with the knife is 6 feet tall, while the officer is 5' 10". If the knife wound hit the liver, that would mean they weren't facing each other head on, but that the officer was maybe a foot or so to his left when the bad guy stabbed him.

If they were more head on, what would a stab wound to the side -- left kidney perhaps -- be with regards to chances of survival/damage/disability?

Any other thoughts/ideas/suggestions/comments would be appreciated :) Thanks!

I pulled out my Second Chance save book (i.e. the list of people whose lives were saved wearing a Second Chance kevlar vest) and the of the first fifteen saves, seven had to do with people surviving being stabbed or slashed with everything from a pitchfork to a broken beer bottle to a seven-inch knife blade. These saves date back to the early 1970s, when vests weren't particularly sophisticated, and even then kevlar offered pretty good protection against some kinds of knife wounds.

So even if the officer is wearing an older vest that isn't specifically made to be puncture resistant (as I believe many of the current ones are), the kevlar should offer him protection unless the knife is more like an ice-pick -- which would probably go right through -- or the knife hits him in an area not covered by the vest.

I'm hardly an expert but I have done some research into ballistic vests for one of my older fics.

A normal 'bullet-proof' vest is designed to stop high speed projectiles such as bullets, not slower moving sharp objects like knives. A different style of vest a 'knife-vest' is designed to stop bladed weapons.

In saying that, due to the fact that there is a layer of tough material to penetrate I think a ballistic vest (assuming here that there is no ceramic plate involved) would have some effect retarding a knife. This is more because there is something between the knife and the officer, rather than the design of the fabric. The vest would likely provide more protection against a slash than a stab.

The officer wearing the vest would still be stabbed, particularly if a bit of force is applied behind the knife but perhaps not as deeply as may otherwise have been.

The type of knife will likely make quite a difference, a smooth knife, ie one without serrates or notches, would penetrate deeper than one that could get slowed by being tangled in the Kevlar weave.

If you are worried about the realism of this scene, the stab wound could bypass the vest altogether, striking up from underneath the bottom of it into the lower abdomen or perhaps under an armpit.

As to the fight itself and where any injury may occur (either through the vest or around it) all you need to remember is that fights are very dynamic, it may not be necessary to explain what angle each combatant is relative to the other at the exact moment. The rogue SWAT officer stabs and slashes his way to freedom and the officer is wounded.

On your original post you mention wondering what a stab wound feels like to the victim. I have heard that it feels like a punch, the victim often not realising it is more serious until later, if that helps.

My EMT instructor offered this bit of knowledge- most wounds to the abdomen can be fixed if treated quickly, the only time you really have to freak out is with chest wounds.

There is lots of stuff in the abdomen, but a lot of it a person can either live without or there is enough excess that pieces can be removed. Spleen could get hit. That used to get removed from people fairly often if it ruptured. Now the treat it a bit differently, but with the amount of damage a knife wound would cause they'd likely take the whole thing. It would cause a ton of internal bleeding and surgery would be required to remove it, but it's survivable with a good prognosis so long as you treat it immediately. The person could still live a full life afterwards, but they'd be prone to infections and illness a bit easier. The blood loss caused would mean they'd need a transfusion and would likely be anemic for a while.

Dunno as much about kidney wounds, but I think if a person was coming from head-on that is a little less likely to get hit. They are a bit closer to the middle of the back than the sides.

Re your further query on stab wounds to the liver: most of the liver is tucked away behind the ribs on the right side, and a kevlar vest would cover the part accessible below the sternum in front. Stabbing between the ribs is chancy and would take a lot of specific effort as there is some very tough muscle there. I don't think you could get a knife wound to the liver in those circumstances at all, and even if by chance the assailant managed it, the liver has outstanding powers of recuperation.

So-so. Something was not impressed.

I was stabbed in the throat a few months ago. Idk the guy. Idky I lived I knew I was dead. Said a preyer & wanted to call my kids & tell them goodbye. They wouldn't let me. Its definitely fucked me up. I can't taste anything, its hard to swallow anything including liquids. FML!

I was stabbed in January of this year. Some guy was trying to steal my purse but ran up behind and got me in the back. I just felt a twinge now, which often happens, and so here I am typing into google to see if this is normal. :s

4 inches to the gut is tough like said, upper L or R you have spleen/liver resp. lower you have the abd. aorta - bleed out quickly.Lower you have intestines and gut (crap) stomach, lower intestines, if it has to be 4 inch maybe you only penetrate 2 inches of it or upper right pec/antierior delt , if he's athletic he ( lets say) exercises -bench press -upper chest has more muscle-deep penetrtation ( no more than 2 inches or deep slash inv. upper pec/front delt (shoulder) may make him pass out after some running away exertion