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A stab wound in the thigh.
OT: Tee hee!
saucery wrote in little_details
Greetings, kind souls! Your assistance, if you do offer it, will be greatly appreciated.

I tried searching the tags, but didn't find anything that matched this exact scenario or answered my specific questions. I've also searched Google extensively for "stab wound recovery time", "femoral artery stab wound", "knife injury in the thigh" and a whole bunch of other phrases, but most resources gave rough estimates on recovery times, and didn't really answer my other questions. I need a better estimate of the recovery time, at least!

Well, here's the scenario:

The stabbing occurs in a lonely alley in London, very late in the night (or very early in the morning, depending on how you look at it). The setting is contemporary (21st century).

A man in his late thirties is stabbed in the thigh, and the knife (at the very least) nicks the femoral artery.

The knife stays buried, since the criminal panics and runs.

The victim falls, hits his head on the cobblestones and loses consciousness.

Since the alley isn't exactly teeming with passers-by, it takes a while (upwards of 10-15 minutes) for help to arrive, and for someone to call an ambulance. The first person on the scene knows enough about first aid to elevate the leg and tie a strip of cloth around the wound, without taking out the knife. And then the ambulance arrives, of course.

The nearest hospital and/or emergency clinic (does Britain have emergency clinics independent from hospitals?) is only about two blocks away, so the ambulance gets there quickly.

The man survives.

My questions are:

1. Since the knife stays buried, the bleeding would be mitigated, but by how much? Would there be a pool of blood around the thigh in the first minute or so, for example?

2. Is it survivable to have the poor sod just bleed out for 10-15 minutes? Should I have help arrive sooner?

3. If he did bleed out - completely - then how long would it take, theoretically, for his heart to stop beating and for him to die? (I need to know this, because he talks about it later, with one of the doctors.)

4. Based on my previous searches on Google and on this journal, it seems that he would require vascular surgery, given that his femoral artery has been damaged. Is this true? If it isn't, then what kind of surgery would he undergo? Obviously, the muscle's been damaged, too.

5. Could someone throw some technical jargon at me? Like, how would the medical professionals attending to him at the hospital describe what's happened to him? I need to make it sound authentic.

6. What would be the recovery time? As in, how long before he's discharged from hospital, and how long before he can walk unassisted?

7. How long before the stitches come out?

8. Is it, um, okay for him to take showers while the stitches are still in there? (The "um" is for certain carnal activities that may or may not take place in said shower. Nothing strenuous, don't worry.)

9. What sorts of painkillers and other medications would the victim be given, both immediately after the wound and in the long term, for recovery? Precise brand names would be of help. (They'd need to be available in Britain.) How long would he need painkillers for? Weeks? Months?

10. The guy used to be a soldier, and had sustained a relatively severe war-related injury in the past (gun-shot wound to the shoulder), so he's made of pretty hardy stuff. But still, what would be the psychological effects of the stabbing? I mean, random enemy fire is quite different from getting stabbed by someone whose face you've seen up-close, in a place you'd come to think of as safe (or, well, at least safer).

Thanks in advance for your help! I will sacrifice many imaginary virgins at the altar of anyone that answers my questions!

Just one comment - you'd be hard put to find cobblestones anywhere in an 'alley' in London. All of the cobbles I know are new and in heavily trafficked areas - to keep people off that area and on the paving.

There are loads of things he can hit his head on, but cobbles aren't a good idea.

Oh, thanks! When I'd Googled the phrase "do cobblestones still exist in London" (and feeling silly while doing it!), I turned up a travel/tourism page that said cobblestones were quite common, but obviously, the insight of a local is far better!

I suppose I could just have him hitting his head on the tarmac, the old-fashioned way. :D

Boggles!

Why not "hit his head on the kerb" or "kerbstone" (can be spelled "curb" too)?

There are old cobbles in Leadenhall Market but that's not accessible at night, and in some other tourist areas - think at the Tower - but, again, not accessible.

I am sure someone will come up with somewhere that cobbles exist and are accessible, but it struck me immediately as very unusual.

There are no cobbled streets that I know off, but there are still a few laid with stone setts. (Cobbles are round stones; setts are flat-topped - see here:http://en.wikipedia.org/wiki/Sett_(paving). They are - or were - often laid standing proud of the mortar they're set in, so you could certainly crack your head on one of the edges.

Stone setts used to be very common but there are only a few streets of them left, usually either because the road is "unadopted" (i.e. the local government authority had no responsibility for it), or it's a "heritage" area, or just because it's so out of the way that nobody has bothered. Up till a couple of years ago I worked at St Mary's Hospital in Paddington, and my office was in what had been one of the the old canal warehouses on the edge of the Paddington Basin (the terminus of the Grand Junction Canal), which was reached by a little alley with stone setts.

But I agree with you that you can just as easily hit your head on the kerb, and it simplifies matters not to have to set the incident in such a rare environment.

Google shows me some photos of cobbles down near Butler's Wharf, but that area is under extensive redevelopment.

Oh, this is amazing! I never knew of these things called 'setts', but now, they're going to make it into a story of mine very, very soon - maybe not this one (as you've said, I might as well just stick with the kerb), but in the very near future (in yet another London-based story!), I will certainly use your information. :)

In the UK, we have A&E (Accident & Emergency) which is where he would be taken (equiv. to US 'ER' as far as I understand). They are always attached to hospitals. Use Google, but there are plenty of A&Es in central London you can choose from. In fact, use Google Street View to find a suitable alleyway, if you like!

Thank you so very much! I shall indeed use Google Street Search, as per your advice!

The problem with nicking the femoral artery is that you bleed out quite quickly - about 2 minutes. But that's the actual main artery right up in the groin, and being stabbed lower down in a branch of the artery will not be as fast. The person who finds him should not tie a tourniquet but use a wad of cloth and apply pressure, without removing the knife.

A regular A&E surgeon should be able to handle the surgery no problems. The stitches will be covered with a waterproof dressing, so he can shower with them in. Whether or not he'll be able to stand depends on the muscle damage. The hospital is also going to be worried about a head injury and loss of consciousness and will observe him closely for at least 24 hours.

He might be given morphine in the hospital if needed, then they'll get him on Solpadeine Plus (prescription) to take home and then Panadol Ultra then Panadol (non-prescription) ASAP. Presuming no nerve or major muscle damage, or bone damage, it's probably not too painful as wounds go. He might just need the major painkillers for a day or two, then painkillers just at night or if he over-exerts himself for another week or so.

Wow, what an informative and flawless answer! (I'm starting to think that this community and its residents are like manna from the gods, when it comes to writerly assistance!) Thank you so very, very much!

Indeed, I looked at some anatomical charts and decided that a femoral branch would be best, and that the stab wound would be located in the front and in the middle of the thigh, rather than up near the groin.

The point about the tourniquet vs. the wad of cloth is GOLD. Seriously. I didn't even think of that...!

I'm also relieved that my man will be able to take a shower and engage in the requisite carnal shenanigans in relatively short order. I'll, um, try to minimize the muscle damage.

Speaking of muscle damage - if someone was stabbed in that area of the thigh (middle and front), and deep enough to reach a branch of the femoral artery, how bad do you think the muscle damage would be, and how long would the recovery take? As in, would he be able to take that all-important shower in a couple of days? A couple of weeks? *shamelessly eager*

If that isn't the right place for him to be stabbed, considering that he needs to be upright sooner rather than later (no longer than 2 months, certainly), where do you suppose I should poke the poor bugger? :D

I love, love, LOVE the exactness of your reply and the names of the drugs and eeeee. Eeee.

ALSO, OH MY GOD, ARE THOSE THE TWELVE APOSTLES IN YOUR ICON? I just went there last year!

Yes, those are the 12 Apostles - I live just near them!

A clean stab to the front of the thigh, not too close to the knee, could cause fairly minor damage, though the surgery will open it up a bit further. It should be tender but largely functional in 2-3 weeks or less - just mess around with the extent of muscle damage (don't sever anything) to get the timing right for your fic. He should be walking short distances without serious pain within a few days.

You're so lucky to live near such a wonderful place! The 12 Apostles are so beautiful. My family and I stayed in cottages close by and I have to tell you, the scenery was so intensely lovely that it was almost like having a religious experience... Oh, the sunsets...!

> He should be walking short distances without serious pain within a few days.

AWESOME. Semi-shower ghost-sex, here I come! (Um. Uh. Never mind!)

(does Britain have emergency clinics independent from hospitals?)

Not really - they are called either "A&E" (Accident and Emergency) or "casualty" departments.

1. Since the knife stays buried, the bleeding would be mitigated, but by how much? Would there be a pool of blood around the thigh in the first minute or so, for example?

Depends - if it isn't moved at all then there could be surprisingly little blood. That's fairly unlikely though.

3. If he did bleed out - completely - then how long would it take, theoretically, for his heart to stop beating and for him to die? (I need to know this, because he talks about it later, with one of the doctors.)

Very fast. If it's a cut femoral artery & the knife were removed, then you could get a fountain of blood & a dead person in short order.

8. Is it, um, okay for him to take showers while the stitches are still in there? (The "um" is for certain carnal activities that may or may not take place in said shower. Nothing strenuous, don't worry.)

Yes :-)


How can a single person rock so hard? Because obviously, you are rocking this comment thread. :D :D

Seriously, thank you SO much. You've answered so many of my questions! I think I'll have the knife stay buried with just enough bleeding to make things urgent in terms of getting him to A&E quickly, but not enough to kill him on the spot.

Your help is much appreciated, O mysterious dancing triangle with limbs. (Is that from Moyashimon? Well, probably not, but it sure reminds me of those cute little critters!)

You're welcome ;-)

It's a riceball (representing the main character, Tohru) from the manga/anime Fruits Basket. It rocks a lot!

OH YEAH! I remember Furuba! Good days, good days... :)

When you say "cobbles", I wonder if you're thinking of something like this?

That's Idol Lane, City of London, fairly near the Monument. I went there once for a job interview. Technically, those aren't cobbles and it isn't an alley, but it may be the sort of thing you're after. Look at those lovely iron posts your victim can bang his head on!

Search Google Maps for "hospital near idol lane, City of London" and I find quite a lot.




YOU ARE MADE OF SO MUCH AWESOME. THANK YOU.

Also, my love for iron posts is undying and eternal. (My characters may not be undying once they meet with those iron posts, though...)

<3

Iron posts at the end of London alleyways are quite common (to prevent cars driving through them).

If your character is anywhere in Westminster or the City of London the nearest A&E is likely to be St Thomas' Hospital which deals with everything from Members of Parliament falling ill in the House, to victims of street crime (they're very experienced with knife wounds).

More than you will probably need to know here: http://www.guysandstthomas.nhs.uk/services/acutemedicine/emergency/emergency.aspx

Those iron posts are called bollards, fyi.

Bollards! I've always been fond of words that end in "lard"! Mallard! Dullard! Akaldfjd. (Sorry. I just tend to get high on learning new words. Thank you!)

It seems more accurate to describe an alley as a 'lane' if it's set in London anyway. There aren't a lot of alleys as Americans would think of them, the yards behind buildings and shops tend to back right up to each other, sharing a wall. A lane, like between shops, seems more likely. A lane might possibly be cobbled in that context. More likely modern 'cobblelock', but that would pass for cobbles.

Thank you very much! 'Lane' it is!

Be careful with London street names - Park Lane is a dual carriageway, nothing like an 'alley'. While my favourite placename, Of Alley (now boringly called 'York Place') is exactly the sort of narrow space between houses you're probably thinking of. Of Alley history.

There are, famously, no 'Roads' in the City of London, though plenty of streets, lanes, alleys, mews, passages etc.

And yet again, you save my story. Thank you very much!

Something to be aware of is that not all hospitals have A&E departments. The NHS concentrates resources so the 24 hour staffing and consultants on call which are required in a minimum nuber of places. In urban areas a couple of blocks from the hospital would be surprising, not least because the hospital will be much bigger than that. Travelling time in the ambulance isn't an issue, ten minutes is typical and the ambulance crew will spend at least that long checking the victim and loading them. A bigger delay will be getting the ambulance to him, from memory the response target is 95% of life threatening emergencies within 15 minutes. That's from your passer-by making the emergency call.

you're totally writing a johnlock fanfic aren't you