The Straight Dope

Go Back   Straight Dope Message Board > Main > General Questions

Reply
 
Thread Tools Display Modes
  #1  
Old 05-01-2012, 06:13 PM
Folacin Folacin is offline
Guest
 
Join Date: Oct 2008
How long to die from puncture?

We've all seen the movie where someone is stabbed in the stomach, or shot with an arrow, and they fall over dead, usually in seconds.

Particularly for the knife-belly wound - this doesn't seem right. As an older, overweight sofa dweller, I'm sure I'd be incapacitated, but I think it would take quite a while to bleed out.

Similarly with an arrow to the chest or back - barring a heart shot, I'd imagine that an average person would live quite a while (taking nothing from Boromir's epic last stand).

So - how long would it take to die (barring a major artery being hit)? Could the average person expect to not be total incapacitated from a single wound?
Reply With Quote
Advertisements  
  #2  
Old 05-01-2012, 06:36 PM
Blake Blake is offline
Member
 
Join Date: Mar 2001
Posts: 10,171
It depends entirely on what damage is done. There is no other possible answer.

An abdominal wound that cuts through a kidney can cause unconsciousness within a second, death in less than a minute. A wound that only damages an empty stomach can heal completely with no medical treatment at all. A chest wound that severs one of the major veins supplying the heart is going to be real nasty. A wound that leaves an open channel to the thoracic cavity can cause both lungs to collapse within a minute and death within 5 minutes.

An important point to realise is that "falls over and dies" is not the same as "falls over dead". Kidney damage, for example, can cause near-instantaneous unconsciousness because its screws up blood pressure control. A blow to the diaphragm can cause a person to drop immediately due to breathing difficulties. It may take an hour to die from such wounds, but the person will fall over immediately and never regain consciousness. From a movie perspective the difference between "falls over dead" and "falls over and dies" is non-existent.

Incapacitated is such a vague term that the second question is almost impossible to answer.If you get stabbed in the abdomen and suffer more than superficial muscle/skin damage you will be almost certainly be doubled over in pain and have difficulty breathing. In that sense you will be incapacitated. Even though fully conscious and able to speak, tend to your own wounds and so forth. You won't be running around much. If you've ever been struck hard enough to have the wind knocked out of you, you know the type of sensation that a stab wound to the stomach is going to cause.
Reply With Quote
  #3  
Old 05-01-2012, 07:13 PM
The Hamster King The Hamster King is offline
Charter Member
 
Join Date: Jun 2000
Location: Los Angeles
Posts: 9,466
Quote:
Originally Posted by Folacin View Post
Could the average person expect to not be total incapacitated from a single wound?
I've heard that taking an arrow in the knee can have some pretty nasty long-term effects.
Reply With Quote
  #4  
Old 05-01-2012, 07:23 PM
newme newme is offline
Guest
 
Join Date: Dec 2009
Insta-death from a stab wound that does not strike a major blood vessel is pure Hollywood. You might faint from the shock of seeing a knife sticking out of your chest, but blood loss will take significantly longer to ensure incapacitation. I seem to remember an episode of Rescue 911 where a guy had a knife stuck in his heart. You could see the knife quiver with each heartbeat. The guy was still conscious as I recall when they wheeled him into the ER. He survived.
Reply With Quote
  #5  
Old 05-01-2012, 09:45 PM
Blake Blake is offline
Member
 
Join Date: Mar 2001
Posts: 10,171
Quote:
Originally Posted by newme View Post
Insta-death from a stab wound that does not strike a major blood vessel is pure Hollywood.
No it isn't.

Quote:
You might faint from the shock of seeing a knife sticking out of your chest, but blood loss will take significantly longer to ensure incapacitation.
No, it won't.

Blood loss can lead to unconsciousness in just over 1/4 of a second. Unusual, but not unheard of.

But more importantly, unconsciousness isn't only or even primarily caused by loss of blood. A wound that causes the collapse of the lungs can cause unconsciousness due to lack of oxygen. A wound that ruptures the gut and spills the contents into the blood stream can cause unconsciousness due to anaphylactic shock. A wound that severs the spinal cord can cause unconsciousness due to simple nerve damage. A blow that simply compresses carotid artery or the ventricle, even without causing any blood loss, can case unconsciousness due to blood pressure increases.

And so on and so forth. The ways that the human body can be rendered unconscious are endless. Blood loss isn't a particularly efficient way to do so.

Quote:
I seem to remember an episode of Rescue 911 where a guy had a knife stuck in his heart. You could see the knife quiver with each heartbeat. The guy was still conscious as I recall when they wheeled him into the ER. He survived.
Yes, and? There are also cases where people have been shot in the brain with a .45 handgun and retained consciousness the whole time.

Does that lead you to conclude that death from being shot in the head with a .45 is also a Hollywood invention?
Reply With Quote
  #6  
Old 05-01-2012, 10:20 PM
newme newme is offline
Guest
 
Join Date: Dec 2009
Lets phrase it this way. What percentage of people in real life shot one time in the torso with a handgun or stabbed once in the torso collapse immediately and die within minutes? How does that compare with people in TV dramas with the same wound?
Reply With Quote
  #7  
Old 05-01-2012, 10:55 PM
Blake Blake is offline
Member
 
Join Date: Mar 2001
Posts: 10,171
Quote:
Originally Posted by newme View Post
Lets phrase it this way. What percentage of people in real life shot one time in the torso with a handgun or stabbed once in the torso collapse immediately and die within minutes? How does that compare with people in TV dramas with the same wound?
I have no idea. Do you?
Reply With Quote
  #8  
Old 05-02-2012, 12:19 AM
opmike opmike is online now
Guest
 
Join Date: Nov 2009
Quote:
Originally Posted by Blake View Post
No it isn't.



No, it won't.

Blood loss can lead to unconsciousness in just over 1/4 of a second. Unusual, but not unheard of.
In what instance would (has) blood loss lead to unconsciousness in a quarter of a second?

Last edited by opmike; 05-02-2012 at 12:20 AM..
Reply With Quote
  #9  
Old 05-02-2012, 12:38 AM
Blake Blake is offline
Member
 
Join Date: Mar 2001
Posts: 10,171
Quote:
Originally Posted by opmike View Post
In what instance would (has) blood loss lead to unconsciousness in a quarter of a second?
It can happen where the carotid artery or some of the other major arteries are severed. In order to ensure the correct blood flow to the brain, the body has a reflex in place to ensure that measures the blood pressure in the carotid artery. If the pressure drops too low the reflex causes unconsciousness in an attempt to get the brain below the level of the heart and maintain pressure.

If the artery is severed the sudden loss of pressure can trigger the reflex and cause an almost instant loss of consciousness.
Reply With Quote
  #10  
Old 05-02-2012, 07:28 AM
Acid Lamp Acid Lamp is offline
Guest
 
Join Date: Mar 2007
The question is impossible to answer accurately as posed. It all depends on what is hit or damaged, complicated by individual toughness and things like the effects of fight or flight. If we assume that nothing but muscle and flesh are wounded, then you could probably go for a long time, and it might even heal up on its own. As soon as you compromise an organ though it becomes really dicey.
Reply With Quote
  #11  
Old 05-02-2012, 08:09 AM
eightysix eightysix is offline
Guest
 
Join Date: Jun 2010
As a medical examiner I see, try to interpret, and try to explain the effects of wounds quite a lot. If you're asking would a person likely literally drop dead from a single wound, I'd say, excluding a single severe wound to the head or heart (including the aorta right when it leaves the heart), probably not. As far as "dropping dead" goes, the way I try to explain it is to think of your ABCs of basic life support in reverse. To maintain life, you try to keep the airway, breathing and circulation functioning at a basic level. Conversely, for life to end, one of those basic systems has to fail. For someone to "drop dead", one of those basic systems has to fail completely and more or less instantaneously. There's really not much that can do that. A kinfe-belly wound, as mentioned in the OP, and for that matter a gunshot to the abdo or even chest (with the above caveats) would not. You'd be more likely to linger like the guy in Reservoir Dogs. How long you'd linger would depend mainly on what damage was done and your baseline state of health.

As far as being "incapacitated", if by that you mean unconscious, it's more or less the same deal, as unconscious in this context is most likely just a pass through point on the way to death. If by incapacitated you mean unable to do much, as in writhing in pain or distress or emotional shock, then all bets are really off as you start going beyond pure physiology and getting into psychological stuff, which can be infinitely more unpredictable.

Other things I can say is, I've seen cases of people stabbed over a hundred times, all over their body, including damaging major blood vessels. There's clear evidence, sometimes witness accounts, of them engaging in a lot of activity, so clearly they did not die or become incapacitated from one wound. I've also seen a few cases where someone was shot through the abdomen severing their aorta, and still managed to run a little ways
Reply With Quote
  #12  
Old 05-02-2012, 08:22 AM
Lemur866 Lemur866 is offline
Charter Member
 
Join Date: Jul 2000
Location: The Middle of Puget Sound
Posts: 16,762
I seem to recall an article recently that claimed about 95% of gunshot wound victims survive. I couldn't find it but here's an article that says that only 8% of wounded soldiers in Afghanistan die from their wounds. http://www.nytimes.com/2011/01/08/wo...pagewanted=all. The same article claims that looking at only GSW, 13% died.
Reply With Quote
  #13  
Old 05-02-2012, 08:45 AM
eightysix eightysix is offline
Guest
 
Join Date: Jun 2010
Quote:
Originally Posted by Blake View Post
Kidney damage, for example, can cause near-instantaneous unconsciousness because its screws up blood pressure control.
I would have to disagree with this, at least mechanistically. The kidney's influence on blood pressure is indirect, mediated by hormones released into the blood and acting on other physiological systems. It takes a little while for that to happen.

I'd question some of the other contentions as well, if only because my interpretation of the OP is what's more typical: dropping dead from a single wound or not. Some of the things you've mentioned seem at best very untypical, at least per my experience.
Reply With Quote
  #14  
Old 05-02-2012, 08:54 AM
Bear_Nenno Bear_Nenno is offline
Charter Member
 
Join Date: Jun 2000
Location: Anchorage, Alaska
Posts: 6,955
Quote:
Originally Posted by Blake View Post
A wound that leaves an open channel to the thoracic cavity can cause both lungs to collapse within a minute and death within 5 minutes.
What kind of wound are you picturing here? A hole in one side of the chest will only cause one lung to collapse; not both.
Reply With Quote
  #15  
Old 05-02-2012, 09:14 AM
Gbro Gbro is online now
Guest
 
Join Date: Feb 2007
Quote:
Originally Posted by Lemur866 View Post
I seem to recall an article recently that claimed about 95% of gunshot wound victims survive. I couldn't find it but here's an article that says that only 8% of wounded soldiers in Afghanistan die from their wounds. http://www.nytimes.com/2011/01/08/wo...pagewanted=all. The same article claims that looking at only GSW, 13% died.
That sounds realistic.
Remember that gunshot wounds are anything from self inflicted injury to the little toe to 3 shots to the back of the head execution.
And the 8% mortality for combat is evidence that death isn't the primary objective of a military firearm.
Reply With Quote
  #16  
Old 05-02-2012, 09:28 AM
kayaker kayaker is online now
Member
 
Join Date: Jul 2009
Location: Western Pennsylvania
Posts: 14,296
Ever watch Reservoir Dogs? Tim Roth's character (Mr Orange) is gut shot in the beginning and remains alive (albeit in pain) for the remainder of the film.
Reply With Quote
  #17  
Old 05-02-2012, 09:37 AM
Der Trihs Der Trihs is online now
Member
 
Join Date: Aug 2005
Location: California
Posts: 36,431
Quote:
Originally Posted by newme View Post
I seem to remember an episode of Rescue 911 where a guy had a knife stuck in his heart. You could see the knife quiver with each heartbeat. The guy was still conscious as I recall when they wheeled him into the ER. He survived.
I recall reading a news story about a kid who fell on a pencil, which pierced his heart and could be seen to move with his heartbeat. Very fortunately his mother was a nurse, recognized what had happened, and kept her head & called emergency instead of panicking and yanking out the pencil. The kid survived.
Reply With Quote
  #18  
Old 05-02-2012, 10:35 AM
Leo Bloom Leo Bloom is offline
Keeping my password unchanged
 
Join Date: Jun 2009
Posts: 6,554
I read an article somewhere that if you simply keep the projectile in the wound the survival rate is significantly increased (although arrows are not much used in battle or crime).
Reply With Quote
  #19  
Old 05-02-2012, 11:30 AM
Bear_Nenno Bear_Nenno is offline
Charter Member
 
Join Date: Jun 2000
Location: Anchorage, Alaska
Posts: 6,955
Quote:
Originally Posted by Gbro View Post
And the 8% mortality for combat is evidence that death isn't the primary objective of a military firearm.
No it isn't. Not only is this not "evidence", it doesn't even follow. You have made a huge leap in logic here.
Have you considered the fact that Soldiers are wearing armor that protects their vital organs? So any gunshot wound is going to be on an extremity. A gun shot would to the arm or leg is not usually fatal. Especially considering that every Soldier carries at least one tourniquet.

Last edited by Bear_Nenno; 05-02-2012 at 11:31 AM..
Reply With Quote
  #20  
Old 05-02-2012, 11:36 AM
drachillix drachillix is offline
Guest
 
Join Date: Jun 2000
Quote:
Originally Posted by Blake View Post
I have no idea. Do you?
I do, Ex EMT here. I saw shootings and stabbings but all of them were conscious and far from dead yet. In one case we had a guy who was stabbed seven times in the back puncturing both lungs. Loss of integrity in the pleural cavity from a knife wound is not like popping a balloon, a little bit of air seeps in with each respiration. It can take a 20-30 min to lose lung function from air or blood filling into the lung cavity.

Becoming unconscious from blood loss takes time. An adult needs to lose the better part of a quart of blood to be looking at dropping over. A quart of blood loss in .25 seconds is easily in the realm of center fire rifle or large caliber handgun hits depending on location of the hit, with a knife, you would have to hit alot of vasculature or be more of a very deep slash than a simple puncture.
Reply With Quote
  #21  
Old 05-02-2012, 11:47 AM
KarlGauss KarlGauss is offline
Out of the slimy mud of words
Charter Member
 
Join Date: Mar 2000
Location: Between pole and tropic
Posts: 6,830
Quote:
Originally Posted by Blake View Post
. . . A blow that simply compresses carotid artery or the ventricle, even without causing any blood loss, can case unconsciousness due to blood pressure increases.
I'm gonna quibble with both examples here. If anything, damage to the ventricle (main heart pumping chamber for those who may not know the word) leads to low blood pressure; through one of direct damage to the pump, arrhythmia, or cardiac tamponade. And, in addition to a stroke which would have no large effect on BP, carotid injury would lead to low heart rate or blood loss, both of which would tend to lower BP.
Reply With Quote
  #22  
Old 05-02-2012, 12:41 PM
md2000 md2000 is offline
Guest
 
Join Date: Feb 2009
Speaking of Hollywood, I think it was in the original Lonesome Dove series - they had the good guy trapped behind his dead horse. The bad guys are standing just out of range, and see his bullets hit the dust not far in front. One starts dancing and taunting him, so our hero loads up a round, aims up at about a 45 degree angle, and - plop - the taunter ends up with a bullet hole in the belly. Cut to scenes of drunken carousing as the rest of them live it up around the campfire safely out of range, as the stupid target practice guy dies slowly and in agony. For good measure, every so often one of the other guys kicks him to justify their bad guy credentials. By morning, he's dead.

Also - When JPII was shot in the Vatican square, then rushed him to hospital where a concern was infection from multiple punctures of the intestines.

Lots of people are shot or stabbed and survive. It depends on the promptness of medical attention, luck or skill in the initial wound placement, as mentioned above. Like being hit on the head and going unconscious, it does not work as simple as Hollywood wants us to believe.
Reply With Quote
  #23  
Old 05-02-2012, 02:09 PM
Chessic Sense Chessic Sense is offline
Guest
 
Join Date: Apr 2007
Quote:
Originally Posted by Blake View Post
Quote:
Originally Posted by opmike View Post
In what instance would (has) blood loss lead to unconsciousness in a quarter of a second?
It can happen where the carotid artery or some of the other major arteries are severed. In order to ensure the correct blood flow to the brain, the body has a reflex in place to ensure that measures the blood pressure in the carotid artery. If the pressure drops too low the reflex causes unconsciousness in an attempt to get the brain below the level of the heart and maintain pressure.

If the artery is severed the sudden loss of pressure can trigger the reflex and cause an almost instant loss of consciousness.
I've both caused this and been a victim of this. The former happened while practicing the rear naked choke hold in Army basic training. The latter happened when my brother came home from basic training and jokingly demonstrated being "part of the club" by choking me out. I hit the floor in less than a second and didn't wake up for another...well, I don't know. I was unconscious. 10 seconds, maybe?

Anyway, the point is Blake's contention of "almost instant" is quite accurate.
Reply With Quote
  #24  
Old 05-02-2012, 02:15 PM
Folacin Folacin is offline
Guest
 
Join Date: Oct 2008
Thanks to all for the great discussion - particularly drachillix for the real world anecdotes.

And, of course, if people didn't generally fall over dead immediately, the whole plan would be ruined when the element of surprise is lost.
Reply With Quote
  #25  
Old 05-03-2012, 11:46 AM
MLS MLS is offline
Charter Member
 
Join Date: Mar 2003
Location: New Jersey
Posts: 7,285
Try reading about the near-assassination of Ronald Reagan. He very nearly died, but walked into the hospital.
Reply With Quote
  #26  
Old 05-03-2012, 12:28 PM
Hermitian Hermitian is offline
Guest
 
Join Date: Jan 2004
Quote:
Originally Posted by Leo Bloom View Post
I read an article somewhere that if you simply keep the projectile in the wound the survival rate is significantly increased.
Yea, but its much cooler to rip the arrow out your own chest and stab a couple of orcs to death with it.
Reply With Quote
  #27  
Old 05-03-2012, 05:41 PM
VOW VOW is offline
Guest
 
Join Date: Apr 2002
Gut shot used to be universally known as fatal. If you didn't bleed to death from a chest wound, it could heal. But gut shot typically means the intestinal contents contaminate the abdominal cavity, leading to peritonitis, gangrene, and death.

A slow, PAINFUL death. Some gut shot victims were known to take their own lives, to avoid the inevitable.


~VOW
Reply With Quote
  #28  
Old 05-05-2012, 03:16 PM
Lust4Life Lust4Life is offline
Guest
 
Join Date: Aug 2006
Quote:
Originally Posted by Blake View Post
It depends entirely on what damage is done. There is no other possible answer.

An abdominal wound that cuts through a kidney can cause unconsciousness within a second, death in less than a minute. A wound that only damages an empty stomach can heal completely with no medical treatment at all. A chest wound that severs one of the major veins supplying the heart is going to be real nasty. A wound that leaves an open channel to the thoracic cavity can cause both lungs to collapse within a minute and death within 5 minutes.

An important point to realise is that "falls over and dies" is not the same as "falls over dead". Kidney damage, for example, can cause near-instantaneous unconsciousness because its screws up blood pressure control. A blow to the diaphragm can cause a person to drop immediately due to breathing difficulties. It may take an hour to die from such wounds, but the person will fall over immediately and never regain consciousness. From a movie perspective the difference between "falls over dead" and "falls over and dies" is non-existent.

Incapacitated is such a vague term that the second question is almost impossible to answer.If you get stabbed in the abdomen and suffer more than superficial muscle/skin damage you will be almost certainly be doubled over in pain and have difficulty breathing. In that sense you will be incapacitated. Even though fully conscious and able to speak, tend to your own wounds and so forth. You won't be running around much. If you've ever been struck hard enough to have the wind knocked out of you, you know the type of sensation that a stab wound to the stomach is going to cause.
Good post.
Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off

Forum Jump


All times are GMT -5. The time now is 06:29 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2014, vBulletin Solutions, Inc.

Send questions for Cecil Adams to: cecil@chicagoreader.com

Send comments about this website to: webmaster@straightdope.com

Terms of Use / Privacy Policy

Advertise on the Straight Dope!
(Your direct line to thousands of the smartest, hippest people on the planet, plus a few total dipsticks.)

Publishers - interested in subscribing to the Straight Dope?
Write to: sdsubscriptions@chicagoreader.com.

Copyright 2013 Sun-Times Media, LLC.