Medical(ish) question

[allmywires]

Two things:

If a character were to have part of their arm amputated on a battlefield, would cauterisation be the best way to stop the bleeding? If so, how long would a sword take to heat (over a fire) to be hot enough to do so?

Second, if said character was pregnant (only early stages) would she definitely lose the baby? (I want her not to).

[SJAB]

Originally Posted by allmywires

Two things:

If a character were to have part of their arm amputated on a battlefield, would cauterisation be the best way to stop the bleeding? If so, how long would a sword take to heat (over a fire) to be hot enough to do so?

Second, if said character was pregnant (only early stages) would she definitely lose the baby? (I want her not to).

Suggest you do a google search there is a lot of info on the net with regards to American Civil war battlefield ampuations. Ok, not the time period you are looking for, but conditions would be close enough. From my own research, limbs were sawn off as quickly as possible, then the blood vessels tied off and a flap of skin (left for the purpose) sewn back over the wound with a gap left for drainage. The basics are not much different throughout history. Quickness was the key.

As to losing a baby. I had a friend who was in a horrible car accident and to the surprise of the doctors the baby not only survived, it at no time showed any signs of problems, then again a woman can just lose her footing, not even fall, and lose a child. There are so many factors, stress, shock etc. With regards to this, you are the writer, if you want her to not lose the child, she doesn't.

[springs]

I don't know the first, but babies are incredibly reslient in the womb. Blood loss might be a factor, though, cos the placenta needs fed, so again, I would have thought speed was the factor. It also depends what stage of pregnancy she's at, I think.

[allmywires]

Originally Posted by SJAB

Suggest you do a google search there is a lot of info on the net with regards to American Civil war battlefield ampuations. Ok, not the time period you are looking for, but conditions would be close enough. From my own research, limbs were sawn off as quickly as possible, then the blood vessels tied off and a flap of skin (left for the purpose) sewn back over the wound with a gap left for drainage. The basics are not much different throughout history. Quickness was the key.

Ah, thanks SJAB. I was googling cauterisation and it kept coming up with skin flaps, eurgh.

Originally Posted by SJAB

As to losing a baby. I had a friend who was in a horrible car accident and to the surprise of the doctors the baby not only survived, it at no time showed any signs of problems, then again a woman can just lose her footing, not even fall, and lose a child. There are so many factors, stress, shock etc. With regards to this, you are the writer, if you want her to not lose the child, she doesn't.

Originally Posted by springs1971

I don't know the first, but babies are incredibly reslient in the womb. Blood loss might be a factor, though, cos the placenta needs fed, so again, I would have thought speed was the factor. It also depends what stage of pregnancy she's at, I think.

Yeah, the blood loss was what I was worried about, and she is in quite a stressful situation. I didn't want people to be thinking, 'hmm, she's gone through quite a lot of trauma, how is her baby still hanging on?' But if it's believable, I will take that and run with it.

[Venusian Broon]

Originally Posted by allmywires

Two things:

If a character were to have part of their arm amputated on a battlefield, would cauterisation be the best way to stop the bleeding? If so, how long would a sword take to heat (over a fire) to be hot enough to do so?

Second, if said character was pregnant (only early stages) would she definitely lose the baby? (I want her not to).

I'm not a medical doctor, but I think using fire/heat to cauterise an amputation to stop blood flow would probably not work. Sure it would sterlise it but it would probably cause huge amounts of pain.

The blood is at pressure and would be trying to force it's way out and you'd have to charcoal a big bit of the arm/leg. My guess is that you won't have time and you'd probably lose the patient through shock.

Best thing I think to do is to put a very tight tournique to stop blood flowing. to the stump. I don't know what era your in, but afterwards you'd want to apply antiseptic (nice) things, I guess, to the wound (and painkillers to the victim). The greeks used honey for wounds, for example, which is actually quite good (concentrated sugar a bacteria does not like)

I think the biggest killer of amputees is the shock - everything has to be done extremely quickly.

As for babies, this I don't know but I'd assume that's it's not a given that a wounded woman would automatically miscarry/give birth. I've read amazing stories of women who have given birth despite horrific adversities.

[alchemist]

As VB said, you'd be better to tie off the major blood vessels (artery first) then worry about cauterising and skin flaps.
To some extent, the body will try to preserve baby's blood flow, so it's quite plausible for baby to survive.

[Mouse]

Ack, I read something very recently (I was researching 999 calls) where a man had his whole arm chopped off. I'm pretty sure they told the person on the phone not to use a tourniquet.

Found it: http://www.guardian.co.uk/society/20...ipt-amputation

edit: reading it, I guess they didn't want him to use a tourniquet because eventually they'd have to reattach the arm. Not sure. The operator just says 'it'll make it worse.'

[allmywires]

Originally Posted by Venusian Broon

I'm not a medical doctor, but I think using fire/heat to cauterise an amputation to stop blood flow would probably not work. Sure it would sterlise it but it would probably cause huge amounts of pain.

The blood is at pressure and would be trying to force it's way out and you'd have to charcoal a big bit of the arm/leg. My guess is that you won't have time and you'd probably lose the patient through shock.

According to wiki (font of all knowledge) in mediaeval times cauterisation with a hot poker was a common practice for amputees. Shock is another thing I hadn't thought of. Hmm. And they aren't exactly mediaeval, I suppose, but they have some concept of antibiotics.

Ugh, Mouse, reading that transcript gave me the chills! yeah, I'm not planning on reattaching her arm.

I think I've got a problem with mutilating my characters...

[springs]

Oh, don't worry, all the best writers do... (mutilate their characters that is.)

On the tourniquet, as far as I know the reason they advise against it is if the person does it for too long, or too tightly, it can cut off blood supply altogether. But I thought this was when, for instance, the arm is still attached and tissue damage might ensue.

Your medics are very professional, I assume? I also assume they have some sort of field hospital?

[allmywires]

Originally Posted by springs1971

Oh, don't worry, all the best writers do... (mutilate their characters that is.)

It's only cos I love them, promise.

Originally Posted by springs1971

Your medics are very professional, I assume? I also assume they have some sort of field hospital?

Well...the medics they do have are semi-healers (sort of hard to explain). But in this instance, it would be a sort of heat-of-the-moment, forced to act to save her life sort of thing.

[psychotick]

Hi,

Cauterization would not be effective if the blood is pumping through the stump, so no, first would be a torniquet applied before the arm was amputated, just above the cut. Then survival of the patient becomes about preventing blood loss, a wound like that could kill in a minute or less, and preventing infection. I'm guessing that in your story there are no antibiotics, so in that case you will need to look at some natural disinfectants applied immediately to the stump - someone said honey and that has been used for centuries on more minor wounds.

Cauterization might be used later, if the blood is still seeping through the wound, seeping but not pouring, as it can seal things shut, but it is incredibly painful, and the shock to a patient likely already very weak would be terrible. It was also used on open wounds when they looked to be becoming infection, though with no antibiotics, it was probably not very effective.

Cheers, Greg.

[I, Brian]

In ancient and mediaeval Europe, cauterising a wound after amputation was the norm.

Death through blood loss, shock, and infection were all still massive risks.

I'm not sure a sword in a fire would be hot enough, though - cauterising irons were used which were better shaped, and left in the ashes to get red hot.

A normal fire will make a sword hot but I'm not sure it would get hot enough to cauterise unless left for a good few minutes in the hottest part of a good fire.

Also, the process could damage the sword as well if attempted.

[AnyaKimlin]

History Cold Case - York 113

This programme has a section on the English Civil War battlefield medicine. It has a part on amputation and I think this was the episode about the packing of the wound with materials that reduced infection.

There is one on a mother who gave birth to triplets over a thousand years ago which has a bit on midwifery through the ages. I will look for it as well.

EDIT - History Cold Case - Mother and Three Babies.

Slight warning - this series is heartbreaking in places.

[allmywires]

Hmm. I might have to rethink the severity of her injury. Thank you for all your responses, though, and I will give those a watch Anya!

Edit: narrated by Stephen Mangan, I will enjoy these

[AnyaKimlin]

If you are remotely emotional have a box of tissues ready. I sobbed my way through some of these. The York 113 isn't too bad.