Author Question: Burn and Crush Injuries

Amitha Knight returns to give her medical insight in this reader question.

Welcome back, Amitha!

Q:

I am writing a novel and understand that you give medical information online which I would be really grateful for.  The two main characters in my current book are hurled out of a burning bus which has smashed into a building after going out of control.  They land on concrete.  One of those characters has been in the smoke-filled bus about 15 minutes.

I would appreciate it if you could tell me the following;
1) What type of injuries would they have received, burns, fractures, concussion etc and what procedures are followed by medics who turn up at such accidents. What equipment would they use? 
2) I want one of the characters to be in intensive care for about 3 days and then be allowed onto the ward, what type of follow up treatment could she receive, what machines would she be attached to etc.
3)I want the second character to be unconscious for about three weeks and then wake up with temporary amnesia.  Is this plausible and what treatment would he receive while he’s
unconscious …. what machinery would he be attached to.
  
Thank you in advance for your help!!!
M.G.
Amitha says:
I will help you the best that I can. My specialty was pediatrics and not intensive care or emergency medicine, so keep that in mind.
1) What type of injuries would they have received, burns, fractures, concussion etc and what procedures are followed by medics who turn up at such accidents.  What equipment would they use. 
The types of injuries sustained could range from anything from a few bruises to severe cranial fractures and multiple broken bones. When medics show up, they will place a neck collar in case there are spinal injuries and basically follow the “ABC” rules for emergency medicine. (some links to read more about this: http://en.wikipedia.org/wiki/ABC_(medicine)) This means if the patient isn’t breathing, they’ll make sure there is no obstruction, then they will intubate the patient as necessary. They will also start IV fluids and take them immediately to the hospital. What they would do *exactly* would depend on the extent and severity of the injuries. For fiction purposes, I would think hard before going into too much medical detail.
2) I want one of the characters to be in intensive care for about 3 days and then be allowed onto the ward, what type of follow up treatment could she receive, what machines would she be attached to etc.
This depends on the type an extent of the injuries. if there was a perforation to the lung, they may have a chest tube. They probably can’t get up and thus would need a foley catheter for urine. they would definitely have some kind of IV fluids attached. This website has some good information about smoke inhalation injuries: http://www.emedicinehealth.com/smoke_inhalation/article_em.htm
3)I want the second character to be unconscious for about three weeks and then wake up with temporary amnesia.  Is this plausible and what treatment would he receive while he’s
unconscious …. what machinery would  he be attached to.
This person who is unconscious might be intubated for at least some of that time, which means they would have a ventilator machine in the room in addition to everything I said in #2. As far as amnesia, there is a blog post on Jordyn Redwood’s blog that may help with this: http://jordynredwood.blogspot.com/2011/08/remember-me-use-of-amnesia-in-fiction.html 
Her website is a great place in general for information like this!
I hope this helps.

*************************************************************************

 Amitha Knight is a former pediatric resident turned writer of middle grade and young adult fiction. She’s also a blogger, a book lover, an identical twin, and a mom. Follow her on twitter @amithaknight or check out her website: http://www.amithaknight.com/. 

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