Author Question: Gunshot Wounds and Rib Fractures

Shanda Asks:

I have a scene where (in my mind at least) someone very physically fit is shot in the torso as they dive to save another from being shot. They then land excruciatingly hard on the edge of raised concrete (think like the front of an outside step) and break three ribs but that injury goes unnoticed as a result of the gunshot wound.

human-skeleton-163715_1280So my questions are as follows:

1. Would it be possible for someone to pick up the injured and run say a mile or two to get them to where help is waiting?

2. Could it be possible to have surgery for the gunshot would and the rib injuries be missed and hours later cause internal bleeding?

3. What would be the typical recovery time for the first and the latter?

4. Would it be realistic that after the second surgery (for the internal bleeding) the patient could not wake up for days having had two trauma surgeries so close together?

Jordyn Says:

Thanks so much for sending me your questions.

1.  Can someone carry an injured person one to two miles for treatment? It would depend on the physical characteristics of the character who is lifting the other person. Carrying someone one to two miles is a long way. I could possibly imagine a man doing this for an injured female and possibly a very fit male for another male, but a female doing this for a male might be stretching it. It would have to be a very fit female character.

On the other hand, could a character with these injuries get themselves to the hospital? The three cracked ribs are definitely going to slow them down and it also depends on what the gunshot wound has injured which you’re not clear on here. If the gunshot wound deflated a lung then they are going to have a lot of trouble breathing.

2. Could the broken ribs be missed on the first medical exam? Probably no. Any patient with a gunshot wound to the torso is going to get plain x-rays of the chest and probably a CT scan of the chest as well— both of which would show the rib fractures. So in the setting of modern medical care it would almost rise to the level of negligence to miss the rib fractures with a gunshot wound to the torso. I don’t see that happening.

3. To determine your typical recovery time I really need more information on this gunshot wound. Where was the character shot and what was injured specifically? The rib fractures themselves will take 4-6 weeks to heal. Rib fractures are very painful and could inhibit breathing based on their location. Also, successive ribs that are broken in more than one place can create a free floating segment that can be very detrimental to breathing as well.

4. A patient could still develop internal bleeding and need to go back to surgery even if the rib fractures are found right away. This would not be a rare event. It is reasonable for a patient to not wake up for a couple of days if they suffered a code during the second surgery due to extreme blood loss and had flat lined for a period of time.

Even the stress/shock of the surgeries close together might be enough for the brain to check out for a time. The problem with a comatose patient is they have to be in the ICU, on a vent, with a tube in every orifice as they say. For instance, a patient can’t be out cold and have no way to pee— so a catheter has to be placed so the urine can come out.

Going down that road can get very complicated for a novel depending on whose POV you’re telling it from.

Best of luck with your novel!

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