Author Question: Treating Injuries Related to Torture 2/2

Today, we’re wrapping up Taylor’s questions about treating injuries related to torture. You can find Part I here.

Question #2: She was whipped/flogged, and has wounds from that across her back. Her shirt is torn, and dried blood makes the fabric stick to the wounds, which is (obviously) painful. How long does it take for mild infection to set in? (Nothing major – no blood infection, sepsis, etc. Just the beginning signs – redness, swelling, warmth, etc.)  How would the wounds be treated? Antibiotics? Cleaning the wounds – how is that done? Can they be stitched?
Jordyn Says: These wounds will need to be cleaned for sure. To get stuck material from wounds we generally saturate them with saline to dissolve the blood and peel away the fabric. I did a recent post specifically about wound infections but on the short side is 12 hours. More commonly is 48 hours and considering her condition, wound infection is going to be a big concern. They cannot be stitched up.

Here is another post I did on stitches but outside time frame for stitching someone up is 24 hours and that is only if the wound is super clean which these would not be. Taking her to the OR for wound cleaning, debridement and dressing placement might be an option if they are extensive. They could do a better job with better pain control. The reason they can’t be stitched is concern for infection– we don’t want to trap pus/germs in a wound. Better to let it drain out. They’ll want to be sure she’s had a tetanus shot within the last five years. If not, she’ll get a booster. Antibiotics are probably warranted in her case– something for skin infections like Keflex. 

Question #3: When the soldiers rescue her from the hospital, how do they move her? She doesn’t have a spinal injury; she’s able to sit up and move in bed. Lying on her back on a stretcher wouldn’t be very comfortable. I guess she would have to lie on her side (the one that isn’t bruised and battered). Are there any other precautions they would need to take?
Jordyn Says: If they aren’t concerned about spinal cord injury than transporting her in a “position of comfort” is reasonable but she’d still have to be secured in seat belts some way.   
Question #4: How long do cracked ribs typically take to heal? She was kicked and/or stepped on by her captors, and has 1 or 2 cracked or broken ribs. If they are only cracked and bruised, if she was given some sort of wrap/brace, is it plausible that she would be able to go “out in the field” again after 2 weeks or so? She won’t be jumping out of helicopters, leaping tall buildings in a single bound, or anything like that – she’ll be interrogating suspects, maybe running for a bit in a foot pursuit, and will have some involvement (to be determined) in the take down of a very bad guy near the end of the book.
Jordyn Says: Cracked ribs usually take six weeks to heal. Here is some information on treatment of cracked ribs. Wrapping cracked ribs is not recommended anymore. We want the patient to be taking deep breaths so they don’t develop pneumonia. Wraps inhibit this. Cracked ribs are painful but not an unstable fracture so she can interrogate suspects and run but it will be quite painful and she’ll have decreased stamina for sure. A take down will be quite painful too because it will be hard to protect the area. 
Hope this helps and thanks so much for your questions! Best of luck with your book. 

Author Question: Treating Injuries Related to Torture 1/2

Taylor Asks:

I have some character injury questions that I could use your help with, if you don’t mind! I contacted you last year with a bunch of questions about car crashes and injuries for another book that I was working on, and you were a tremendous help. I have some questions for this story, and thought I’d reach out to you again.
This story is a political thriller. One of my characters (Erin) is an American government agent who is ambushed and kidnapped by an Iraqi insurgent/terrorist leader while working in Iraq. He took her for two reasons. One is that he wants to use her as leverage/a bargaining chip to get what he wants. The other, more significant, reason is revenge. John (her current partner/coworker) had been a member of the US Army Special Forces. During a mission in the Middle East, he killed a fairly high-ranking terrorist who was responsible for the deaths of several US military members. That happened to be this man’s brother. Now this man has taken Erin, and plans to kill her – he wants John to know the pain of losing a loved one, and plans to make them both pay for John’s “crimes.”
One of her guards helps her escape after three or four days. He can’t deliver her back to the Americans, so he takes her to a local hospital and hands her over to the staff there for medical care. She is then rescued by the military a few days later. 
Iraqi insurgents are well known for their methods of torture and brutality to their captives. Fortunately for Erin, she was spared the worst of it; all things considered, they didn’t treat her TOO terribly.
Question #1: She’s hungry and dehydrated (they gave her very little food and water.) Other than IV fluids and adequate food and water after she is rescued, is there anything else that would need to be done?
Jordyn Says: In a time frame of four days, yes, she is likely dehydrated but she shouldn’t be terribly malnourished. A couple of liters of fluid (Normal Saline or NS) should get her feeling much better. Than some fluids that have some sugar and electrolytes in it at maintenance until she’s eating well and peeing well.  

We’ll continue with the remainder of Taylor’s questions tomorrow!