Tuesday, April 15, 2008

TRAUMATIZING YOUR CHARACTERS?

FROM OUT IN THE FIELD....



TO THE MIDDLE OF THE ER. HERE IS A GREAT PICTURE OF TWO TRAUMA TEAMS WORKING SIDE BY SIDE ON PATIENTS!




CJ Lyons gave a presentation (which I missed because I'd had a prior commitment) at the DR Conference on Trauma in the ER. I believe it dealt with how to make your manuscripts realistic when your characters are injured. It was the really great stuff that only ER/ICU/Trauma nurses and doctors can really get into. I believe she had great pictures and accurate details.

This got me to thinking. When I'm doing a critique and there are inaccurate details regarding injuries that come up, I'm compelled to set the author straight. You want your work to be as accurate as possible. This adds realism and ups the stakes for your reader. You want them to lean forward as they are reading and think "OH, NO!" Providing realistic details can do that.

So, this begins my series on SHOCK. There are several kinds of shock~cardiogenic, hypovolemic, septic, and anaphylactic.

I'm going to save cardiogenic for later. My character from THE DOCTOR'S DECEPTION, Dr. Stone Lassiter will have a lot to say about that. Being a Cardiovascular surgeon, he is the expert!

Let's start with hypovolemic shock. When your character suffers blunt trauma, is shot or stabbed they will bleed. Of course, it all depends on the severity of the injury, but hypovolemia is a direct result of intravascular volume depletion. Here are the signs and symptoms he/she will experience:

~Rapid pulse
Pulse may be weak (thready)
~Rapid breathing
~Anxiety or agitation
~Cool, clammy skin
~Weakness
~Pale skin color (pallor)
~Sweating, moist skin
~Decreased or no urine output
~Low blood pressure
~Confusion
~Unconsciousness

So, now what do you do? Well, that will depend on what genre you write. If it is a contemporary, call 911! Immediate help is the best chance of survival. You'll want to keep your character comfortable and warm (to avoid hypothermia).
Have him/her lie flat with the feet lifted up about 12 inches to increase circulation. However, if the person has a head, neck, back, or leg injury, leave him or her in the position in which they were found unless doing so poses other immediate danger. Do not give fluids by mouth--especially if they have injury to the gut/abdomen! If you must move your character, try to keep him or her flat, with the head down and feet lifted up. Any change in position will affect your character's blood pressure. And he probably doesn't have much to start with. Stabilize the head and neck before moving a person with a suspected spinal injury. This is classic C-Spine immobilization.

Once your character arrives in the ER, things are going to move fast. Lab is drawn, X-rays are taken, IV's are started and opened wide open. Blood transfusions will be given. Once he is somewhat stabilized, he will probably be whisked off to surgery to fix the area of injury.

If you have questions or aren't sure about something, it is always best to ask an expert. You want the details of your book to be accurate! If you don't know anyone, you can always email me. I've been a nurse for 13 years~9 of those working ICU/CVICU/Trauma. If I don't know the answer, I work with some great intensivists who will!

Good Luck!
Kathleen

3 comments:

Susan Macatee said...

Great blog, Kathleen!
I write historical, so 911 is not an option, but it helps to know how a wounded person will react.

Morgan St. John said...

wonderful! I'm going to have to mark this... I often find myself with injured or dead bodies lying around my stories! :) thanks for sharing.

Rebecca Ryan said...

Thank you Kathleen!