Medical question

[Redsatinsheets]

I have a scene in a story I am writing where a person is pulled out of cold water with a gash on the forehead. They are obviously hypothermic and, as it turns out later, the gash came with a 'free' concussion. Is it reasonable for this individual to be unconscious for several hours while they regain temperature self regulation and the effects of the blow to the head wear off? I am assuming that the individual has no serious issues such as a brain bleed. Or would this person be at least somewhat aware and responsive?

And as a doctor would you try to keep the person alert or would you let them 'sleep it off'?

Asking for a friend.

 

[KyleR215]

How long was the person in the cold water? How cold is the water?

If they are hypothermic, and had a gash in the forehead, what is the blood loss?

There are a lot of variables. Is the person in reasonably good health? Underlying health issues?

In a perfect world (a TV hour procedural) this person could be rescued from the water with this gash. As they “warm up” they could have moments of lucidity. They could see aliens with 8 arms and Jetson spaceships.

This “cold person” could be in a cabin and see a bottle of Aunt Jemima syrup and think she is his caretaker.

This is your story. You write it.

 

[OralAllOver]

I have a scene in a story I am writing where a person is pulled out of cold water with a gash on the forehead. They are obviously hypothermic and, as it turns out later, the gash came with a 'free' concussion. Is it reasonable for this individual to be unconscious for several hours while they regain temperature self regulation and the effects of the blow to the head wear off? I am assuming that the individual has no serious issues such as a brain bleed. Or would this person be at least somewhat aware and responsive?

And as a doctor would you try to keep the person alert or would you let them 'sleep it off'?

Asking for a friend.

1st priority is to warm them up and determine if they are in shock... consciousness helps!

 

[Redsatinsheets]

How long was the person in the cold water? How cold is the water?

If they are hypothermic, and had a gash in the forehead, what is the blood loss?

There are a lot of variables. Is the person in reasonably good health? Underlying health issues?

In a perfect world (a TV hour procedural) this person could be rescued from the water with this gash. As they “warm up” they could have moments of lucidity. They could see aliens with 8 arms and Jetson spaceships.

This “cold person” could be in a cabin and see a bottle of Aunt Jemima syrup and think she is his caretaker.

This is your story. You write it.

It is my story but I want to make the medical side right. I don’t want to go against Mother Nature’s laws.

 

[Redsatinsheets]

1st priority is to warm them up and determine if they are in shock... consciousness helps!

Priority one was to apply a quick compression bandage to scalp to slow or halt bleeding. Followed by warming them up from the core. They were plucked out of the ocean having been there for some time. I am assuming their core temp was near critical. It makes a better story to have the victim be unconscious for a few hours to allow the rescuer time to recover themselves. I do want things to be possible.
Movies seem to indicate that a whack on the head and you go out for a while. Real life seems to show people coming back in moments or maybe minutes. Had not considered shock. I guess I need to google some more.

 

[RobertTurner1982]

I have a scene in a story I am writing where a person is pulled out of cold water with a gash on the forehead. They are obviously hypothermic and, as it turns out later, the gash came with a 'free' concussion. Is it reasonable for this individual to be unconscious for several hours while they regain temperature self regulation and the effects of the blow to the head wear off? I am assuming that the individual has no serious issues such as a brain bleed. Or would this person be at least somewhat aware and responsive?

And as a doctor would you try to keep the person alert or would you let them 'sleep it off'?

Asking for a friend.

I don't know about medical procedures, but once I found myself in a situation where a friend's body temperature dropped to the point where she wasn't going to make it without help. In this situation, getting medical help wasn't a possibility, and being so, I was alone and on my own.

Fortunately, there was no gash or concussion, just hypothermia. She kept wanting to go to sleep, but I made her stay awake and fed her warm water to warm her from the inside. I don't know what the correct medical procedure might be, but it worked.

In your hypothetical situation, you mentioned a gash? The first thing you have to do is stop the bleeding. If they bleed out, you will lose them no matter what you do. And as far as a concussion, I don't think you will find a one-size-fits-all answer. I have heard that if a head injury is bad enough, the doctors may put the patient in an induced coma to keep them alive, and if the injury is not too bad, they may feel it is best to keep the patient conscious to warm them up. I think every situation would be different and have to be handled differently.

Just my opinion, but if the patient is in the hospital, they have all kinds and procedures and equipment to bring the patient back, but if you are out in the boonies alone, you do what you have to do. And perhaps, say a little prayer......

 

[Redsatinsheets]

I don't know about medical procedures, but once I found myself in a situation where a friend's body temperature dropped to the point where she wasn't going to make it without help. In this situation, getting medical help wasn't a possibility, and being so, I was alone and on my own.

Fortunately, there was no gash or concussion, just hypothermia. She kept wanting to go to sleep, but I made her stay awake and fed her warm water to warm her from the inside. I don't know what the correct medical procedure might be, but it worked.

In your hypothetical situation, you mentioned a gash? The first thing you have to do is stop the bleeding. If they bleed out, you will lose them no matter what you do. And as far as a concussion, I don't think you will find a one-size-fits-all answer. I have heard that if a head injury is bad enough, the doctors may put the patient in an induced coma to keep them alive, and if the injury is not too bad, they may feel it is best to keep the patient conscious to warm them up. I think every situation would be different and have to be handled differently.

Just my opinion, but if the patient is in the hospital, they have all kinds and procedures and equipment to bring the patient back, but if you are out in the boonies alone, you do what you have to do. And perhaps, say a little prayer......

Patient is a thousand miles from nearest human. Rescuer is a doctor. Patient pulled from cold ocean water. He puts a quick dressing on scalp wound then using body heat starts to warm them up. I would prefer for patient to be unconscious for at least a few hours for doctor to attend to other issues. Blood loss is not a big concern. Hypothermia is and now I suspect loss of consciousness might be as well. Perhaps the patient can just be in a stupor for a while.

 

[RobertTurner1982]

Patient is a thousand miles from nearest human. Rescuer is a doctor. Patient pulled from cold ocean water. He puts a quick dressing on scalp wound then using body heat starts to warm them up. I would prefer for patient to be unconscious for at least a few hours for doctor to attend to other issues. Blood loss is not a big concern. Hypothermia is and now I suspect loss of consciousness might be as well. Perhaps the patient can just be in a stupor for a while.

In a story,(if it's fantasy), you can write just about anything and get away with it; however, in a real world situation, you may have to deal with some pretty hard realities. In my opinion, based on what little experience I have, to bring a person back from hypothermia depends on factors like how far their core temperature has dropped, (brain, heart, lungs, etc), what physical equipment/aids you may have available, (blankets, heater, shelter, etc), and the ambient temperature. And as far as the rescuer being a doctor, without medical equipment/aids, that might not be much more advantage than someone with outdoor experience. In an emergency situation, the rescuer may have to depend on personal experience and what he/she can find or make.

From what I understand, in extreme cold situations, one of the first things that happens is the blood stop circulating in the extremities, (legs, hands, arms, feet), and frostbite sets in. I think you would want to keep them conscious if possible, and keep them moving to keep their blood circulating. If they are unconscious, I think you would have to massage their extremities to encourage circulation. Also, muscle movement does create some body heat: i.e. people get hot and sweat when they are physically active.

Using your own body heat to warm the hypothermia victim does seem like a good idea; however, you will need some way to insulate both you and your victims body heat from the air around you. From my experience camping, for example, if you have a two person sleeping bag, and both of you are cold and get in the bag clothed, you will both remain cold; however, if you both get into he bag naked, the sleeping bag will insulate you from the outside air, and your combined body heat will warm both of you. Clothes will insulate your body heat from each other.

I think to a great degree, what you would do would depend largely on the climate you are in, your personal knowledge/experience and what you have to work with. Just my thought, but it might add to the story if the rescuer had to come up with ideas of how to save the hypothermia victim in adverse conditions. Also, it sometimes helps a story by turning the rescuer into the hero.

Just my thoughts................

 

[Redsatinsheets]

In a story,(if it's fantasy), you can write just about anything and get away with it; however, in a real world situation, you may have to deal with some pretty hard realities. In my opinion, based on what little experience I have, to bring a person back from hypothermia depends on factors like how far their core temperature has dropped, (brain, heart, lungs, etc), what physical equipment/aids you may have available, (blankets, heater, shelter, etc), and the ambient temperature. And as far as the rescuer being a doctor, without medical equipment/aids, that might not be much more advantage than someone with outdoor experience. In an emergency situation, the rescuer may have to depend on personal experience and what he/she can find or make.

From what I understand, in extreme cold situations, one of the first things that happens is the blood stop circulating in the extremities, (legs, hands, arms, feet), and frostbite sets in. I think you would want to keep them conscious if possible, and keep them moving to keep their blood circulating. If they are unconscious, I think you would have to massage their extremities to encourage circulation. Also, muscle movement does create some body heat: i.e. people get hot and sweat when they are physically active.

Using your own body heat to warm the hypothermia victim does seem like a good idea; however, you will need some way to insulate both you and your victims body heat from the air around you. From my experience camping, for example, if you have a two person sleeping bag, and both of you are cold and get in the bag clothed, you will both remain cold; however, if you both get into he bag naked, the sleeping bag will insulate you from the outside air, and your combined body heat will warm both of you. Clothes will insulate your body heat from each other.

I think to a great degree, what you would do would depend largely on the climate you are in, your personal knowledge/experience and what you have to work with. Just my thought, but it might add to the story if the rescuer had to come up with ideas of how to save the hypothermia victim in adverse conditions. Also, it sometimes helps a story by turning the rescuer into the hero.

Just my thoughts................

Thank you for the reply.

The one thing I have read on medical sites is that you must always warm up the core before the limbs. Your body turns off blood flow to the limbs when cold. If you warm them up first the super cold blood in the limbs flow into the torso and drop your temperature even further. Better to have some first bite then be dead.
In my case frostbite is not a concern as the ocean water is above freezing but well below safe body temperature.
First aid sites always agree that stripping both parties down and going skin to skin in a sleeping bag is the best course of action outside a hospital.
In my story, the two will end up saving each other.

 

[Profligateous]

If you're writing fiction, you can take a literary-license, as long as it is in the possibility of the reader's imagination.

 

[Redsatinsheets]

If you're writing fiction, you can take a literary-license, as long as it is in the possibility of the reader's imagination.

I would agree to a point but when the science is wrong in a non science fiction story it leaves a bad taste in my mouth. Things still need to fall down, blood needs to be red, and electricity still provides shocks.

 

[Profligateous]

I would agree to a point but when the science is wrong in a non science fiction story it leaves a bad taste in my mouth. Things still need to fall down, blood needs to be red, and electricity still provides shocks.

That is true, but if a story is too scientific, it can detract from the passion of the story. Sometimes characters are more exciting when they have to be inventive. Just a thought.

 

[Redsatinsheets]

That is true, but if a story is too scientific, it can detract from the passion of the story. Sometimes characters are more exciting when they have to be inventive. Just a thought.

As in most things it’s a balance. In the movie “encounters of the third kind” they make a stupid science mistake that ruined it for me. When asked what the tension on a power line was the answer was in pounds per square inch and not volts. Had they had a science advisor, they would not have screwed up.
In the case of “The Martian” and “project Hail Mary” the author researched the science to make sure it was as real as possible and yet made it all relatable to the average person.
That is my attempt with my new story. Get the science right but not make it the focus.

 

[Profligateous]

As in most things it’s a balance. In the movie “encounters of the third kind” they make a stupid science mistake that ruined it for me. When asked what the tension on a power line was the answer was in pounds per square inch and not volts. Had they had a science advisor, they would not have screwed up.
In the case of “The Martian” and “project Hail Mary” the author researched the science to make sure it was as real as possible and yet made it all relatable to the average person.
That is my attempt with my new story. Get the science right but not make it the focus.

Not to start an argument, rather to simply share an opinion........

Sometimes in movies and/or literature, the viewer/reader, (or writer), can become so focused on accuracy that through misinterpretation, he/she lessens the enjoyment of the story.

This statement for example: "When asked what the *tension* on a power line was"

According to Merriam/Webster dictionary, the definition of tension is: "The act or action of stretching or the condition or degree of being stretched to stiffness", which could be measured by pounds per square inch.

However, the measurement of volts, (voltage), is a much more complicated definition. Electricity in a power line is the movement of electrons through metal. Electricity can be measured in voltage. Volts, (or voltage), is the electrical potential difference or pressure between two points in a circuit. This pressure is an electromotive force, (EMF). EMF is not a physical force, but rather a measure of energy per unit of electric charge.

I paraphrased the definition of voltage trying to not write a dictionary.

I saw the movie "Encounters of the Third Kind" also, and didn't enjoy it either. Not because of scientific inaccuracies, but rather because of the premise that somehow aliens from space could or would prolong human life, then return these ageless people to earth for what reason? And that the character Roy Neary was somehow selected to climb The "Devil's Tower" in Wyoming just to witness all of this. To me, Richard Dreyfuss just wasn't believable in that character.

There is another movie that might better illustrate my point that focusing on scientific inaccuracies can lessen the enjoyment of the story:

"Being There" was a Peter Sellers movie released in 1979, (based on a novel of the same name by Jerzy Kosinski), that told the story of a simple-minded gardener with the single name "Chance". Having seen the outside world only through television, Chance the Gardener was forced out of his home into the world without the means to take care of himself. Through a series of misunderstandings, (people hearing only what they wanted to hear), Chance the Gardner become Chancy Gardner, a sage who could influence presidential policy.

This might have remained a nonsensical comedy of little worth, if it were not for the last scene. In the last scene, Chance the Gardner absentmindedly wandered away from a funeral into a park, where he casually walked across the surface of a pond. Obviously, walking on water is scientifically impossible, (depending on one's religious beliefs); however, while scientifically impossible, this scene defined Peter Sellers character, and turned this whimsical comedy into a cult classic.

In my opinion, the purpose of fiction, (whether movie or literature), is to escape reality for a brief moment. Life is hard enough, and if we demand too much accuracy, we can miss the whole point of the art. Sometimes we have to let go of reality for a brief moment and enjoy art for what it is.

Just my thoughts..................

 

[Redsatinsheets]

Not to start an argument, rather to simply share an opinion........

Sometimes in movies and/or literature, the viewer/reader, (or writer), can become so focused on accuracy that through misinterpretation, he/she lessens the enjoyment of the story.

This statement for example: "When asked what the *tension* on a power line was"

According to Merriam/Webster dictionary, the definition of tension is: "The act or action of stretching or the condition or degree of being stretched to stiffness", which could be measured by pounds per square inch.

However, the measurement of volts, (voltage), is a much more complicated definition. Electricity in a power line is the movement of electrons through metal. Electricity can be measured in voltage. Volts, (or voltage), is the electrical potential difference or pressure between two points in a circuit. This pressure is an electromotive force, (EMF). EMF is not a physical force, but rather a measure of energy per unit of electric charge.

I paraphrased the definition of voltage trying to not write a dictionary.

I saw the movie "Encounters of the Third Kind" also, and didn't enjoy it either. Not because of scientific inaccuracies, but rather because of the premise that somehow aliens from space could or would prolong human life, then return these ageless people to earth for what reason? And that the character Roy Neary was somehow selected to climb The "Devil's Tower" in Wyoming just to witness all of this. To me, Richard Dreyfuss just wasn't believable in that character.

There is another movie that might better illustrate my point that focusing on scientific inaccuracies can lessen the enjoyment of the story:

"Being There" was a Peter Sellers movie released in 1979, (based on a novel of the same name by Jerzy Kosinski), that told the story of a simple-minded gardener with the single name "Chance". Having seen the outside world only through television, Chance the Gardener was forced out of his home into the world without the means to take care of himself. Through a series of misunderstandings, (people hearing only what they wanted to hear), Chance the Gardner become Chancy Gardner, a sage who could influence presidential policy.

This might have remained a nonsensical comedy of little worth, if it were not for the last scene. In the last scene, Chance the Gardner absentmindedly wandered away from a funeral into a park, where he casually walked across the surface of a pond. Obviously, walking on water is scientifically impossible, (depending on one's religious beliefs); however, while scientifically impossible, this scene defined Peter Sellers character, and turned this whimsical comedy into a cult classic.

In my opinion, the purpose of fiction, (whether movie or literature), is to escape reality for a brief moment. Life is hard enough, and if we demand too much accuracy, we can miss the whole point of the art. Sometimes we have to let go of reality for a brief moment and enjoy art for what it is.

Just my thoughts..................

Thank you for your thoughts. They were articulate.
When I said the volt issue ruined the movie for me, I should clarify that when someone mentions the film, that is the first thing I think of. Followed by the music theme and mashed potatoes.
Some of the comments I got on my last story were that it was not believable. Not sure I fully agree, but I am trying to make my second story more so. And so, I am trying not to have a doctor do something stupid or have the victim do something improbable.
Although it makes for a more difficult narrative to write, having the victim not be fully unconscious but rather stupefied by cold and concussion seems the right way to go.

 

[Profligateous]

Thank you for your thoughts. They were articulate.
When I said the volt issue ruined the movie for me, I should clarify that when someone mentions the film, that is the first thing I think of. Followed by the music theme and mashed potatoes.
Some of the comments I got on my last story were that it was not believable. Not sure I fully agree, but I am trying to make my second story more so. And so, I am trying not to have a doctor do something stupid or have the victim do something improbable.
Although it makes for a more difficult narrative to write, having the victim not be fully unconscious but rather stupefied by cold and concussion seems the right way to go.

Unfortunately today, there is no shortage of people who apparently feel their life's mission is to criticize other people's work. In my opinion, I think if there were only a few reader's who found your story less than believable, I wouldn't concern myself with their opinion. At the same time, if the majority of your reader's found your work less than believable, I would try to learn from it and write a better story next time, which appears to be exactly what you are doing.

No one is perfect, and consequently, no story is perfect. For example: From what I have read, (I didn't see the movie myself), the final scene of "The Curse of the Black Pearl", over the right shoulder of Captain Jack Sparrow, (Johnny Depp's character), there was a crew member wearing a white shirt, a tan cowboy hat and sunglasses. Not something you would expect to find in a movie supposedly set in 1751. While some viewer's criticized the error, most movie goers found it amusing, and their support turned the Pirate's of the Caribbean franchise into what is probably the most successful movies of Johnny Depp's career.

I think what makes a story appealing/enjoyable is not the absence of flaws, but the identity of the characters. If you love or hate a particular character, the reader is less likely to notice inaccuracies. For example: In the novel "Doctor Zhivago", (by Boris Pasternak), the story is set in the Russian Revolution of 1917. In both the novel and the movie, the emotional identity of the main characters are so strong that you feel empathy for some and hate others. By keeping the reader/viewer focused on the emotional identity of the main characters, any inaccuracies are irrelevant to the story, and therefore unnoticeable.

Just my thoughts..............