The In’s and Out’s of Battlefield Medicine: A Guest Post by Robert Weaver
When your hero is wounded fighting the Bad Guy, or an important character’s life is in jeopardy, unless your story is set in a modern city, the heroes are likely going to have to provide aid themselves.* It helps to know what kind of injury is being dealt with, to provide appropriate care. Unless you have a medical professional to consult for accuracy, it is better not to get too detailed, and also consider the level of gore your readers will tolerate.
Battlefield injuries fall into three broad categories:
- Crushing blows – e.g. fists, clubs, frying pans, mattocks, thrown rocks
- Cutting swings – e.g. swords, axes, daggers, scythes, some pole weapons
- Impaling stabs – e.g. arrows, quarrels, bullets, daggers, some other pole weapons
- Radiant energy burns – e.g. lasers, particle beams, plasma bolts, “heat rays”
As a related point, worthy of a whole essay on its own, is the issue of armor. The purpose of armor is to deflect or turn blows, disperse and reduce the impact energy of a blow. The fact is that different kinds of armor do this in different ways.
Crushing blows can break bones, raise bruises, cause concussions and mess up soft tissues like internal organs, all without a great deal of bleeding. Cutting swings damage tissue and cause massive bleeding, depending on where the blow strikes. Impaling stabs cause some bleeding, depending on where the blow lands and whether the impaling object stays stuck in or gets pulled out. Impaling also causes internal damage and bleeding, but may not bleed much on the surface. Radiant energy burns will very likely cauterize (seal surrounding blood vessels by burning/melting) but the real damage is internal tissue damage by heat transfer.
So, now that we have an idea of what the cause of death is, how do your heroes prevent it? Battlefield medicine all begins with ABC – Airway, Breathing and Circulation. Have the medic/healer/hero check whether the stricken person is breathing – that covers the first two. Check the victim’s pulse at the neck, the wrist, inside the elbow or inside the thigh. Now comes the messy part: control bleeding and treat for shock. Loss of blood volume is the killer, as the body cannot supply sufficient oxygen to the brain and vitals. Without oxygen, the organs shut down and you die. Be careful when examining the victim. Don’t move or turn them until they have been examined; there might be hidden injuries or spinal damage that could be aggravated by sudden movement.
Anything that can be used to control bleeding is ok, and if the heroes are in the wilderness, the less conventional may be more available and dramatic. Clean linen strips, torn cloaks or clothing, even mud will work. Direct pressure on the point of bleeding is key. And it will have to be maintained for a long time – like 10 minutes or more. Without getting too technical, preventing shock means keeping blood supply to the vital organs in the torso and head. Keep the victim lying down and elevate the feet. Loosen clothing. Give water slowly to keep blood volume up.
Treat crushing blows by covering the affected area, controlling swelling and bleeding. Treat cutting swings by bandaging the affected area combined with direct pressure. Warning! Introducing a tourniquet is a serious step. In most low-medical-tech environments, applying a tourniquet will prevent death from blood loss but almost certainly mean losing the limb. Treat impaling stabs (without the impaling object) as with cutting swings. Objects impaled in the body should be immobilized until well after the bleeding is stopped, then carefully and slowly drawn out while applying pressure to the tissues around the object. This will HURT for your patient, so give them a sedative first. Yanking an arrow out of your chest while the blood is still flowing is like getting stabbed again. Radiant energy burns should be kept clean, any bleeding controlled, and whatever burn salve is available should be applied.
Recovery time should be based on available healing technology or magic. The less of either is available, the longer it’s going to take. Instant-healing will require some serious explanation. Don’t forget the danger of infection, especially in dirty & low-tech conditions.
*Stereotypical disclaimer: Please note that this advice is intended to provide you with a general idea of what a medic would do in an emergency situation. It is not intended to serve as a guide to a real medical situation. If you or someone you know is seriously injured (especially as a result of medieval-style combat), please use common sense and call 911 immediately. We at LHP are not responsible for stupidity.
Posted on June 15, 2011, in Fantasy, Guest Bloggers, History, Medicine, Robert Weaver, Science Fantasy, Swordsmanship for Dummies, Writing Hints and Helps and tagged battlefield medicine, creative writing, fantasy, first aid, injuries, science fantasy, science fiction, treatment, writing hints and helps. Bookmark the permalink. 1 Comment.