#accurate whump

[scifimedic]

Hi! I just found your blog and noticed you have some posts where you explain how to write certain medical conditions, and I was wondering - could you perhaps do a post on blood poisoning, please? I am struggling with it a little lol.

I have a character that got stabbed, and I don't know what are the odds they could get blood poisoning and if yes, how fast and generally how it progresses.

If you don’t have time or something, don't sweat it, it's just a silly idea I got lol :D

Episode 4 of SciFiMedic Explains: How do I write sepsis?

Hi Anon!

So, your character got themselves stabbed, huh? Before we get to the nuts and bolts of how this is going to progress, we have to clear up a little choice of words here. 

The term blood poisoning is not the medically correct term for an infection inside the blood- we call it sepsis. Unless you meant literal poison from the weapon (which I can do a follow-up post on, if that’s the case) I’m going to guess that we’re talking about a severe, system-wide infection of the blood. 

Let’s walk through a few options: 

Scenario 1: 

Your character is stabbed in an area with lots of big blood vessels (highlighted red in diagram), and while everyone does all they can, the poor guy quickly dies of blood loss. There’s no time for infection to set in. 

Scenario 2: 

Your character is stabbed in a non-lethal area, like the arms, legs, or shallowly on the gut (highlighted green in diagram) They’re able to bandage themselves up, or maybe someone helps them out and they manage to get the bleeding stopped. 

Unfortunately, 12 hours later, they notice red streaking coming from around the wound. They also: 

Feel freezing cold, but have a high temperature

Are dizzy

Are shivering

Can’t quite catch their breath and feel the need to pant

Throw up

Look pale

These are all signs of the injury going septic, which is when the infection spreads away from the site of the wound and into the bloodstream. It happens fast. From the onset of these symptoms, they can be dead within only 12 hours. 

Here’s what needs to happen for them to survive: 

1: Hospital. No buts, no delay. If you want them to survive, they need advanced medical treatment, detailed below. (I will allow for a field hospital, or a makeshift hospital with a trained professional and plenty of supplies.) 

2: Blood and wound cultures. This means taking a small tube of blood from the arm, rubbing a cotton swab in the wound, and then sending both samples to the lab for study. They will smear the sample on a slide, put it in a warm, wet environment, and wait for it to grow out. Then, they’ll pop it under a microscope and run chemical tests on it to find out what the infection is. This process can take up to 4 days. The good news? The more pathogens that’s in the sample, the faster it will grow out. If you have blood that is severely infected, it could take as little as 12 hours to see results. (I know this from personal experience.) 

If you’re in a field hospital, unfortunately this is a luxury you don’t have. See next step. 

3: IV antibiotics immediately. Since you don’t know the bacteria causing the sepsis, you don’t know which antibiotic to give. Good news, people a lot smarter than I have created a plan for this. 

3a: According to this study done by the National Library of Medicine, 67.9% of people presenting outside a hospital setting had their wounds infected with either Staphylococcus aureus or Pseudomonas aeruginosa.  3b. Thankfully, we have two very strong antibiotics- Vancomycin and Ciprofloxacin- that can each treat these pathogens. Unfortunately, each antibiotic is effective against only one of these pathogens, and nearly useless (or has developed resistance) against the other one!  3c. Good news, these antibiotics can be safely run together. Boom, you’ve just slammed (and it’s a slam- these drugs are horrible for you long term) 67.9% of patients with the right antibiotics to start treating their sepsis.  3d. What about the other 32.1% you may be asking? Good news, they’re not doomed. Just because a given antibiotic isn’t the best choice against a certain pathogen, it doesn't mean it will be completely ineffective. You may be buying them more time for the cultures to come back. You can also take your next best guess, and switch the antibiotics after a few hours if they aren’t having any effect. 

4. Fluids. IV time! The biggest tell that someone has sepsis is that their blood pressure plummets to dangerous levels (which is what will eventually kill them, but we’ll get to that.) In order to prevent that drop, we need to raise the blood pressure by adding more volume to the blood through fluids. They might also need a blood transfusion, depending on how much blood they lost from the initial stab wound. 

It’s important to note that it may not be possible to gain IV access, because when the blood pressure is that low, the veins tend to shrivel up and disappear (not literally.) In that case, your next best option is an IO, which is a needle drilled into the center of the upper arm bone, or lower leg bone. Yes, it hurts. 

5. Vasopressors. Fancy name for medications that force the blood pressure to come up. There are four main pressors: 

Norepinephrine

Epinephrine

Phenylephrine

Vasopressin

They should be added in that order, although this article admits there isn’t too much hard evidence to back this up.

It’s important to note that this is ICU level care, and unless we’re in the middle of the woods, we will have transferred there.

How do you know if it’s time to add another pressor? You’re not getting the results you need- AKA the blood pressure is continuing to stay or fall too low. In the ICU, we use a different measure of blood pressure that most people aren’t as familiar with, called a MAP score. It’s easy, I promise. 

We use this method because it’s more representative of the amount of blood actually getting to the organs- though that is debated quite a bit in various circles. In America however, that’s the way most ICUs do it. 

The ultimate goal for a sepsis case is to have a MAP above 65 mmHg. You can use this calculator to play around with the numbers and see if the blood pressure you’re thinking is within those parameters. If it’s not, time for another pressor. 

At this point, your character is passed out most of the time. They’ve got a high fever, rapid heart beat, and are covered in sweat. They might also have a seizure from the fever and general stress on their body- at the very least they’ll be shaking from the chills. Their skin will be very, very pale, and might look kinda blue or gray in places- kinda like spots. 

6. Hold your breath. No, not literally. But at this point, you’ve done all you can and you have to wait for them to either get better, or get worse. 

If they get better, they’ll slowly start to maintain their own blood pressure, the fever will come down, and they’ll be able to string a coherent sentence together again. Recovery from sepsis can take a long, long time- as many as two to four months in the hospital. It totally depends on the person and how strong they are. The fittest, luckiest patient I’ve seen recover from sepsis was with us in the ICU for three weeks, then spent another month in a step down unit doing various therapies to regain strength. 

However… if we’re looking at failure… well, then it’s time to move onto scenario 3. 

Scenario 3: 

After completing all of the above steps, they end up getting worse. Don’t worry, it’s not your fault- sepsis is fickle and kills fast. At this point, their kidneys are starting to fail from the inadequate blood pressure- you’ll need dialysis for that. They might stop breathing, or be unable to oxygenate their blood properly, then they’ll need a ventilator. At this point, they’re not stable enough to go into surgery anymore, so there’s no hope there. Eventually, the high fever will cause seizures, which will lead very quickly to brain death. As little as 12 hours after the initial dizziness and red streaks, their heart stops and they’re pronounced dead. 

Summary: 

The odds of your character developing sepsis from a non-fatal stab wound without immediate medical care are high- 90% 

If they’re rushed to a hospital, their odds are better- 50%

If they do develop sepsis inside a hospital, they’re likley to survive- only 10.55% of people die of this kind of wound infection.

If they develop sepsis outside a hospital, then it’s almost certain they will die- 99% 

Disclaimer: Although I’m in school to become a medical professional, I’m not one yet. All mistakes are mine, and I’m always open to discussion.

Anon, this was a fun prompt! If this isn’t quite what you were looking for, feel free to submit another ask with more follow up questions!

Everyone else, also feel free to send me an ask, or reblog this (or any SciFiMedicExplains Episode) with a scene you’d like me to help you write!

[thereweredragonshere]

Buff Astrid looks like she gives the best hugs

She defo does

[c3realkilluhz]

I’m not elaborating anything either …

[whumping-valentine]

We use being cold, hungry, and tired a lot in our writings, and that makes sense! Those aren't pleasant feelings, but what's not used enough is all of the other symptoms that can occur under those conditions.

Being malnourished not only causes the feeling of hunger, but can give you headaches, and make you feel weak, faint, sick, cold, and tired. It makes you irritable, unable to concentrate, and can even cause wounds to take longer to heal, while brusing much more easily. After a while you even develop an aversion to food, and don't want to eat. You feel nauseous just thinking about it, and breaking a fast isn't something you can do with a flick of your fingers. Your body isn't used to eating, and it may not sit well with you.

Not eating can also cause your blood sugar to drop, which is a whole entire thing in and of itself, and you don't have to be a diabetic to experience it. Low blood sugar is horrible 0/10 do NOT reccomend (but definitely do in whump!)

As for being cold, it can not only be uncomfortable, but it can make you feel physically ill. Especially when paired with a lack of vitamin D from low sun exposure. You just constantly feel sick, and may even begin to feel hot. It is absolutely FREEZING in my room all the time and I always feel sick. Horrible. Do it to your whumpees and tell them if they're good they can go outside and lay in the sun. That's shit's awesome when you're cold.

And of course, with sleep deprivation, it not only makes you drowsy, but it basically screws everything up. Your ability to think, your coordination, your strength. All you wanna do is curl up into a ball and go to sleep, no matter where you are. There's so much you can do with a tired whumpee.

The most fun thing about all of these is that they can generally go together all at once, inflicting symptoms of the others in an endless loop of torment. So yeah, go nuts! It's miserable!

[amirmeavid]

Merlin and Mordred but Mordred hasn't reached Stage 3 Disillusionment yet:

Merlin: *making the fire while on a hunting trip* What?

Mordred: *wheezing. coughing. sobbing. because why is his GOD doing menial tasks!?* This outrage! This is heresy!

Arthur: ..the soup? *hesitantly licks the spoon* Its not that bad.

Gwaine: Yeah, trust us Mordred. Merlin makes great soup!

Mordred:

Mordred:

Mordred: What did you just say?

Merlin: Oh no.

Mordred: *starts throwing a hissy fit because no, thats illegal, but also he can't tell the knights how important merlin is because what if his god SMITES him?!- (merlin does not yet know how to this, or he would have alreadu done it)*

*2 hours later*

Mordred: WHAT DO YOU MEAN HE ALWAYS DOES IT?! DO NONE OF YOU KNOW HOW TO COOK!?

Long story short, Merlin's chores dramatically decrease when Mordred is around, because nobody wants to kill their youngest knight by stress, even though they don't know why he acts that way.

Merlin is grudgingly pleased.

[cravesunconditionallove]

On your recent post for Vivisections

Do you have any more advice or maybe a quick scene lay out on how you'd accurately describe and show it? I've not seen many people explain this before I'd love to know more!

Permission to infodump?? awesome :D

Because it's on topic here, there are a few blogs I think need a mention because they have AMAZING medical/torture writing advice (@scripttorture and @justkidneying )

You didn't ask whether the character lives or dies, I don't know which you want so here's info on both scenarios:

Dying:

First off, without anesthesia, the pain alone would likely lead to a thing called Neurogenic Shock, which will in turn cause a BP drop and organ failure among other things. Your character will likely be breathing quickly, appear pale, have a rapid pulse, and be confused if they are still conscious. And yelling in pain of course.

For death due to blood loss: it's hard *not* to hit a major blood vessel if you're flaying someone open neck to groin, and that will also lead to quick death without immediate treatment. Cautery (using electricity to burn an area, stopping bleeding) will work on smaller bleeding but major blood vessels not so much. Symptoms are similar to shock: clammy/pale skin, thready/weak/rapid pulse, loss of consciousness.

Other: you can also risk damaging organs (someone being vivisected probably isn't going to be staying very still, even restrained, and one slip of a scalpel and oops, that's the aorta...) A punctured lung could lead to pneumo/hemothorax (air/blood in the chest cavity (pleural space), where it shouldn't be) causing respiratory distress—and then shock, and without treatment—death. If the heart is damaged, death would be near instant. Other organs like the liver, kidneys, bowels, spleen etc are pretty big bleeders, so see my Blood Loss section.

Sepsis: If they don't die immediately, sepsis is a big risk, as even in sterile environments you can't completely prevent it. Sepsis is when an infection reaches the bloodstream and is very serious. I imagine whoever is vivisecting the character probably wouldn't care too much about using sterile technique, so you can bet on an infection happening. This can set in within hours or days. Symptoms include high fever, pain, confusion/delirium, sweaty/clammy skin, low blood pressure.

Now, if you want them to live?

Surviving:

If the vivisectionist wants their patient/victim to survive, they'd need a lot of materials. Like any major surgery you'd need blood products, fluids, antibiotics, ligatures, and a way to keep the pain (somewhat) under control. Alcohol has been used in the past for similar procedures, but you could also just opt for a dose of opioids.

Antibiotics are necessary, opening someone up like that is a MAJOR risk (see "Sepsis").

I imagine they'd also somewhat monitor the character's vitals. They'd also probably have a few assistants to help with similar smaller tasks like that—stopping bleeding or handing tools, etc.

Closing the wound: Stitching someone up from such an event would be a lot of work, as you have to close many skin layers (muscle, fat, and the surface skin) and bandage it.

If you don't want to stitch them up immediately, a wound vac (negative pressure wound therapy) would be a good option. Doctors use these in cases of things like compartment syndrome. It is used when you cannot close someone back up right away.

Bandages and proper wound care are also important, you'd need to change the bandages every few hours for the first few days as deep wounds tend to produce a lot of fluids (called "exudate.") Sometimes doctors place drains to help drain away this fluid faster.

All in all, Healing from this would take months, not to mention the psychological trauma from all of this.

The scene:

Writing these scenes is honestly so variable so here's a few thoughts of mine:

You could describe the environment: (cliche, but cold metal table? Harsh lighting? Straps? A table with sharp scary-looking objects on it? How about the scent of disinfectant (or its absence).

The initial sensation would be the biggest to focus on: does the vivisectionist take their time? (pressure before pain?) shock as nerves fire as they are severed (lightning sensation shooting upwards), and the body’s instinctive flinch or freeze. Initially screaming, swearing? Sweating, rapid breathing, muscle spasms, or even vomiting as the body tries to cope?

Smells: Metallic tang of a large amount of blood (I personally HATE this smell, it's like having a penny in your mouth, or if you've ever used a metal scrubber to clean a pan, it smells kind of like that.), burning flesh (if they use cauterization) etc

If the character is partially sedated for it, keep in mind they will still react to pain, albeit sluggishly.

I hope this helps!

[whumpster-dumpster]

Had a dream from the POV of a non human whumpee who had a pretty bad fever and the caretaker for some reason had to use one of those candy thermometer probes instead of a regular thermometer to track their temp and keep holding it in their mouth because the probe was so much more uncomfortable under their tongue but it was all they had. It was great

[allthingswhumpyandangsty]

the struggle a whump writer — who wants to write their blorbo as canonically accurate as possible — goes through when their blorbo is bulletproof, knifeproof, physically invincible with healing ability that makes any injuries they sustain go away almost immediately in canon, and so trying to Whump them means having to try to come up with convincing reasons why they're hurting now or why bullets can pierce their skin this time or why their healing ability is out of reach in this specific scenario. thus they can feel the pain and are severely injured; it will be a long and difficult road toward recovery, etc.

*I know we could always ignore canon and that's what most of my fics are about, but my mind still needs me to portray them as canonically accurate as I can when it comes to things that aren't about the state of the character's love affair (who they date in canon) or if they're alive in canon. like my brain needs me to write them as 'in character' as possible, and it's a pain in the ass when my brain also sees their 'healing ability' as part of what's 'in character' for my blorbo. sighs.

[nat-1-whump]

Mending spells are for objects, healing spells are for people. That was one of the very first things Whumpee learned from Mentor as a spellcaster. Though they weren't quite sure what caused this difference, they also weren't one to test it. Every spell Mentor taught had been passed down and refined for generations, so Whumpee trusted that they had good reason for emphasizing that such a distinction existed.

Well, at least, they never intended to test Mentor's instructions. Now that they'd tripped and fallen into a ditch full of jagged rocks while looking for spell components in the woods, they were considering it as an option.

A boulder scraped against them on the way down, leaving a thick red streak of blood along the edge of the ditch. They groaned as they lay on their side. Each frantic, shallow breath sent a wave of stabbing pain through their body, undoubtedly because of a broken rib or two. As their mind stopped spinning, they realized they were clutching at a large gash that ran across their stomach.

They pushed themself into a sitting position, still cradling their stomach. "Mmnh... Somebody. H-help! Please!" Tears ran down their cheeks, stinging the cuts that dashed across.

Moments passed, yet there was no response. Whumpee began to try to call out again, but they were taken by a coughing fit and fell onto their back. They winced, feeling blood spatter from their lips.

Whumpee cursed themself for using up their one health potion earlier in the day on a stupid scraped knee. And then foolishly separating from the rest of their party, which was surely hours down the path by now. They hadn't even properly learned how to cast a healing spell, one of the more difficult spells to learn, thinking that carrying around a potion meant they wouldn't have to.

At this point, even if a mending spell wasn't specifically meant to heal, they figured it had to be better than nothing. And they knew it well, having used it to repair things countless times. They closed their eyes in an effort to calm themself enough to focus. They took a shaky breath, rested one hand above their stomach and clutched their spell focus with the other, and whispered the spell.

A soft light shone from Whumpee's palm. It flickered for a moment before fading away. Whumpee propped themself up on their elbow to look, only to find that the wound continued to flow steadily, coating their fingers with sticky blood. Nothing had changed. They sank to the ground again, defeated, when they felt a warm tingling sensation across their skin.

A scream tore through their throat as their flesh started to warp, twisting into strips and sprawling across the wound like vines. The pain left them writhing on the ground and choking on splintered cries.

"... Ple-please... It hurts! Make it stop!" They weren't sure to who or what they were calling, but it didn't matter. Every desperate plea went unanswered in the empty forest, as the magic continued its work undisturbed. Whumpee sobbed with each surge of pain. Every movement sent a sharp, burning pain from their wound, but they couldn't hold still, not like this.

Finally, the pain slowed down to a dull, throbbing sensation. Whumpee shuddered and carefully pulled themself back onto their elbows to look. The wound didn't look much better than before, other than having some rough strands of flesh stretched across as if it had been clumsily sewn over with rope. At the very least, it seemed like the spell had pulled the wound shut by a little bit and slowed the bleeding.

Whumpee stared up at the sky. Though they'd left in the bright afternoon, the sky was now fading to a warm purple, speckled with a few faint stars. If this was the best they could heal themself, they had no better choice than to wait and hope someone found them, and soon.

[b0amagination]

Home Is Where The Fanart Is

Happy Fanuary! What's Fanuary, you ask? It's my own little excuse to draw some very long overdue art for my friends, and develop better style with lineart at the same time!

Without further ado, I started with an author whose work captivates me in a truly indescribable way. It would be truly terrifying to a hacker to see how often I'm on her blog rereading an old favorite or an entire story. I will never be able to find the words to explain the magic of her storytelling, but I sure try my damndest every time.

Kirsten @whumblr 's Zayne and Jay of HIWTHI have had a deathgrip on my soul since the first chapter back in 2020 and, though I've drawn them before, once was never going to be enough.

And, well, maybe I figured out the plot of this interaction and impulsively wrote fanfiction. At the end of the cut are a few bonus detail shots as well <3

Content warnings: Belting, forced stripping (partial, not sexual), and canon-typical home invasion.

~~~

“Aren’t you tired of this old song and dance?” Zayne flashed him an unimpressed look, then glanced down at his own outstretched hand. Still empty. 

“I am. Glad you finally agree,” he huffed and brushed past, only to be caught by the collar of his button down. The grip tightened and pulled him, stumbling, face to face with his unwelcome visitor. His eyes cast down. 

“Then why is that belt still around your waist?” 

Jay bristled. He knew damn well how long his day had been, because he’d started unloading it on Zayne the moment he arrived home. If it weren’t for the sudden order that cut him off, his tormentor would have still been listening to that afternoon’s office melodrama. The last thing he needed was to present his battered body on a platter before the long weekend. 

“I have more than one, you know. If you can rummage through my fridge, you can give my closet a passing glance every now and again.” Regret only came on after handing him an open invitation to look through more of Jay’s belongings, but he suspected Zayne had already done more than his fair share of that.

“As it happens, I was looking for this particular belt.” He drew a finger along the smooth leather. “If you’re craving ice cream, an ice lolly just won’t cut it.”

“Does the trick for me,” Jay shot back and turned away down the hallway. “Here, I’ll show you where they are.” His brisk pace far too closely resembled running, and the heart pounding in his throat mimicked that well. He’d hung last time’s belt separately when he remembered he didn’t have the funds to simply keep discarding them. Probably the same reason Zayne didn’t care to use it again.

Just like a cat. The moment something was designated his, his interest dissipated. 

On an instinctual level, Jay knew he wouldn’t make it to the bedroom, but some part of him still had the audacity to be surprised when a hand twisted his hair and flung him toward the wall. Even though his shoulder took the brunt of the impact, the blow to the head was enough to skew his glasses. Jay leaned back and raised a hand to set them straight when Zayne took hold of his shirt and yanked it from his trousers.

“Get off!” In finding a stable place to lean back, Jay had unwittingly trapped himself against the wall where a knee now dug into his hip, holding him still enough to free one button, then another. He wrapped fingers around Zayne’s wrist. “The hell are you doing?!”

“Why don’t you deduce that yourself, Jayboy? Surely you can be a more reliable source than your coworker found.” A fist drove into his gut and Jay lost his grip, allowing the shirt to be shucked off him and thrown aside. 

“You could’ve just asked!” He tried to swallow the clear hypocrisy. Somehow, he only happened to think these plans through about two minutes after initiating them, and wondered how he hadn’t already anticipated the outcome.

“Try giving the same order three times in a row. See how patient you are when your punching bag cusses you out,” Zayne shrugged, reaching for the undershirt next when Jay hugged his waist in protest. He didn’t understand why Zayne held him by the hip instead until nimble fingers flicked out the end of his belt, pulled to free the buckle’s prong, and whipped it out in a single flourish. 

“On your knees.”

“Wait, wait- fuck!” The full length cut across his front, only shielded by thin cotton, but the familiar sting throbbed on his jaw. A tentative touch found hot, angry skin just below his cheek. “That was my face, Zayne!” 

“You clearly don’t care to heed my requests today. I don’t see any reason to return the favor.” He doubled the leather over and tilted his head.

Finally Jay made eye contact, turned his back, and slid to his knees. 

“No. Face me.”

“I’m not letting you bust my lip with a belt!” 

He’d already resigned himself to the shove when it came and caught himself just before he hit the wall again. Zayne’s boot landed on his ankle and couldn’t hold back a smile at the yelp it forced out. 

“Then you’d better get your arms up and make sure I can’t.”

[voidwolf]

shoutout to that person on tiktok who said that whump is like porn for asexuals. bro wasnt lying

[lancedoncrimsonwings]

I don't have the words to express how much I love this. It's really going to help me with this thing I am writing- I had been debating scrapping the broken-rib-punctured-lung thing completely because it just didn't look survivable but now I can keep it AND write it accurately!

I already have so many ideas, but I'll be sure to revisit if I get confused!

Thank you again, you're an absolute legend!!

Episode 2 of SciFiMedic Explains: How do I write broken ribs with primitive field surgery for a collapsed lung?

Original prompt submitted by @lancedoncrimsonwings.

“Character has broken ribs on one side, then fell from a horse (landing on the injured side and dislocating their shoulder by trying to brace to protect their ribs). Is it likely the fall would worsen the break, and if a rib punctured their lung, how would someone with them first aid that in the wilderness? (Medieval times, generally). They have access to water, a dagger, a form of herbal ish pain relief/sedative made from poppies, and reeds. Survivable or nay?”

This is a fun scenario!

Falling from a horse may seem fairly mundane, but many life threatening injuries can happen, especially if the horse steps on you. To end up with a dislocated shoulder, they would most likely land on their outstretched arm.

The instinct to fling out an arm when falling is stronger than the instinct to pull in and brace broken ribs. The shoulder would most likely dislocate anteriorly from this kind of injury. 

Source

Here’s a step by step guide on reducing a shoulder via the Hennepin technique: 

Lie down. Flat on their back with no pillow. 

The person who’s helping them should gently grab the injured arm by the wrist and bend the elbow to 90 degrees. Support the elbow with one hand, hold the wrist with the other. You can also hold their hand. 

Gently press the elbow to their side. 

Keeping the elbow near their side at all time, gently pull their wrist away from their body, externally rotating their shoulder away. This should go extremely slow, at least 10 minutes to allow muscles to relax. 

The shoulder will make an audible “pop” when it slides back into it’s socket. The pain goes away immediately, but is replaced with a dull throb a few hours later. You want to bind the arm to the chest to prevent movement of the joint as it heals. 

Source: Merck Manuals 

Now… it sounds like a dislocated shoulder isn’t the worst of their problems. Whoever is helping them may be more concerned about their obviously injured shoulder and focus on treating that first, while completely missing the fact that they’re showing symptoms of a pneumothorax, which is what happens if a rib punctures a lung. 

There are two ways you can play this. 

Option 1: Closed-Simple Pneumothorax

This can happpen when a broken rib pops a hole in the lung. This can be a tiny little nick, or a larger hole. Because it’s simple, that means that the air that’s coming into the pleural space (the area between the outside of the lungs and the inside of the chest, normall filled with slick fluid) is able to get back into the lungs again. There is a slight pressure build up, and the lung is slightly compressed, but you can have a simple pneumothorax and not notice it for literal months. The treatment is simple, let it heal on its own. There’s not much you can do, even with modern surgical practices. It’s better for everyone to leave it be. 

Option 2: Closed-Tension Pneumothorax 

Based on the supplies you’ve given me, this is probably what you’re thinking. A tension pneumothorax happens when that air coming into the pleural space isn’t able to get out. With each breath, more air is forced around the lung, collapsing it. The only way to relieve this pressure is to manually release the air by poking a hole in the chest wall. Before you do that however, we have to make sure they actually have a collapsed lung. Here’s the signs & symptoms: 

Decreased breath sounds on the bad side

Sharp pain in the chest

Panting

Fast heartbeat

Jugular Vein Distension (photo)

Tracheal deviation away from injured side (photo) 

Blue lips and fingernails

Jugular Vein Distention

Source

Tracheal Deviation

Source

While this is not a pneumothorax case, I could correctly diagnose a right-side tension pneumothoarx from this picture and listening to breath sounds. 

Alright, you’re sure it’s a pneumothorax? Fantastic. Now it’s time for the fun part. Here’s a step-by-step guide using the supplies (and time period) you’ve given me. 

Step 1: Identify the site you’re going to poke a hole. Refer to handy-dandy diagram for reference.

Source: PlumCast

Step 2: Clean as best you can. If you have strong alcohol, use that. If you have soap and water, use that next. Failing all else, use the cleanest cloth you have with some clean water to wipe off any dirt. The level you’re able to clean will determine the likelihood your character will survive. If you have alcohol, they’re more likely to pull through.  

You should be cleaning the chest, the daggar, and the tiny, hollow reed. 

Step 3: No time for pain medication, it’s not going to kick in anyways. DO NOT give them alcohol to drink for the pain. Use the smallest blade you have to make a small hole in the chest wall right between the 4th and 5th ribs. They only need to go about an inch if the patient is skinny. Most EMS units today use 3” needles, but not the whole needle is inserted. You probably won’t hear any air movement until you pull the dagger out, so it may take a few tries to get deep enough.

Step 4: Pull the blade out and insert the reed. Once the reed enters the pleural space, air and blood should come rushing out. Relief will be immediate, and the JVD and tracheal displacement should fix themselves in less than a hour. 

Step 5: Secure and prevent reoccurrence. That reed needs to stay in place. Use bandages or whatever you have to keep it there. You also need to create a one-way valve to prevent the air from just being sucked right back into the chest cavity through the convient hole you just made. Get a clean rag, soak it in lard, oil, or water if you have to and secure it loosely over the reed. The idea is that when they exhale, the free air in the chest is allowed to escape, but when they inhale, the cloth snaps shut over the reed and prevents air from entering. 

Step 6: And now it’s up to their body. The reed should be changed every 12 hours minimum to prevent infection, the one way valve as well. It’s important to note that if you’re using water on the cloth for your one-way valve, you’ll need to keep that wet. Now is the time for pain medication as well, boil the poppy seeds in clean water to make a tea. Poppy contains a similar chemical to morphine, so they will get some relief from this. It’s really hard to drink when lying flat on your back, so drip a washcloth in the tea and let them suck on it. 

Complications

Your biggest enemy is going to be infection obviously. There are several things you can do to prevent it. 

Clean the site. Alcohol or soap and water every 12 hours minimum (do it with the reed change). Make sure you’re cleaning the open wound, but don’t scrub into the chest wall, that’s going to push bacteria further into the wound. The signs of a local infection are: 

Red streaks coming from the wound

Pus

Warmth

Swelling

Green or yellow pus

Pain

If infection starts to develop, increase the cleaning to 4 hour rotations, and continue to replace the reed at that time. Signs of a developing system-wide infection: 

Fever

Nausea

Vomiting

Chills

Cold sweat

Fast heartbeat

Both honey and garlic have been clinically proven to have antibacterial properties . Apply crushed garlic and honey to the wound. Garlic also appears to be effective if consumed as well, honey is just topical. 

Sources:

Honey: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3609166/

Garlic: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458355/

i can’t make this shit up

Pneumonia is a serious complication. Honestly, if they get pneumonia, they’re dead. They will have a high fever, start coughing, and die fairly quickly with a primitive chest tube in place. Sorry. :( 

Sepsis is also a death sentence. It’s a system-wide blood infection charterised by a high fever, low blood pressure, then sudden system shutdown and organ death. There’s not a lot you can do without real antibiotics, so avoid this if possible. 

Thankfully, the line between a bad local infection and sepsis is not easily identifiable without a hospital (a blood pressure cuff, really) so you can have quite a bit of angst around this and still have them pull through in the end. 

 What about the broken ribs? Leave them. There’s nothing you can do. Trying to manipulate them with your hands will only make it worse if you’re doing it blind (without X-Ray guidance.) 

It’s been awhile… now what? Normally, this patient would be rushed into the OR to repair the hole in the lung. Since you don’t have that, here are a few long-term options. 

The lung heals itself neatly. This is totally possible. You’re looking at at least two months though… and it’s a stretch. This character better have plot armor. Note: if you have pierced ears, you know that a hole in the body eventually seals itself off and doesn’t ever heal shut. Same with your makeshift chest tube. Once the lung has healed and it’s time to remove the reed, you may need to scrape the skin of the hole down a little to encourage healing. That’s another few weeks of healing. The lung can regain full capacity, and free air in the pleura will be absorbed into the bloodstream.

The lung heals poorly. As long at the hole in the lung is closed, the body will take care of the rest and absorb the free air. Same scraping for the chest tube site. They may lose use of the damaged lung- some people can learn to live without sections of their lungs but will never be able to do what they used to. It’s important to remember that the broken ribs may have healed in a place where they permanently damage lung function. 

The lung never heals. This means a permanent chest tube. The infection will eventually catch up to them, and they’ll die. 

Best case scenario survival odds: 60% 

Worst case scenario survival odds: 0%

Essentially, if you want them to survive, you can write it in a way it’s medically possible. But they have to fight hard, be strong, and have a healthy body with good fat stores before the accident. 

Disclaimer: Although I’m in school to become a medical professional, I’m not one yet. Please don’t sue. Can you even do that from a Tumblr post? I don’t know. All mistakes are mine, and I’m always open to discussion.

‘crimson, thanks for the detailed question. I had so much fun researching this stuff. Hope this helps, and feel free to ask clarifying questions. (Tension pneumo stuff can be really confusing.)

[thereweredragonshere]

Some more Hiccup/Astrid whump? Pretty please?? 🤭 (I like seeing them suffer‼️)

Sadstrid :(

[max-nicoxfandom]

Some trauma/whump/abuse scenarios for you, because your character can be traumatized without having the literal joker for a parent. Like not all abuse is so outward, I would argue that most abuse looks more like this.

Feel free to add your own, this is just stuff I've experienced

Yelling. I don't mean being yelled at. I mean a child being in a household where their guardian is always stressed and always yelling. It puts your body in fight or flight mode for all of eternity, trust

Sex and other adult topics being discussed with or around a child before they can understand what they're talking about

In the same vein, adults talking about a child while right in front of their face, and not caring what they hear or believing that they don't understand what they're hearing (they always do)

Gaslighting. Phrases like "you dreamt that" "you're being too sensitive" "that never happened" "don't lie"(while telling the truth)

Guardians not supporting the child's interests, or even down right denouncing them, whether they do it by taking the interest away or insulting the child for participating or some secret third thing

Misplaced anger/adult taking out anger on the child

Food scarcity, specifically by refusing to buy food that a picky eater would eat, or not having enough money to keep food on the table

In a similar vein, buying luxury items like game systems, new clothes, TV's, etc, while not being able to afford to put food on the table (and if you want to be even cooler the guardian will make the child feel bad for complaining about not having basic needs met by pointing out all of their luxury items they've been bought, double points if the child didn't want or ask for any of it)

Being treated as a burden, or saying things like "you're too/so expensive" "you're so needy" "you're too spoiled"

Guardian A trying to turn their child against guardian B, making themselves look like the better caretaker or better person.

Guardian who treats their child as a friend, or overall not having enough boundaries between parent and child

Emotional absents. Being there, but never engaging with their child. On the flip side, forcing their kid to participate in something bc the guardian likes it, even if the child hates it

Parentifying their child or forcing them to take care of their household in an adult manner, like helping raise the other children, housework above their skill level, paying bills, etc

Lack of privacy. A guardian telling people about something the child doesn't want people to know about. It could be an embarrassing story, it could be about their sexuality, it could be something that sounds harmless

Physical abuse but only while inebriated, and being (what's at least perceived as) a good parent otherwise

Preventing a child from sleeping while they're tired/extreme sleep deprivation

Repeatedly breaking their trust, like not doing things they promised they would do, saying things they don't mean, bring people who don't like their child around their child, ect

Name calling

Feel free to add your own, or hop into my askbox !! It is always open !!

[misstressviole]

Lucifer before and after the fall

[maybeitsalivescribbles]

VH - Divide And Conquer

(Tw: attempted torture)

“I can't believe we finally have caught the legendary Vampire Hero”, said Villain.

The two Heroes glanced at each other and shrugged. The taller one frowned.

“Legendary ?” he repeated.

Villain looked at him with interest.

“Oh yes,” he said. “Many have fallen before your might, Vampire Hero. At least two or three of my opponents are behind the bars because of you.”

“Two or three and you call that legendary ? You're easy to impress.”

The other Hero was nervously following the exchange. Compared to his companion, he seemed much younger and frailer. His eyes were shinier and shinier with tears that did not quite fall. When at least it looked like he couldn't take it anymore, he stepped between the two, saying:

“Stop ! It's my fault ! It's all my fault if we got caught. Hurt me, not him!”

Villain gave the young Hero an amused look:

“Why is that little thing with you, Vampire Hero ?”

His interlocutor shrugged:

“You know. He's new. I'm supposed to show him the ropes or something. You have to teach them some way or some other. ”

“Is that so.”

Villain lift the smaller Hero's chin with a finger:

“My dear little one, how can I hurt him ? Many have tried and many have failed. I'll just make him have a nice little sunbath so he's neutralized. But since you've asked so nicely, I will take care of you.”

“Surely there must be another way ! I'm sure you can do better. I-I'm sure that deep inside, you're a little pure of heart.”

“ You heard your protector, you need to learn.”

He grabbed Hero by the arm, who turned his head toward the man who accompanied him. The latter just shrugged.

“Do you think he cares ?” simpered Villain to his ear. “Oh, he doesn't. He might be on your side, but Vampire Hero is evil. You're better off with me.”

Hero whimpered but didn't resist as he was dragged into the stairs.

“There are seventeen steps. Do you hear the sound they make ? There's an echo, so the prisoners down there can hear me coming. It’s all in the anticipation.”

In a sweet voice, he kept describing their surroundings while they were both descending into his torture room. During all the way, the small one didn’t dare fight back. He soon found himself tied up to a chair, helplessly squirming, his eyes giving a pleading look more than ever.

“So, young Hero,” purred Villain, “as it is your first time, I will make you a favor.”

“R-Really ?”

“Yes. Do you see all these instruments in the shelf in front of you ?”

Hero looked at the whips, the canes and the nails, and shuddered so violently it almost looked fake.

“I'm going to let you choose one among them. If not, I will choose, and you won't like it very much if I do.”

“You don't have to do this ! I-You just will make Vampire Hero angry and you don't want to !”

“You think he will rescue you?”

“I know he will.”

“How touching. But for now you're mine. So make your choice, before I get impatient.”

Hero pondered for a few seconds, then whispered:

“Um – the taser ? Yes – the taser, please.”

“If you ask so nicely.”

Villain delicately took the black rectangular shape in his hand and switched it on.

“Why, if I might ask ? Do you think it will hurt less than the others ? Let me prove you wrong.”

The half-hour that happened then looked much more pleasant for Villain than for Hero. And yet, as time passed, Villain felt somewhat uneasy. That had nothing to do with torturing a man, of course. He liked the thrashing, he liked the begging, he liked the naive faith of the innocent who was certain that he could be saved. Maybe that had something to do with the other Hero. While Villain was amusing himself, Vampire Hero was out of his sight. He might have been careless. He glanced at his watch, but Hero making a rather unconvincing whimper forced him to turn his head.

Perhaps that was the problem. Villain was used to the sounds of pain – the gasps, the moans, the howls, the cries and the pleas. He loved all of them without distinction, and of course he knew that they were a little different with each person. It was a familiar melody that Hero was singing, but thinking about it, it was slightly out of tune, and it got progressively worse. It was getting on his nerves. These rookies these days – they didn't even now how to scream right.

“Let's have a break,” he said.

“Oh well, I guess I’ve held that long.”

Villain raised an eyebrow, amused:

“Getting defiant, are we ? Careful, you sound like you’re disappointed.”

He stared into his prisoner’s eyes, hoping to get a look of terror, but all he got was a frown. Hero...genuinely looked displeased.

“Sorta”, he said. “In my time I didn’t have this kind of toys to play with. I guess having a little blue spark in your hand looks fun, but that doesn’t look like it does that much damage.”

“In your time ? What are you talking ab- wait.”

Hero tilted his head. For a moment he sounded impassible, but he broke soon enough. A loud, loud laugh resonated in the room, while the prisoner was squirming in his chair for a very different reason than before. His way of moving betrayed no pain at all.

“Are you shitting me,” said Villain, whose voice was now icy.

Hero grinned:

“You tell me, pal. I can’t believe you swallowed my “pure of heart” bullshit. I was laying it on so thick.”

Villain glared at him.

“Not that you were especially subtle either”, Hero added. “Oooh, the anticipation !” Do that again?”

Villain stood up and went to the door as fast as self-respect allowed. There was no one left under the sunlight. The guards were on the ground, unconscious.

“How -”

He turned back. Hero was now standing up, neglectfully throwing away the remnants of the straps that held him a moment before. He dramatically exclaimed, a hand on his heart:

“Oh no, he got away ! My, my. Poor little me. Tell you what, though. If Vampire Hero were so legendary, you should have bothered to know what he looks like. I didn’t mean to pass for someone else, but you’ve so graciously given me the opportunity.”

“It can’t be ! How could the – the other have escaped then ?”

“I hate to break it to you, but they are several heroes with super strength.”

Villain blushed and stayed quiet, his lips pursed. Hero picked up the taser, looked at it with curiosity, and switched it on. With a smile – a very worrying smile - he got closer.

“Hey, I warned you. I told you that Vampire Hero was going to rescue me.”

*

Vampire Hero is a recurring character. His job is to troll current villains. Check the Vampire Hero Masterlist or Tag for more snippets with him.

Or back to Hero x Villain Masterlist.