How to beat up your characters: 100 helpful links!

Generally warning: Some of these pages have pictures of wounds of the bloody and unpleasant
variety. Not that there’s a pleasant sort of wound. But seriously--never Google degloving. Ever.
Bluhhh. Be forewarned!

General resources
WebMD
Mayo Clinic first aid
Mayo Clinic diseases
First Aid
PubMed​: ​The s​ ource for biomedical literature
Diagrams: ​Veins​ (towards heart), ​arteries​ (away from heart) ​bones​, ​nervous system​, ​brain

Burns
General overview​: Includes degrees
Burn severity​: Including how to estimate body area affected
Burn treatment: ​1st, 2nd,​ and ​3rd ​degrees
Smoke inhalation
Smoke inhalation treatment
Chemical burns
Hot tar burns
Sunburns

Incisions and Lacerations

Essentials of skin laceration repair​ (including stitching techniques)
When to stitch​ (Journal article--Doctors apparently usually go by experience on this)
More about when to stitch ​(Simple guide for moms)
Basic wound treatment
Incision vs. laceration​: Most of the time (including in medical literature) they’re used
synonymously, but eh.
Types of lacerations​: Page has links to some particularly graphic images--beware!
How to stop bleeding: ​1​, ​2​, ​3
Puncture wounds​: Including a bit about what sort of wounds are most likely to become infected
More about puncture wounds
Wound assessment​: A huge amount of information, including what the color of the flesh
indicates, different kinds of things that ooze from a wound, and so much more.
Home treatment of gunshot wound​, also ​basics
More about gunshot wounds​, including medical procedures
Tourniquet use​: Controversy around it, latest research
Location pain chart​: Originally intended for tattoo pain, but pretty accurate for cuts
General note: Deeper=more serious. Elevate wounded limb so that gravity draws blood towards
heart. Scalp wounds also bleed a lot but tend to be superficial. If it’s dirty, risk infection. If it hits
the digestive system and you don’t die immediately, infection’ll probably kill you. Don’t forget the
possibility of tetanus! If a wound is positioned such that movement would cause the wound to
gape open (i.e. horizontally across the knee) it’s harder to keep it closed and may take longer
for it to heal.

Broken bones
Types of fractures
Setting a broken bone​ when no doctor is available
Healing time of common fractures
Broken wrists
Broken ankles/feet
Fractured vertebrae: Neck (​1​, 2​ ​), ​back
Types of casts
Splints
Fracture complications
Broken noses
Broken digits: ​Fingers​ and ​toes
General notes: If it’s a compound fracture (bone poking through) good luck fixing it on your own.
If the bone is in multiple pieces, surgery is necessary to fix it--probably can’t reduce (“set”) it
from the outside. Older people heal more slowly. It’s possible for bones to “heal” crooked and
cause long-term problems and joint pain. Consider damage to nearby nerves, muscle, and
blood vessels.

Concussions
General overview
Types of concussions ​1​, ​2
Concussion complications
Mild Brain Injuries​: The next step up from most severe type of concussion, Grade 3
Post-concussion syndrome
Second impact syndrome​: When a second blow delivered before recovering from the initial
concussion has catastrophic effects. Apparently rare.
Recovering from a concussion
Symptoms​: Scroll about halfway down the page for the most severe symptoms
Whiplash
General notes: If you pass out, even for a few seconds, it’s serious. If you have multiple
concussions over a lifetime, they will be progressively more serious. Symptoms can linger for a
long time.

Character reaction:
Shock​ (general)
Physical shock: ​1​, ​2
Fight-or-flight response: ​1​, 2
​
Long-term emotional trauma: ​1​ (Includes symptoms), 2
​
First aid for emotional trauma

Treatment (drugs)
WebMD painkiller guide

Treatment (herbs)
1​, ​2​, ​3​, ​4

Miscellany
Snake bites​: No, you don’t suck the venom out or apply tourniquettes
Frostbite
Frostbite treatment
Severe frostbite treatment
When frostbite sets in​: A handy chart for how long your characters have outside at various
temperatures and wind speeds before they get frostbitten
First aid myths: ​1​, ​2​, ​3​, ​4​, ​5​ Includes the ones about buttering burns and putting snow on
frostbite.
Poisons​: Why inducing vomiting is a bad idea
Poisonous plants
Dislocations: Symptoms ​1​, ​2​; ​treatment​. General notes: Repeated dislocations of same joint
may lead to permanent tissue damage and may cause or be symptomatic of weakened
ligaments. Docs recommend against trying to reduce (put back) dislocated joint on your own,
though information about how to do it is easily found online.
Muscular strains
Joint sprain
Resuscitation after near-drowning: ​1​, 2 ​
Current CPR practices​: We don’t do mouth-to-mouth anymore.
The ​DSM IV​, for all your mental illness needs.

Electrical shock (you’re welcome, Brian!)

Human response to electrical shock​: Includes handy-dandy voltage chart
Length of contact needed at different voltages to cause injury
Evaluation protocol for electric shock injury
Neurological complications
Electrical and lightning injury
Cardiac complications
Delayed effects and a good general summary
Acquired savant syndrome​: Brain injuries (including a lightning strike) triggering development of
amazing artistic and other abilities

Outline from talk

·​ ​Yourcharacter’s hurt. Now what?
o​​What’s the type of injury? We won’t go into detail here, but the main point is that for
whatever kind of wound you have, there are numerous factors to consider that’ll impact both
your immediate effects and ultimate healing time. Most injuries boil down to three main
questions, with some overlap between them: Where, what kind, and how bad? We’ll look at the
four types of injuries you see most commonly in stories--that is, burns, lacerations, fractures,
and concusssions--and for each type I’ll give some specific considerations. Don’t worry about
writing them all down; I’ll be posting the outline to Google Docs. These are just questions to ask;
for answers, consult the glorious Internet.
§​ ​Burns
·​ ​1st, 2nd, 3rd degree
·​ ​How much skin involved the burn
·​ ​What would the location of the burn make it difficult for the character
to do
·​ ​How was it inflicted: open flame, steam, boiling water, hot tar, burning
oil…
§​ ​Cuts
·​ ​How long?
·​ ​How deep?
o​​Does it hit an artery (spurter) or a vein?
o​​Does it cut through muscle, impacting movement?
·​ ​Made with clean or ragged edge? Or by blunt force?
o​​Incision vs. laceration
·​ ​Where on body?
o​​Towards feet? On scalp?=Extra bleeding
o​​Try drawing a line on yourself the wound would be and move
around—see how your own motions would make the wound stretch and
what muscles would be affected. Example: knee scar.
·​ ​How much blood lost
o​​Males have more blood than females (generally); larger you
are, more blood you have.
·​ ​If transfusions possible, does character know blood type? How much
blood is available?
§​ ​Broken bones
·​ ​Which bone?
·​ ​How was it broken, and what kind of break would be a likely result?
o​​A tumbling fall down a slope, resulting in comminuted (multiple)
fractures in the ribs
o​​A blow through chain mail with a sword, resulting in a simple
fracture
o​​A heavy punch to the shoulder giving a hairline fracture
o​​A troll trying to twist your arm off: spiral fracture
 ·​ ​Possible complications: Sticking through skin (compound), badly
dislocated, nearby blood vessels severed, etc.
·​ ​Quick note: Even today, comminuted fractures may require multiple
surgeries to right, and they’re not always perfect. In, say, a medieval
setting, even a simple fracture (if not set correctly) could heal wrong and
cause lifelong chronic pain and decreased limb motility.
§​ ​Concussions
·​ ​How hard a blow?
o​​The brain is really sensitive, and sometimes even a seemingly
light one can cause seriously bad effects. Correlates with…
·​ ​How long should your character be knocked out for?
o​​Even a few seconds can indicate serious damage! You can’t get
knocked out for a few hours and be fine directly afterwards.
·​ ​Symptoms of brain swelling: Headaches, nausea, vertigo, lack of
coordination, uneven pupil dilation/pupil unresponsiveness (very serious!),
loss of use of some body parts, slurred speech
·​ ​Have they had concussions before? The effects are likely to be worse
with each repeated concussion.
o​​Now that you’ve read up on the basics of the injury you’ve inflicted, how does your
character react? What about the characters around him/her?
§​ ​Shock: A major traumatic injury can cause your character to go into shock for a
while. This can be a good thing, giving them time to limp to safety before they
start paying attention to that gaping wound in their leg. It can also be a bad thing:
you know how they kept fighting after breaking their arm? Well, now that
humerus is in multiple pieces and good luck getting it back together, ever. Shock
isn’t magic, though: it won’t keep you from fainting from blood loss, keeling over
with a brain injury. If your leg is badly broken, it’s pretty much useless to you.
§​ ​Keeping your head
·​ ​Has character been injured in this way/other ways before/frequently?
·​ ​What’s their level of pain tolerance? (Some people take Tylenol for
paper cuts; others soldier through migraines without painkillers.) Related:
How much pain would that type of wound inflict? Some body parts more
sensitive than others. TATTOO PAIN CHART
·​ ​Can they handle blood? Maybe they can, but the sight of their own
blood gets to them. Maybe that doesn’t bother them at all, but the way
broken bones bend the wrong way absolutely does them in. Maybe they
can take just about anything, but seeing people they love in pain affects
them heavily.
§​ ​Doing first aid
·​ ​What would they realistically have on hand to treat injuries?
·​ ​What knowledge about treatment would they/other characters
realistically have?
o​​When and from whom did they receive that knowledge?
 §​ ​Example: If they’re older, or perhaps have only received their
medical knowledge from half-remembered hints heard from old
relatives and shady corners of the Internet, they might think that
putting raw meat on a black eye, buttering a burn, or putting on a
tourniquet to prevent blood loss are good ideas. All of those are
actually bad ideas: ineffectual at best, and seriously harmful at
worst, and the results can be correspondingly bad. With some
Internet digging, you can find plenty of examples of outdated first
aid advice, and often the debunkings include when and where the
bad tips first turned up. Also, maybe you can find old Boy Scout
guides or other guides that would contain first aid advice in used
book stores or online.
o​​How well could they remember it in a stressful situation?
§​ ​People make mistakes! Could forget to pick debris from wound,
fail to clean, wrap too tight, cover when should be uncovered, use
greasy ointment on burn… Again, repercussions of these mistakes
can be interesting
§​ ​Do they just freeze up entirely?
§​ ​Would they be able to Google/otherwise look up/ask someone
about what to do?
o​​Long-term treatment and recovery
§​ ​What’s your setting?
·​ ​If fairly modern/futuristic
o​​What drugs are available? Remember that prescription strength
painkillers, well, require a prescription, or someone having some on hand
already from a previous prescription… or criminal activity.
o​​Do these drugs have side effects? Are they addictive?
o​​Do the characters know, or are they able to find out, which ones can be
safely mixed? What about the maximum dosage? If not, do they suffer ill
effects from overdosing/bad mixing?
o​​Can these characters safely go to a hospital? Realistically, would they
need to?
·​ ​If historical or fantasy
o​​If historical/real world setting, be careful about using namebrands
(Tylenol) and make sure said drug would be available at that time period.
Wikipedia useful here!
o​​If using herb lore
§​ ​Remember: In real life, few herbal cures are 100% effective (exceptions
being purgatives and poisons—the ones that do really simple things)
§​ ​Consider dosage
§​ ​Make sure, if real plant, it grows where your setting is
§​ ​Would your characters know some obscure bit of lore?
§​ ​How common are these plants?
 §​ ​If magic’s involved, what’s the cost? Is the effectiveness 100%? Easy
fixes are boring!
§​ ​How long does it take your characters to recover? There’s lots of factors here!
·​ ​Age (older typically meaning slower)
·​ ​Overall healthiness
·​ ​Gender
·​ ​Quality of available treatment: drugs, surgery, physical therapy
·​ ​Can they actually stop and rest and recuperate?
·​ ​Any outstanding conditions? Complications (such as infections) during
recovery period?
·​ ​Tendency is generally to make recovery period way too short. But something
like a broken tibia can take months to heal. While it can be annoying to drag a
character along on crutches, it also provides opportunities for plenty of plot
complications and realistic details.
o​​To sum up: Know the details about your wounds, even if you don’t include all of them.
Know what your characters know about first aid, and how they’d react to injuries in
themselves and others. Know what’s available to them. Make sure your recovery period
is realistically long enough. It’s a lot of research, but it’s well worth it—and to make your
job a bit easier, here’s a nice long list of resources.