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in that 1 thomas sanders video with yogurt i bet prince never had the intention of doing it properly with anxiety prince just wanted to fucking spit at him like an infant and he did

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anonymous asked:

Okay, so I need some of your genius for a moment. In my story, my MC gets stabbed in the upper abdomen (like right under the ribs area). She is pretty good shape and is 4-5 months pregnant. Now, I guess my question(s) would be, would getting stabbed there result in a punctured lung (like I want it to) or should I move the wound up? How long after being stabbed would she be able to still live without treatment? Also, how would it (stab wound/collapsed lung/trauma) affect the baby?

Hey there nonny! I am far from a genius – in medicine, they say that the smarter you are, the higher up in the hospital you work, and there’s a reason I work outside and down the hill – but I’ll try and give you a hand! I know I have one around here someplace

Okay. First, with entry under the ribs, the trajectory of the knife wound would have to be tracking up to get to the lung. This is totally possible. It would also damage the diaphragm, which may or may not be significant; if the diaphragm itself is too damaged, it can’t really cause the negative pressure that makes humans inhale, and makes this whole thing about 8,000x worse.

The lung can collapse easy-peasy, which is the really dangerous part. Unless someone smart puts a needle in her chest (needle decompression), puts in a chest tube (tube thoracostomy), or cuts down to her lung (finger thoracotamy), she’s in deep doodoo.

Pregnancy means she’s breathing for two, and the nightmare scenario here is that the fetus is only 16-20 weeks gestational age (medfolk use weeks, not months, for gestational age). That’s not cooked enough to be viable on its own. Unfortunately, fetuses are very sensitive to oxygen deprivations, and moms need enough oxygen – and enough blood movement – to support two lives.

The problem with a lung collapsing is that it not only puts pressure on the lung itself, reducing gas exchange, it also winds up putting pressure on the heart and great blood vessels; it’s called a tension pneumothorax. Again, it’s relieved as above. It can develop over a few  minutes.

But if it’s not relieved quickly, baby and mom are going to have some serious trouble ahead, and it may be fatal for at least one of them.

The awful truth in trauma is this: if a pregnant person (remember, trans men dads can be pregnant too!) is dying from trauma, the first thing to do is to deliver the fetus – viable or not. The procedure used to be called a perimortem C-section, but it’s now getting called a resuscitative hysterotomy to make a poinnt: This procedure can (in later pregnancy stages) save two lives. Mom no longer has to act as a life support unit, and baby can get treated all on its own. This is the end stage, the last hail-Mary. It’s a once-in-a-career thing for most emergency providers, and many will never do one.

In your character’s case, the fetus isn’t viable. Viability is only considered around the 25th week mark, and even then it’s more likely to die than not. So it’s only mom’s life it would save. (You can move the pregnancy forward – for realism I’d go for at least 30 weeks – if you want her to nearly die but have baby survive, or have both of them survive).

In terms of a timeframe, the tension pneumo can develop over 10-30 minutes, and be lethal in about 5-15 minutes after it develops. So your character has less than an hour to get herself some care. 

Good luck with your story. Feel free to send follow-ups if this isn’t as clear as I hope it is.

xoxo, Aunt Scripty

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