First Aid/Arrow to the Abdomen



I'm writing a book and one of the girls (16 yrs old) is shot with a barbed arrow in her abdomen. It pierces her intestines, liver, lung and one of her kidneys. How long could she live with proper first aid? There is no ambulance coming. What could her brothers do for her as she dies and how would she die(In detail)? How much pain would she be in and would she be coherant for the whole thing?


ANSWER: Hello Dannei,

I would give her 12 hours before she was unconscious with no possibility of recovery. within 30 sec to a minute she would start feeling increasing abdominal pain and the abdominal organs bleed and swell. She would experience immediate shortness of breath from the arrow entering her chest cavity (collapsing her lung). The lung injury, if not corrected would be fatal within 30 min to an hour.

I would suggest a 14 gauge IV cathiter in the upper chest   with an Asherman valve over top   Though the IV catheter may clot off it there's a lot of bleeding into the chest cavity? A chest tube would be better, even a urinary catheter used as a chest tube (this all depends on what is in the medical kit/ if a medical kit is available).

As far as her dying, like I mentioned earlier... within 12 hours she would be very close to death (if her collapsed lung was cared for by decompressing the chest). There would likely be a large amount of severe pain, with referred pain to the back, right shoulder, inner thigh, and urinary tract. within 10 minutes she would likely urinate blood, with red clots noted in the urine. Breathing will be difficult, even with decompression of the chest. As far as consciousness.. that could vary a lot. from 30 minutes to several hours depending on blood loss, respiration's and oxygen within the blood, and how she handles pain. First aid treatments may allow her to stay conscious for longer but within 6-12 hours I'd expect her to be unconscious, especially if she didn't have advanced surgical care.

I hope that was enough information. It's really kind of hard to say how the injury will play out exactly since there are a lot of variables that can change her outcome (too many to discuss, in detail here.

Good luck with your story.


[an error occurred while processing this directive]---------- FOLLOW-UP ----------

QUESTION: Say the arrow was ripped out then how quickly would she bleed out? Say I changed the scenario and The arrow pierces her spleen, lung, kidney and heart. How quickly would she die and would it be very painful?

ANSWER: Hello again Dannei,

if the arrow was ripped out she would bleed out quite quickly, possibly in 30 min to a couple hours. The pain wouldn't be much different that it would be from the first scenario, though there would be more trauma as the arrow was removed (like being shot a second time, in the same spot).

Sorry for the delay in writing you back, finals are comming up and it's getting warm here (in Upstate NY so work's been getting busy).

Happy writing,


---------- FOLLOW-UP ----------

QUESTION: Say I changed the scenario and The arrow pierces her spleen, lung, kidney and heart. How quickly would she die and what could they do for her in that scenario to keep her alive for as long as possible? (They have a really good first aid kit.)

p.s.-Sorry for all the questions. Just a lot of things I want to consider.

Hello again,

The spleen and heart wold lead to death rather quick, (the heart probably slightly more so than the spleen, but both will lead to death within 30 min to an hour). without a trauma surgeon and a thorocotomy tray the patient would likely die from  the injuries to the heart within 5-20 minutes.

The spleen injury, maybe a couple hours survival at most. It's nothing that could be manages without immediate surgery.

Good luck (again) with your story.


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Marcus LaBarbera


I am available to answer most questions related to: first aid, pre- hospital medicine, EMT and Paramedic questions, medical transport, critical care transport, ICU/CCU care, sedation, and medicine in general.


I have worked as a NYS Paramedic since 1993 for both community based ambulance companies and large commercial agencies. I Have experience as bike team commander, and shift supervisor for a commercial ambulance. As a member of the Disaster team I was deployed to Louisiana for 20 days following hurricane Katrina. I worked along side the county Haz-Mat team as a "Tox-Medic" with advanced training in treating injuries from chemical agents. Besides my experience on the on the ambulance I have worked in a number of hospital based offices including dialysis and a sleep lab.

I started my EMS career as a NYS CFR (Certified First Responder)in 1989, an EMT in 1991, a Paramedic since 1993, and a CCU transport paramedic since 2005. I currently hold certification as a: NYS Paramedic, Critical Care Transport Paramedic, ACLS/CPR/PALS certified. Advanced Haz-Mat Life Support certified (AHLS). In the past I have taught CPR and ACLS to my coworkers and the local community.

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