First Aid/woman pregnant and stabbed

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Question
QUESTION: Hi,

My question is about a young pregnant woman. She's in labor and an EMT(Not a real EMT, it's just his cover) stabs her. Her brother is with her. She's stabbed in her abdomen twice. Once in her spleen (the knife is twisted, then pulled out)and once in her uterus (again the knife is twisted out). What could her brother do for her as she's in labor and stabbed? She already has contractions and what would be the effects of the injury on her body? (I may have some follow up questions but this is all I can think of for now.)Thank you.

ANSWER: Hello Chrissie,

Both the spleen and uterus are extremely vascular and bleeding would be a major concern. Add the fact that the patient is pregnant and is already at a blood volume deficit and has heightened vitals (blood pressure -relative- , and high pulse rate because of the active labor), this spells big problems. The best first aid for this kind of injury is direct pressure, though controlling bleeding from these internal organs is going to be hard and even with the best first aid she will continue to bleed. besides applying direct pressure and having her lye down, I'd find a quick way to get her to a hospital.

Good luck with your story.

Marc

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

QUESTION: Would she continue to be in labor or would her body terminate the pregnancy? Is there a way that she could survive this even while delivering the baby? How would her body hold up? If no help could get to her what would be the longest she could survive, say she delivered the baby and is still bleeding from her wounds?

Answer
Hello again Chrissie, (I apologize for the long delay in responding back, finals at school took most of my time).

The body (the characters body) will attempt to save it's self over that of the unborn baby, so in signs of severe shock (as she would be in) yes, the blood circulating to the womb would be interrupted and the unborn child would suffer the consequences. I'd say she could survive herself maybe an hour with good first aid care, The spleen is vary vascular, a "blood reservoir for the body" she would likely die from a good stab wound to the spleen if not treated quickly (in surgery within an hour). I hope that answers your questions well enough.

Marc

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Marcus LaBarbera

Expertise

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.

Experience

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.

Education/Credentials
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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