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First Aid/Fiction: Stab wound to shoulder


Hi Marcus,

I saw your previous answer on this topic (, and while my question is similar, there are some differences due to the technology level in my book that I wanted to ask about.  Character stabbed in the shoulder area, with no hospital care or surgery available - she can get it stitched up, and there'll be painkillers available (opium, basically), but no antibiotics.  So my question is threefold:

1. I assume infection is going to be the biggest risk?  Given that she doesn't die, how long is it likely to be before that and the wound itself could be enough better for her to travel extensively on foot, without pain medication?

2. If the rotator tendon gets nicked, is it possible for her to regain full or partial use of the arm without surgery?  Would any numbness improve?

3. Would the internal damage/the tendon itself scar the way that skin does, so that eventually it stops healing further in spite of all previous function not having been restored?  How long would that take to happen, if so?

Thanks very much!

Hello Justine,

To answer your questions the best I can...

1.  shoulder injuries, or any joint injuries for that matter are painful. Opium is an old pain killer which would work but I would bet you end up with an addiction to Opium after. Search for ancient herbal remedies for wounds, I believe Yarrow was used by the Vikings as a wound antiseptic? after stitches are in for 5-10 days the skin should start healing enough to remove the stitches. I doubt very much your victim will be without pain, unless great, professional, surgical work is done in a well equipped OR.

2.  Rotator tendons can be very painful when damaged, even when only bumped. A nick to the tendon would likely greatly reduce the strength and range of motion of that arm until surgery could be preformed.

3.  I would expect the tendon to get worse and worse (not heal well), without surgery and eventually fail making the arm useless. If the arm is kept in a sling for months, and then slow, regular strength exercises are started you may gain use of the arm again though range of motion, and full strength may never return and reinjury is very possible.

This probably wasn't the answer you were hoping for but I hope it will help write a more accurate story. Good luck writing.


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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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