These are some comments from a surgeon with martial art's experience on knife injuries he's treated and posted on my old talk forum many years ago. Interesting to read.
"... [A]nyway, the upshot is that killing someone with a blade isn't as easy as
it looks on TV. The scene where someone gets stabbed in the belly, then
looks shocked, and then drops dead is unrealistic. Either a fair amount of
damage needs to be done, some very vital structures injured, or a fair
amount of time has to pass if the wounds aren't horrendous in order for
someone to die from stab or slash wounds.
There's quite a bit of
variability as to how folks respond to trauma in general. Some seem to
die with minimum injury, and others seem to withstand huge blood loss and
horrific injuries. I haven't a clue what differentiates these two
populations, but wish I knew....
I said it before, and I'll say it
again. In a conflict for my life, I would rely on a blunt force
instrument to the head before a bladed weapon to just about any anatomic
structure to most quickly stop a threat. It doesn't matter what level
of adrenaline you've got or what drugs you may have in your system. If
you're struck hard enough in the head, you're going down. Also, the long
term implications of a survived head injury are (in general) worse than
those of a knife wound you recover from.
Trauma and human
response to trauma is very interesting. I don't know if I believe that
primates and humans, in particular, are harder to kill. Hunting injuries
to animals are typically (hopefully) quite precise and should result in a
rapid, humane kill. Fighting injuries to humans presenting to trauma
centers are less so. I would guess those folks shot by skilled snipers
die quickly, similar to hunting wounds.
Anyway, at risk of being
accused of being "disturbing" again, here are some generalities for
delivering fatal wounds with a bladed weapon.
blade must absolutely be sharp. I've operated on plenty of folks in
which a dull edge pushed structures away rather than incising them.
Arteries are relatively thick-walled and elastic; a dull edge will
displace rather than cut them.
Second: All other things equal, a larger blade will be better.
Third: Relying on a single wound to incapacitate an opponent is a bad idea.
Anatomic considerations: The body's actually pretty well designed
and protects the most important structures. If you want to get to the
heart, there are two reliable ways. A very sharp and sturdy knife thrust
strongly just left of the sternal border around the fourth interspace (about
nipple level on a guy) will do it. Otherwise, just go under the
sternum (under the xiphoid) and aim at the left shoulder. This is
basically how we place a needle in the pericardium to drain fluid out
from around the heart.
The flexor/medial/anterior surfaces of the extremities are where the money is. In the arm, that's the inner aspect
of the upper arm, the crease at the elbow, the palmar aspect of your
forearm. In the lower extremity, imagine a line from the crest of your
pelvis to your pubic bone. About one-half of the way up (usually a bit less,
actually) you get your femoral artery and vein. If the weapon is
directed back and up into the abdomen a bit, you can get the iliac
vessels. These are especially hard to get to surgically and cannot
easily be treated with direct pressure. The femoral artery goes medially
down the thigh (there's a deep branch as well) and then behind the knee
in the mid-line roughly. It breaks into three vessels below the knee and
is no longer that great a target.
(This was a case I worked back in the 1980s. Road rage. This kid got cut on the arm, then fought back against the bigger knifer, and disarmed the knife! Swung it back at the guy. The guy fled. I wish I could show the kid's face here. He was smiling a lot in the emergency room. He was totally untrained. I arrested the knifer a few days after. - Hock)
In the abdomen, you'd be
trying to get to the aorta or the vena cava. This would be actually VERY
difficult with anything you're likely to carry around. There are some
posterior approaches that would work, but I doubt they'd be useful in
the middle of a chaotic fight. The liver occupies the right upper
quadrant and is a giant target. A large knife and multiple wounds would
be necessary, and there is no guarantee whatsoever that this would end a
Stab wounds to the chest, in general, are likely to
get the lungs, which can result in collapse (by pneumo or hemothorax) and
bleeding quite a bit. Here you might actually do well with a
smaller knife; since, if the opening in the chest is big enough, they
won't get what's called a tension pneumothorax. In a similar vein, a
small wound to the heart like an ice pick doesn't kill by bleeding. The
blood gets in the sac around the heart; and when the pressure builds up,
the heart can't fill. If it can't fill, it can't pump; and that's that.
The neck is a tried and true target for bladed attacks. A tracheal
injury in and of itself may well do nothing. The carotid artery is
medial to (on the inside of) the jugular vein and is a good target.
Honestly, if I were able and wanted to inflict maximum damage from a
bladed attack to the neck, I would insert by stabbing where I thought the
jugular/carotid were and direct the knife to the contralateral side and
backward. When withdrawing, I'd try to pull the whole thing over to the
other side. Alternatively, you could direct it to the other ear (the back
of it). If you make a muscle in your neck, you'll see your
sternocleidomastoid muscle. There's an inverted "V" formed by this muscle
as one head goes to the clavicle and then goes to the sternum. The
hollow at the top of this V is a pretty good shot on the carotid and
If you get stabbed or cut and the guy runs off (or if
it's an accident, etc.), the common treatment is DIRECT PRESSURE. Don't use pressure points above the injury. Get some rags
or whatnot and jam them right on the wound and push HARD. Tie that pressure off if you have to. Virtually all
extremity injuries and even direct pressure on most neck injuries can be controlled by this
maneuver (of course, don't choke someone to death).
Bear in mind that a fatal wound won't necessarily
equal stopping your opponent. It does you no good if you get killed, and
then your opponent dies later in the ED or in the ICU."
Email Hock at HockHochheim@ForceNecessary.com
Hock's webpage www.forcenecessary.com
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