Blast damage..

[Amanita]

Another bit of writing here..

I'm working on a story, and one of my characters gets caught in the middle of this incident:

http://www.nytimes.com/2001/12/02/ny...own-blast.html

Now, here's the catch- she's not human. She's the avatar of the building itself.
She's flesh and blood alright, but larger and tougher than a human. So she's not going to be hurt as badly as a human would be, but for the purposes of this story, she's gonna take some sort of damage. I wonder if the fact she's larger (over 8 feet tall) might work against her- there's more of her to take the hit, she makes a larger target, perhaps?

FYI- Here's what a skyscraper-avatar looks like:
http://ladyamanita.deviantart.com/ga...et=24#/d36xx6a
(This isn't One New York Plaza, her pic is a work in progress..This pic is one of her neighbors, any NYC residents might recognize him)

So what kind of damage might somebody caught in an explosion like that end up with? Now, for the purposes of this story, she gets to keep all of her limbs, and takes no permanent damage. So nothing life-altering, just enough that they would be justified in keeping her for a day or two.

[Geek King]

Depending on how close we're talking about, deafness (temporary or permanent) from the compression wave, and probably some bruises and contusions from being thrown around a bit. They would certainly keep the person for observation if there were worries about a concussion or other head trauma. There could also be shrapnel imbedded in the character.

The main place the size would come in is area for the wave of compressed air from the explosion to hit. Also, possibly for debris to fall on the character. If the explosion is underground, like the story, it will be dangerous further away because the explosion will be contained and focused somewhat by the walls. In a tight tunnel, you could even get a bullet-in-the-gun-barrel effect, if the explosion is big and fast enough, though that would likely be more deadly than you're looking for.

[Seshat]

Physics of sudden acceleration (ie: change in velocity - speed or direction) on the human body. Or any other, similar body.

The initial impact occurs. This is against the skin, the outer surface of the eyes, the eardrums, and all other unprotected external parts of the body. In a compression wave of air, eg from an explosion, all parts of the external body become affected - even those facing away from the blast get an 'echo' effect.
In something like a car accident, this initial impact is with the car seat and/or seatbelt, depending on the direction of the velocity change.
NOTE: car seats are padded to absorb some of this velocity change, and seatbelts are designed so that they 'give' enough to absorb velocity change, minimising the damage from this and the next impact.

A secondary impact occurs. Bone and muscle impact against the skin and the whatever-is-being-impacted against. The skin and the subcutaneous layer of fat provide a small cushion - the more subcutaneous fat the less damage to the cushioned areas of bone and muscle.
The internal liquids in the eye get tossed around, and the eye itself impacts against the eyelid, the orbit, and the eye muscles. If you've ever felt half-blinded on a roller coaster or in a car accident; now you know why.
(This sort of thing is also why there are strict limits to how much acceleration change roller coasters and other thrill rides are permitted to have.)


A tertiary impact. Internal organs, including the brain, get slammed against the bone or muscle structures that surround them. With enough force, the brain can be slammed against the skull hard enough to bleed, even if the skull itself doesn't break. Tendons that hold other organs in place can be overstressed; organs can be bruised or damaged against their supportive bones. Organs supported by muscle are less likely to be bruised/damaged, since muscle has more 'give', but it's still possible.

Impact echoes. Everything continues to jounce around for a bit before it finally settles back. This jouncing (yes, it's a technical term, so there) isn't exactly good for damaged organs, tendons, bones and muscles.

[Amanita]

Interesting stuff. Now, according to the news article, the blast didn't cause structural damage to the building. So I don't think it was a severe one, on par with a bomb. But it apparently caused its share of cosmetic damage- cinderblock walls blown over, and the like.

So it's entirely possible that my skyscraper avatar either gets cinder blocks rained down on her, or gets blown right into a wall- either way, it's concussion time for her, as well as a nice scalp/crown laceration, which I imagine would bleed enough to produce a small pool of blood around her head, while she's laying there on the floor. Luckily her skull is much tougher than a human's, which protects it from outright fracture here.

Now, fortunately for her, she's wearing an armorweave tunic and pants, with solid leather boots- Despite the fact she's an office tower's avatar, she has no use for the thin, delicate clothing and impractical shoes favored by many female office workers. So those clothes would protect a lot of her body from lacerating trauma, but she would still have a lot of bruising under those clothes, right? That armorweave (designed to resist sharp objects) might also complicate undressing her later- something designed specifically to resist being cut into by a determined attacker isn't going to yield to the scissors paramedics carry. So if she's conscious, would the paramedics have her take that stuff off herself, or if there's another of her species around, have them assist?

So there she is, bruised, bleeding, concussed, and laying in a mess of broken cinder blocks.
While she's initially knocked unconscious, she recovers quickly, and shortly afterward pulls herself to her feet, despite her worried brother Two New York Plaza trying to get her to stay down until the paramedics arrive. When the paramedics get there, she's ambulatory, but might she be unsteady on her feet, perhaps leaning on her brother to stay upright?
Why doesn't she do the rational thing and sit or lay down? There might be a crowd of office workers milling around wondering what's going on- for starters, she might not want to show weakness to some of them. And to others, she might be trying to project reassurance- workers might figure that whatever happened, it can't be too bad if the building's avatar is still up and kicking, after all.

What would happen once she got to the hospital? For a concussion, would hospital staff discourage her from sleeping? One thing I forgot to mention- these beings are psychic, very much so. I imagine she would be firmly discouraged from using those abilities- normally using them causes no strain or injury to their grey matter, but that might be a different story for somebody with a head injury, and doctors might err on the side of caution.
What kinds of drugs might somebody with a concussion and overall lots of bruising be given? Anything that would make a person loopy, or would that be a bad idea- after all, if somebody starts talking or acting strangely then, it might be a real pain to figure out whether it's the drugs or the head trauma causing it.

[Rapscallion]

So, you're effectively talking about a modern dryad?

Rapscallion

[Antisocial_Worker]

I love the way the art flows through this community.

[Amanita]

Yeah, building-dryad is pretty much what another City of Heroes player called a character of mine in game, who is a skyscraper avatar.

So while her origins are a bit unusual, she's still going to have some of the same medical concerns as her human occupants and builders. I'm just trying to figure out how she might be treated showing up in the ER after an incident like this- even if some of her needs are different from a human's, at least knowing what standard medical procedure is, I can work with that.

[Argus]

One question: How much do the paramedics and ER personnel actually know about her kind (and medical treatment thereof)? I'm wondering whether her visit to the ER might be used as a teaching opportunity for staff who aren't actually treating her.

For that matter, the article you linked mentioned three firefighters being taken to a burn center in midtown, but would an avatar want to stay closer to the building? The actual medical people on the boards might comment on the likelihood of such requests being granted, but Google Maps does show several emergency rooms within a mile (including one teaching hospital).

[Amanita]

In this story, her kind have been around awhile, and a city the size of NYC would have its own dedicated facilityl for her species- you've got not only thousands of building avatars, but also cranes, bridges, and visiting ships and airplanes. I imagine it might be somewhere in midtown, perhaps affiliated with one of the more prestigious teaching hospitals in the area.

[Amanita]

So we've established that she's got a concussion, what's the standard course of treatment for somebody brought to an ER with that?

[crazylegs]

Paramedics carry tuff cuts rather than plain scissors, some also carry rescue hooks - http://www.spservices.co.uk/item/Bra..._0_2463_0.html - which quite easily get through motorcycle leathers.

If your character is over 8 feet tall then they won't fit into a normal ambulance, nor a bariatric one.

If you only want your character in hospital for a day or too then being knocked out by a falling object would be your best bet - a pt who is KO'd but neurologically sound will require some time under observation even though they're not badly injured.

[Amanita]

The problem with her armorweave and anything paramedics carry is that her clothing's designed to resist determined attacks from bladed weapons- Another member of her species (much stronger than a human) trying to slash or stab her with extremely sharp blades. Fortunately, by the time they show up, she's conscious enough to take it off herself, if the paramedics don't try to discourage her from moving around enough to do so.

I imagine a place with a large population of her kind might have ambulances specially built for them, especially if there's a hospital dedicated to serving them.

And knocked out would work- the initial blast and falling debris would do it.
What happens when somebody presents at the ER with that, not to mention the scalp/crown laceration that causes a nice little blood pool to form under her head?
For what it's worth, she's ambulatory- up and moving around, despite her brother's protests. So by the time she gets to the ER, she's got no problem moving on her own, or responding to ER staff's questions.

[crazylegs]

You'll probably want to look at the local immobilisation guidelines for the location. When someone has a mechanism of injury (being involved in an explosion would count) that suggests a spinal cord injury and has a distracting injury (such as the head inj) or is unconscious they would get collared & boarded/scooped/vacuum mattress (see local guidelines for local preference). However an isolated head inj (with no LOC) wouldn't require immobilisation, however with no LOC there would be no need to keep your character in hospital.

For UK immobilisation guidelines see JRCALC Guidelines (2006)

Hope that helps a little

[Amanita]

Would they collar and board somebody who was up and walking around when they arrived? By the time first responders get there, my skyscraper lady has already gotten up and is moving around. If the patient's mobile like that, is there much point to immobilization? I imagine the fact that she's missing a few minutes of time from where she was blacked out would be a cause for concern. That and the fact that so soon after the incident, that head wound is still bleeding like a stuck pig.

[Seshat]

Yes, there is. Especially if the patient is concussed or otherwise might not be responding properly to pain signals.

It is possible for a person to have spinal injury and not be aware of it because they're too loopy, or too focussed on some other injury. So (as I understand it), standard practice is to c-collar (cervical collar - neck immobilisation) anyone who, in the conservative judgement of the attending medical personnel - MIGHT have a neck injury.
Similarly, to strap someone to a backboard if they might have a back injury.

We're talking about preventing paralysis here. Taking the simple precaution of using a relatively inexpensive device (C-collar or backboard) that's right there in the ambulance is the course of wisdom.

Let the ER physician decide whether or not to take it off, and whether or not to scan the patient for a busted spine.


My husband was C-collared after he'd been up and walking around for a day, because 'y'know, loves, my neck isn't feeling any better after all' ... and some questioning from us, and the idiot had fallen onto his head and not told us.