Dying of sepsis, and horseriding accidents

[elmenora]

Setting: fictional history, kind of a mashup between the roman empire and early turkic peoples plus lots of made-up stuff.  This particular scene is in a fairly remote desert, in early spring (very warm days, near-freezing nights).  The characters are going to a market town on their own to trade some things, and have no way to contact anyone else

Comments

[anonymous]

Red streaks are exactly what you want; it's caused by the infection getting into the lymphatic system and spreading systemically. As the infection spreads she will get a fever and chills, and eventually she will go into septic shock. This entails red, hot, sweaty skin (unlike most other shock, which causes skin to be pale/cool/clammy), so that's another visual thing you can show, along with slowing pupil response and confusion/delirium/decreased level of consciousness. Less visual signs include a rapid, weak pulse and fast, shallow breathing. Once she goes into shock she's not long for this world.

On that subject, sepsis kills incredibly quickly. She could easily go from feeling completely normal to dead in 24-48 hours. Four days sounds like a good time frame; a couple days for the infection to start setting in enough for her to notice symptoms, and another day or two to death.

I'll let someone with more horse knowledge answer the second question.

[anonymous]

Same anon here - it just occurred to me to ask if you have any questions about what they might do to try to treat the infection before she dies.

[elmenora]

Oh, thanks! No, they're not able to do much and they know it. Briefly consider amputation and then realize how much it's spread and how unqualified they are, so they settle for keeping her warm and giving broth.

[anonymous]

I ask because bathing the wound in hot water/salt can help to draw out the infection, and doesn't really require any medical expertise. Interestingly enough, honey can have a similar effect; it has antimicrobial properties and was used as a wound dressing in ancient times.

Once the infection has gone systemic, of course, they're fighting a losing battle, but if you do decide to show some of their failed first aid attempts that might be helpful.

[ivorysilk]

Usually, a gopher hole won't trip a horse that's not going faster than a trot, but sometimes a horse that spooks at something could rear or jump sideways or something unexpectedly. You could maybe use something like a rabbit dashing across the path or something near her feet, causing her to stumble or jump, and if she then stuck her foot in a hole or something she could injure herself. Also, sometimes terrain, like wet leaves or something would work, I think, if she had to jump something and slipped on them on the other side. Or possible, if she picked up a stone in her foot and was a little lame, and the rider didn't notice, a stumble could then cause an injury?

[elmenora]

Good to know.

The rider is very competent (she's been riding since before she could walk), so having her just not notice lameness seems a bit odd. I like the jumping over something and slipping idea, that's a great one!

[poniesandphotos]

Does the horse have to be injured, could it be poisoned or colic? Colic is one of the main causes of horse death. The horse could eat a bush on the trail that was poisonous and go down hill pretty quickly, particularly if the people riding it though it was just being lazy and continued to push it. The horse, if not feeling well would most likely begin to droop her head, shuffle her feet and eventually trip which could give your character the opportunity to jump off if that motion is important to you

[elmenora]

It's important that the character be thrown/jump/fall, since that's where she's injured... what exactly happens to the horse isn't plot important as long as they can't take it with them.

Thanks for the description, and the youtube suggestion. Although, yikes... kinda graphic D: I'm leaning towards the jumping-and-slipping scenario, it seems like the easiest to draw plus is obvious what happened even to us non-horsey people.

[poniesandphotos]

Is it important that they not be going very fast? I only ask because we humans bounce surprisingly well. I've had plenty of serious falls from horses in my life and while it IS dangerous we bounce pretty well. I would suggest her falling into something sharp if you need a laceration. I came off my horse at a full gallop and flew into a concrete slab with a metal pole coming out of it and suffered some decent injuries but nothing super duper deep, mostly internals/compressed spine/concussion sort of stuff.

Alternately if you're ok with a slightly different injury you could have the horse fall on a limb and crush it/lacerate it while thrashing in pain. If she got stuck in the saddle when the horse fell and had some sort of pointy weapon strapped to the saddle she would have to free herself from a large, out of it's mind animal that didn't much care about her just then.

[elmenora]

Ouch! Glad you came out of that okay,

Do you think a sharp rock or stick might work for a puncture wound? They can be going fast if necessary, but it's a long trip so they'd be taking it easy most of the way. I'm mainly trying to avoid concussion, broken bones, etc.

Sorry if this is a double post, LJ is acting funny.

[mudg3t]

I got an infection in my leg after a trauma do I might be able to help. I didn't (thankfully) suffer sepsis but if it had gone on longer then it would have. I have a nice big hole in my leg where they had to cut out the necrotic tissue. I initially thought I had flu - ridiculous fever, achy and I slept a lot. I vomited and didn't have much of an appetite. I was really thirsty though. The site was massively swollen and there were red patches around the site as well as all along my lower leg. They spread as the infection went on. Because I had cellulitis (under the skin) I had bruising where the haematoma and necrosis was, which you won't have with a puncture or laceration, but you will notice necrosis around the site. It will smell and there will be pus. With a puncture, the bacteria is pushed deep within the wound (which is why we don't stitch up puncture wounds). The character will feel lethargy, nausea, and probably be quite incoherent as the infection progresses. They will be sweaty and feel cold, as a result of the fever.

I hope

[elmenora]

Oh dear, I'm sorry you had to go through that. Thank you for sharing, it's very helpful to have a first-hand account :)

[lilacsigil]

Spreading red streaks and swelling and blackening at the wound site is what you want. There may or may not be visible pus (more likely in a laceration, less likely for a puncture) because the real damage is inside. I agree with the above poster that she'd have 1-2 days getting sick but still able to function, then another 1-2 days to die.

[elmenora]

Perfect, thanks. Would the wound site get noticeably worse in the time it took her to go from very sick to dead?

[lilacsigil]

It's up to you. The more injury you have on the surface (like a deep, long gash) the more you'll see. Tissue necrosis (black and gummy) will spread and stink, but it won't be a huge amount visible in that period of time.