Questions for a crime mystery novel

[beasempere]

Hello All,

I joined this forum to see if I could get some medical questions answered. I'm currently writing a crime mystery novel, which involves some medical expertise.

a) Is it alright for me to ask medical questions here regarding a novel?
b) If so, is this the place where I should ask the questions?
c) As I revise my story, I will periodically come back here to ask a question, so should I keep all questions to one post?

Any and all assistance will be noted in the book's acknowledgements. Thank you for your time, and I hope I'm not intruding too much.

Bea

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[SpartanWolverine]

Hello,

This is a pretty lightly trafficked area on the forums where you probably won't get many responses. It's mainly for undergraduates and medical students to ask questions about research projects and publishing in academic journals. However, I don't see why you couldn't ask questions here regarding background research for a book.

 

[beasempere]

Hello,

This is a pretty lightly trafficked area on the forums where you probably won't get many responses. It's mainly for undergraduates and medical students to ask questions about research projects and publishing in academic journals. However, I don't see why you couldn't ask questions here regarding background research for a book.

Thanks, SpartanWolverine. I didn't want to intrude so I thought this would be the area, and I figured medical students would be the best to ask.

In regards to my book, there's a part where the killer injects the victim with Succinylcholine, tortures and then cuts an artery where they ultimately bleed to death. My question here is during autopsy, what would show the victim was alive when cut open and then the artery cut? I have the coroner state that the victim was alive through it all because the pupils were fixed and dilated. Is this a true statement?

Thanks for any help.

 

[SpartanWolverine]

The thing with sux is that it's a fast-acting drug that leads to total paralysis within 60-90 seconds. So the victim in your story would stop breathing due to diaphragmatic paralysis and die from respiratory failure within a few minutes. I don't believe sux is ever regularly looked for at autopsy, so there would have to be suspicion that it was used. The coroner might find puncture wounds and sux metabolites can be found in the body.

As far as your question, assuming your killer worked quickly, I would think the loss of blood volume would be the biggest indicator that the person was alive. There would possibly be some evidence of bruising/swelling at the site which would point to living, perfused tissue.

I'm no expert on anesthesia or pathology, however, so you'll definitely want more opinions.

Sent from my SM-G900T using SDN mobile app

 

[beasempere]

The thing with sux is that it's a fast-acting drug that leads to total paralysis within 60-90 seconds. So the victim in your story would stop breathing due to diaphragmatic paralysis and die from respiratory failure within a few minutes. I don't believe sux is ever regularly looked for at autopsy, so there would have to be suspicion that it was used. The coroner might find puncture wounds and sux metabolites can be found in the body.

As far as your question, assuming your killer worked quickly, I would think the loss of blood volume would be the biggest indicator that the person was alive. There would possibly be some evidence of bruising/swelling at the site which would point to living, perfused tissue.

I'm no expert on anesthesia or pathology, however, so you'll definitely want more opinions.

Sent from my SM-G900T using SDN mobile app

This is great. Thank you so much. My killer actually performs a tracheotomy so the vic doesn't stop breathing. But I actually overlooked the fact that the coroner should have noticed the tracheotomy hole, which could be one thing that makes her believe the vic had paralysis. Your response just made me think of this. I really appreciate it. I'll definitely be contacting you so that I can put you in the acknowledgements.

 

[SpartanWolverine]

This is great. Thank you so much. My killer actually performs a tracheotomy so the vic doesn't stop breathing. But I actually overlooked the fact that the coroner should have noticed the tracheotomy hole, which could be one thing that makes her believe the vic had paralysis. Your response just made me think of this. I really appreciate it. I'll definitely be contacting you so that I can put you in the acknowledgements.

Boy, that's a thorough villain with some gnarly plans. Haha, and yes, a tracheotomy (note: "tracheotomy hole" = tracheostomy) would certainly be immediately noticed and send up some red flags.

 

[beasempere]

Boy, that's a thorough villain with some gnarly plans. Haha, and yes, a tracheotomy (note: "tracheotomy hole" = tracheostomy) would certainly be immediately noticed and send up some red flags.

You have really been helpful. I found a doctor on the site, Goodreads, and he's given me some information, but your explanations are concise that I understand them. LOL! I'll be back here for more insight. I hope you'll be around. Thanks again.

 

[beasempere]

Okay, I have another question. If a killer takes an air pump, jabs it into a vein and pumps air into a person, approximately how long would it take for the bubble to hit the lungs or heart and kill the person? This would be called an air embolism, right? Would the average person know how to find an artery? Would the air embolism need to be in the artery to cause death? Thanks for any and all help.

 

[SpartanWolverine]

Okay, I have another question. If a killer takes an air pump, jabs it into a vein and pumps air into a person, approximately how long would it take for the bubble to hit the lungs or heart and kill the person? This would be called an air embolism, right? Would the average person know how to find an artery? Would the air embolism need to be in the artery to cause death? Thanks for any and all help.

Interesting question. If air is injected into venous blood, the lungs do a pretty good job reabsorbing air bubbles when they reach them... generally no serious problem up to about 20ml over a short period in an average person. With air over 20ml in a vein it will potentially get lodged into the right side of the heart and/or spill over into the arterial system and cause some serious damage. Air emboli in the arteries can block the areas fed by those arteries with the brain and heart being the most critical, as you might expect. This is dangerous at even very small volumes... on the order of 1 ml or less. When you think about the way the arterial and venous system works this kind of makes sense -- veins travel towards the heart with increasing diameter until they get to the lungs where air and gas exchange happens pretty freely. Arteries travel away from the heart with decreasing diameter vessels that lead to tissue. These tissues are not happy when the capillaries or arterioles are blocked with air bubbles.

So,
1) Could an average person use a "pump" (what kind?) to instill air in the venous system? I suppose that's possible.
2) Could air in the veins kill a person? Yes, with sufficient volume (40+ ml).
3) Is it called an air embolism? Bingo.
4) Would the average person know how to find an artery? Probably not; it takes a little bit of skill/practice... but there's always good ol' Youtube with videos on how to get ABGs and the like.
5) Would an air embolism need to be in an artery to cause death? Not necessarily, as described above, but it is certainly much more dangerous with much less volume of air.

Hope that's helpful once again.

 

[beasempere]

Interesting question. If air is injected into venous blood, the lungs do a pretty good job reabsorbing air bubbles when they reach them... generally no serious problem up to about 20ml over a short period in an average person. With air over 20ml in a vein it will potentially get lodged into the right side of the heart and/or spill over into the arterial system and cause some serious damage. Air emboli in the arteries can block the areas fed by those arteries with the brain and heart being the most critical, as you might expect. This is dangerous at even very small volumes... on the order of 1 ml or less. When you think about the way the arterial and venous system works this kind of makes sense -- veins travel towards the heart with increasing diameter until they get to the lungs where air and gas exchange happens pretty freely. Arteries travel away from the heart with decreasing diameter vessels that lead to tissue. These tissues are not happy when the capillaries or arterioles are blocked with air bubbles.

So,
1) Could an average person use a "pump" (what kind?) to instill air in the venous system? I suppose that's possible.
2) Could air in the veins kill a person? Yes, with sufficient volume (40+ ml).
3) Is it called an air embolism? Bingo.
4) Would the average person know how to find an artery? Probably not; it takes a little bit of skill/practice... but there's always good ol' Youtube with videos on how to get ABGs and the like.
5) Would an air embolism need to be in an artery to cause death? Not necessarily, as described above, but it is certainly much more dangerous with much less volume of air.

Hope that's helpful once again.

OMG! You are awesome! You explain things so well and I understand what you describe. This is definitely helpful, and will make my novel real and believable. Thank you so much.

 

[beasempere]

It's me again. I have one more murder in my novel that I need more clarification about, and then I'm done. The victim is fed a sandwich of poison hemlock. Do you know how long it would take for the person to die?

 

[SurfingDoctor]

Most fatal ingestions take hours...

From International Programme on Chemical Safety http://www.inchem.org/documents/pims/plant/conium.htm
"In severe cases, there is usually a rapid onset of symptoms; death occurs rapidly (in less than 3 hours) if no treatment is given. Death is due to respiratory arrest from paralysis of respiratory muscles, although central depression may play a role after ingestion of very large doses (Lampe, 1985)."

 

[beasempere]

Thanks much.