Unconsciousness and death From Edged Weapons: (PART 1)

Unconsciousness and Death

Surviving an Edged Weapon Attack
By Darren Laur
Aug 2009
Recently, I read an article on surviving an edged weapon attack, where the
writer spoke specific to knife wounds, as they related tounconsciousness and
death, which I found quite troublesome given the fact that his numbers just
did not reflect the empirical experience/data that I have witnessed over my
23yrs of being a law enforcement professional.
In this article, the author first quoted a book written by Captain W E
Fairburn called Get Tough: How to Win In Hand-to-Hand Fighting published
in 1942. On page 99 of this text (fig.112) Fairburn provides the following
information specific to loss of consciousness in seconds and Death specific
to knife wounds:
Brachial Artery:
Unconsciousness 14 seconds, death 1.5 minutes
Radial Artery:
Unconsciousness 30 seconds, death 2 minutes
Carotid Artery:
Unconsciousness 5 seconds, death 12 seconds
Subclavian Artery:
Unconsciousness 2 seconds, death 3.5 seconds
Heart:
Unconsciousness instantaneous, death 3 seconds
I attempted to locate any medical literature surrounding the time that this
book was published to support the above noted data, but I was unable to do so.
If anyone reading this can provide me with the medical literature that
supports Fairburns data from that time period, please send it my way.

Based upon the above noted Fairburn data, I began my literary review of the
martial art/self-protection/combatives academia, specific to unconsciousness
and death specific to knife wounds, and what I found was very surprising if
not troublesome. Much of the data supplied in these books, articles, and
papers that I reviewed were just a rehash of Fairburns numbers, and others
were anecdotal at best, and more often than not just plain negligent. None,
and I mean none, cited any medical literature to support their claims. Some
stated that they had spoken to a medical professional (doctors and
paramedics) to validate their claims, but yet they did not provide the names of
these medical professionals, or their credentials, or even medical research
links which would have helped validate their published writings.
After reading the above noted martial art, self protection, and combatives
academia, and being less than impressed with their reported data specific to
unconsciousness and death as it relates to knife wounds, I too decided to
connect with the medical professionals. Two of the doctors that I connected
with are experts in their field of medicine; both specialize in trauma care and
critical care medicine, and have a plethora of firsthand experience in dealing
with those who have been injured via an edged or pointed weapon:
Dr Lorne David Porayko:
Full time Critical Care Medicine/Anaesthesiology specialist in Victoria,
Vancouver Island Health Authority
Critical Care team leader
Works in conjunction with Dr Christine Hall
Martial Arts background in Judo (black belt level), MMA, Krav
Honoured to say that Dr Porayko is one of my full time students
Dr Christine Hall:
Full time emergency medicine specialist in Victoria, Vancouver Island Health
Authority.
Trauma team leader and educator.
Previously, program director for emergency medicine at the University of
Calgary.
Master's degree in epidemiology from the University of Calgary.
Cross-appointed in the department of community health sciences through

the faculty of medicine at the University of Calgary and also the faculty of
medicine's department of surgery at UBC.
When it comes to unconsciousness or death attributed to an edged weapon
attack, we are talking about what the medical community calls Shock. Dr
Porayko defines shock as, the development of multi-organ failure due to
insufficient oxygen being delivered to the tissue to meet their metabolic
needs.
Specific to shock as it relates to unconsciousness and death, Dr Porayko
stated the following to me:
A 70kgs (154lbs) males circulating blood volume is about 70ml/kg which
equals about 5 litres. Cardiac output is about 5-7 litres per minute. All the
great vessels of the body act as a conduit of approximately 15-20% of
CO/minute which equals about 1 litre per minute. The great vessels include the
innominate artery, Subclavian arteries, carotid arteries and some include the
iliac arteries. The 4 atria, 2 ventricles and aorta all conduct the full cardiac
output thus are well protected in the centre of the body behind the sternum
and in front of the thoracolumbar spine.
So why is the above noted information important, because hemorrhagic shock
(blood loss) is based upon how much hydraulic fluid (blood) is leaked from the
body. When it comes to understanding hemorrhagic shock, I would guide you to
the following links that were provided to me by Dr Porayko:
http://ccforum.com/content/8/5/373
http://ccforum.com/content/8/5/373/table/T1
Dr Porayko advised that based upon the above noted link:
A class II shock category (750-1500ml) would leave most dizzy and very
weak
a Class III or Class IV shock category (1500ml-2 litres of blood loss) would
leave most with the inability to stand up right
Specific to my questions about unconsciousness and death if specific
anatomical arteries or veins were cut, and given all the medical variable
associated, the Doctors had to make the following assumptions first before
they could answer my questions:

1. There is no compression of a lacerated artery underway. This was irrelevant

for a lacerated vein due to the fact that a vein cant be compressed
2. The subject is previously healthy with a normal haemoglobin concentration
and has a normal VO2 max prior to being wounded.
3. If an artery is the target, the artery is incompletely transacted. Completely
transacted arteries go into vasospasm and retract into their perivascular
sheaths which markedly reduces bleeding and even stopping bleeding all
together in the case of smaller vessels. On this point Dr Porayko stated that
this is the reason the Ghurkhas were trained to twist their knives in the
femoral artery after puncturing it- to avoid a clean surgical transaction, thus
preventing the vasospasm and retraction into the perivascular sheath, and
instead to intentionally cause a hole in the vessel sidewall which is much more
lethal.
4. The adventitia (a saran wrap like layer around the blood vessel) does not
seal the wound ( The doctors stated that this usually does happen in survivors)
and/or a clot does no form after blood pressure drops.
The doctors also noted:
although exsanguinations (death from blood loss) from a venous injury is much
slower that an arterial one (because mean arterial pressure is usually at least
10x central venous pressure), the venous injury is much more difficult to treat
and generally if arterial injured patients survive to hospital with manual
compression, they will do well whereas major venous injured patients often die
even after getting to the operating room
Of note, both doctors opinioned that the numbers provided by Fairburn and
other combative/martial arts instructors that I provided to them for review,
specific to times for unconsciousness and/or death, are way too short. Both
stated that they believed that these numbers are based upon complete
cessation of all cardiac output through the involved vessel which is not the
norm. In fact Dr Pryayko brought to my attention that during the French
revolution when thousands of people were beheaded by guillotine, the
attending doctors documented the presence of vital signs in the body for up
to two minutes.