The severity is
based exclusively on the location and depth of penetration seen in autopsy.
- The important medical
considerations include the type of weapon used e.g. knife length, shape,
straight or serrated, and manner of assault, whether the stabbing is
overhand/underhand.
- The gender of the assailant may
have some importance, in that women tend to stab "overhand."
Penetration tends to be deeper with the "underhand" thrust.
- Stab wounds to the chest should
always be considered dangerous and likely to cause death until proven
otherwise.
- Central stab wounds, below the
clavicles and to either side of the breastbone means sternum, can result
in penetration of the heart. Chest wounds can result in puncture and
rupture of the lung or marked bleeding within the chest cavity causing
hemothorax.
- Stab wounds to the abdomen will
often result in an exploratory laparotomy to rule out serious damage. Slow
bleeding inside the abdomen is extremely difficult to diagnose, and should
be considered a possibility in every case.
- Stab wounds to the upper back can
involve the lung or heart.
- Stab wounds to the lower and
middle back can involve the kidneys and ureters. Evaluation of stab wounds
to the back that may have punctured the kidney will require intravenous
pyelography for evaluation. The presence of blood in the urinalysis
indicates injury to the kidney, bladder or ureter.
- Examination for sensation,
movement and pulses of the victim should be carefully done and documented
in case of stab wounds to the hands/legs that do not lacerate nerves,
blood vessels, or tendon structures.
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