Sunday, September 23, 2012

Arrow Wounds

With all the recent popularity of bow and arrows (The Hunger Games, Revolution), can you tell your readers the proper way to deal with injuries like this?
Thanks, Kimber


Arrows are an old weapon and a unique weapon. Let’s start by looking at the arrow itself—that lends a lot to the understanding of the injury and treatment.

A Bit About Handmade/Homemade Arrows Ala Hunger Games

The earliest recorded information about arrow injuries and their treatments comes from the 1800s, when the Bow and arrow was still a common weapon—not yet supplanted by guns.
First, let’s look at the traditional hand-made arrow, like in Hunger Games or Revolution.

The arrow was comprised of a head, a shaft, and feathers.

The arrowhead—usually rock or bone—was shaped into a roughly triangular shape. The tip needed to be sharp and able to “cut” the skin, and had to be sturdy enough to penetrate clothing. Arrows were often shot with enough velocity that they could lodge in bone, although perforation of the skull was uncommon unless the victim was hit in the eye socket.

The shaft was typically made of dogwood stripped of bark, then soaked and twisted to ensure a straight shaft that would rotate. The shaft had to be long enough to stabilize the flight of the arrow, but be of a length easily portable in a quiver. A horseback-seated archer needed to be able to reach over his shoulder and pull an arrow out of the quiver.

The end of the shaft was stabilized by feathers. The choice of feather was based on the weight of the arrowhead. The bigger and heavier the head, the bigger the feather needed to balance it. The other function of the feathers was to influence the spin of the arrow. Like a quarterback, an archer wants spin in the flight. A rotating projectile goes farther.

The head was bound to the shaft with tendon and sinew. The reason for this (other than convenience) is this: when the arrow penetrates body tissue, the blood and moisture loosens the binding. When the well-meaning friend went to remove the arrow, the arrowhead remained inside the victim, where it generally did more damage by moving—those sharp edges—and caused infection. Compared to bullets, which are hot (and more likely to be sterile) and blunt (less likely to cause damage once they’ve stopped), arrowheads could not be left in place. The easiest way to get one out was to cut down to the head and extract the whole thing. This was the best chance for survival.

Chest wound were more dangerous, especially if it wasn’t a through-and-through injury.

Poisoning an Arrowhead

An old method was to take a chunk of raw animal liver and entice a rattlesnake to bite the liver. I have no idea how they got the snake to do this. Then the liver was buried and allowed to rot for a few days. The meat was disinterred, and arrowheads (already mounted on shafts) were dipped in the rotten poisoned liver and allowed to dry. The consequence of this—even if the arrow was successfully removed, the victim often died of poisoning, either from nasty bacteria or the rattlesnake poison.

The Modern Arrow

Most arrows today have machine-made carbon shafts and sharp cone-like points. Their shape is conducive to going deep with a low velocity, and tends to cut through body structures in its path. The good news is the arrow tends to act like a plug—if it lodges in the heart, the last thing you want to do is pull it out. Same for penetration of major blood vessels. The upshot is you can’t tell exactly where it is or what it punctured.


The arrow should be stabilized in place, usually with gauze or cotton around the arrow at the entry site, and the patient should be transported like this. Many patients have a stable blood pressure and heart rate. In the ER, X-rays may be obtained. A CT scan can help map the tract of the arrow and give medical personnel a better idea of what structures may be affected. The arrow is generally removed in surgery.

Barbed arrows are similar to the handmade ones, causing more damage and tend to be fraught with more surgical peril during extraction. Again, don’t pull the arrow out.
In fiction, the choice of the arrow—homemade or machine-made, poisoned or plain—depends on the scene you’re looking for. Just…don’t pull out the arrow.

Cheers, Kelly
Kelly has worked in the medical field for over twenty years, mainly at large medical centers. With experience in a variety of settings, chances are Kelly may have seen it. Sometimes truth seems stranger than fiction in medicine, but accurate medicine in fiction is fabulous.
Find her fiction at


  1. Kelly - I love this information...thanks for this most excellent blog. I've read every one:)

    1. Glad you're enjoying it, Kay Dee.
      Thanks for following.
      Cheers, Kelly