Page last updated at 12:00 GMT, Wednesday, 31 May 2006 13:00 UK

Treating the victims of knife crime

By Caroline Ryan
Health reporter, BBC News

Knives handed in to police
Knives handed in to London police as part of the current amnesty

Knife crime is hitting the headlines.

The latest victim was a father of three, stabbed in Bristol over the bank holiday weekend.

Staff in A&E departments are on the front-line of the battle to save stabbing victims.

Responding to such attacks have always formed part of A&E care.

Official statistics show the number of deaths from stabbings has remained relatively constant over the last decade.

But Grant Williams, chairman of the Royal College of Nursing's Emergency Care Association, says that his experience suggests the situation is getting worse.

I don't think people do recognise the damage they can do
Grant Williams, Royal College of Nursing Emergency Care Association

"We have certainly seen an increase in people attending with violence-related injuries, after being attacked with knives, but also machetes and other sharp implements - people use whatever is to hand."

Dr Ravi Dasan, an A&E consultant at University College London Hospital added: "Ten years ago, we probably never saw knife cases.

"But there has been an appreciable rise in the last couple of years, particularly among young people.

"There seems to be a problem linked to gang culture and to football culture."

'Bravado' attitude

Stabbings can cause a range of injuries.

Someone who has tried to defend themselves from an attack will have wounds on their hands.

FATAL STABBINGS (ENGLAND AND WALES)
1994 - 231
1995 - 243
1996 - 197
1997 - 200
1997/8 - 202
1998/9 - 201/CPS:FACT>
1999/00 - 212
2000/01 - 214
2001/02- 261
2002/03 - 266
2003/04 - 234
2004/05 - 236
Source: Home Office

These can need operations to reconnect nerves and tissues, or even plastic surgery.

The real danger to life comes if the weapon has damaged a major organ or artery, when the victim can easily bleed to death.

Doctors can try to stem the bleeding, but have to be able to act quickly to be successful.

Anyone who has been stabbed will be dealt with like any other patient - on the basis of their injuries.

The most important points are to check a person's breathing and their circulation.

If someone walks in to A&E, they will be assessed based on the depth of the wound, its angle and where it is on their body as well as the amount of blood a person is losing.

When a stabbing victim is being brought in by ambulance, the emergency team is ready in the resuscitation room to receive them.

Mr Williams said: "I don't think people who carry knives do recognise the damage that can be done. Many have a 'bravado' in their attitude.

"Many of the cases which I come into contact with tend to be gang-related, or involve people living in that socio-economic community.

"I think people erroneously believe carrying a knife is for their own self-defence when pulling knives is likely to result in someone being seriously injured."

Paralysis risk

Movies are also cited as part of the problem.

Numerous action films include scenes where the hero is stabbed in the chest, but pulls the knife out before continuing to chase the villains.

But, in real life, a wound to the chest is likely to cause potentially fatal leaks of air or blood into the chest - even if no major organ has been punctured.

Mr Williams said: "People certainly wouldn't be carrying on fighting."

Surgery
Stabbing victims often require surgery

Dr Dasan added more effort was needed to convey the potential consequences of knife wounds to young people.

"There needs to be a greater level of community awareness that a stabbing can be fatal.

"There can also be long-term consequences if a victim survives.

"A wound to the back can hit the spinal cord and leave someone paralysed. Depending on where the wound is, someone can be left paraplegic.

"A wound to the neck could cause a neurological disorder, a nerve disorder or damage to the facial muscles."

Domestic disputes

However, both experts stressed stabbings were not solely linked to gang or street crime.

FATAL STABBINGS (ENGLAND AND WALES)
There needs to be a greater level of community awareness
Ravi Dasan, A&E consultant

Mr Williams says some of the most horrific cases he has seen have involved domestic incidents.

"A row might get out of hand and one partner or the other has grabbed a kitchen implement.

"I'm aware of quite a few domestic disputes which have ended up in manslaughter cases.

"There was one case where a man came home early from a night-shift to find his wife in bed with another man.

"They were both stabbed. She died and the man was seriously injured."



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