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You and some friends are staying in a remote cabin in the woods. The sun has set. You’re all sitting by the fire when you hear a strange noise coming from outside. Someone goes to investigate, but after a few minutes, they haven’t returned. You go out to find them, and suddenly a shadowy form leaps out at you!
Countless horror movies start this way. And while vampires, xenomorphs and the undead don’t exist in the real world (hopefully!), if you’re a horror fan, you may find yourself wondering: Would I survive the life-threatening scenarios that the heroes in movies always make it through?
We asked an emergency medicine doctor how someone could, theoretically, survive injuries and wounds from horror movies before help is available — turns out, their advice is relevant for real life, too. (Though if you’re wondering how to survive demonic possession, infection with a rage virus or other supernatural incidents … sorry, you’re on your own.)
Before we jump scare you, some quick ground rules. Most of us won’t be injured in haunted houses, alien planets or creepy forests, which means help is usually not far away. In any medical emergency, you should always call 911 immediately, and then do whatever first aid you can.
Also, trigger warning, things are about to get a little gruesome. If you’re recovering from a traumatic experience, or are disturbed by descriptions of violent injuries, this article might not be for you.
How to survive impalement
Believe it or not, impalement is the actual, technical term doctors use to describe a wound where a foreign object has pierced or punctured the body. In horror movies, it’s common for someone to get stabbed and then immediately pull the knife out. Number one rule? Don’t do that.
“The fact that it’s stuck in the body means it’s also applying pressure, so what you don’t want is to pull it out and then have an open cavity wound you can quickly bleed into, especially if it’s in your chest or abdomen,” says Dr. Nathan White, an emergency medicine physician at Harborview Medical Center.
Instead, he says you should stabilize the object, making sure it won’t move around when you move. This could mean securing it in place with a shirt or whatever you have on hand. The main goal at this point is to prevent blood loss, White says, so wrap the wound as much as you can — before, you know, running away from the slasher at top speed.
If the wound is from a gunshot, it’s important not to try to get the bullet out, as there’s likely significant internal damage.
“Also, don’t try to cauterize the wound, don’t be a hero,” White says. “You’re going to add a burn injury.” (More on that in a sec.)
How to survive a deep, bleeding wound or amputation
Say you’ve, I don’t know, escaped the warehouse of a serial killer who tests people with grisly games that involve things like self-amputation. Will you be able to survive with one less finger until you can get help?
Probably yes. With any open wound, including an amputation, the most important thing is to control blood loss, because bleeding out is what will kill you first.
Step one is applying direct pressure to the wound. Don’t pack anything dirty into the wound, White says, unless you have something sterile like gauze available. If you’re bleeding from an arm or leg, try to find something you can use as a tourniquet and tie it tightly above the wound to lessen blood flow to the bleeding area. Tourniquets may seem like an easy fix in the movies, but in reality, they are often applied incorrectly, so it is important to get help on the way as soon as possible.
Want to practice some of these skills first-hand, just in case of a future zombie apocalypse? There’s a program called Stop the Bleed where you can learn how to prevent someone from bleeding out and actually save lives. (It can be a very important skill to have in case of a more real-world horrific scenario, like an active shooter situation.)
How to survive a head injury
There’s a wide range of ways to injure your head, from a concussion to a skull fracture to an internal hemorrhage. If an open wound is involved, just be prepared for a lot of blood.
“The scalp has a lot of blood vessels, and they are difficult to close up after a laceration,” White says. “You need to put direct pressure on the wound to slow the bleeding down, but if a fracture is involved, you don’t want to push the fractured bone into the brain.”
Emergency medicine doctors will often put in temporary stitches or staples to try to bring the scalp tissues back together. In the case of bleeding in the brain, adding pressure is the last thing you want to do.
“If intracranial pressure increases, it decreases the amount of blood that can flow through the brain,” White says.
Elevating someone’s head to 30 degrees and loosening anything that’s around the neck can both help. Also be mindful of potential injuries to the upper spine, so neck stabilization is also important.
Sometimes, doctors will actually drill small holes, called burr holes, into the skull to help release some of the pressure. But you need, you know, an actual neurosurgeon to do that.
How to survive an eye injury
Another common horror trope? Sharp things and eyeballs. Basically, this is a situation where you definitely don’t want to focus on stopping the bleeding.
“Don’t apply pressure to an eye wound, especially if it’s a penetrating injury and the eyeball has ruptured in some way, because if you push on it…stuff might come out,” White says.
Enough said. In fact, bleeding out from an eye injury is very unlikely, White says, so the main thing to do is shield the eye from further injury by putting a makeshift eye patch over it.
How to survive an attempted strangulation
If a killer is trying to strangle you — or a giant alien monster wraps its whip-like tail around your throat — getting away is just the first challenge. Often, a hero will escape, cough a bit, then continue on as though nothing happened.
But in any blunt vascular injury to the neck, blood vessels can get stretched out and their inner layers torn, White says. At first, this will just hurt, but later on it can lead to blood clot formation, which can lead to a stroke. Seemingly innocuous things like mild whiplash, an adjustment at the chiropractor’s office, or even a very violent sneeze (yes, really), can cause this to happen.
“If you have marks on your neck, neck pain, or any kind of facial trauma, don’t just shake it off. Get the bad guy first, then go get it checked out at the hospital,” White says. (But seriously, go to the hospital.)
How to survive a burn
Being burned alive? Yeah, not much is going to help with that. Whole-body burns require intensive medical care at a burn center like Harborview Medical Center ASAP. But smaller burns can be treated with first aid.
Putting out the fire that’s devouring your flesh and then immediately cooling the burned area is the first priority. Running the burn under room temperature tap water will do the trick. This is important, because just extinguishing the flames doesn’t mean the burn will stop, well, burning. White uses the analogy of cooking meat: when you turn the burner off, the meat still sizzles. (Gross.)
Hydrating is also important, since the inflammation caused by the burns makes the body lose fluids quickly.
After cooling the area, you might notice some blistering. However tempting, don’t pop the blisters yourself. Blistering means a burn is deeper than you think and that you need medical care.
What horror fans get out of watching scary movies
So, you did it, you survived the horror movie. But that’s just the beginning. (And did you actually survive, or are you still trapped in the nightmare world of a vengeful killer with knives for hands? Sometimes it’s hard to tell.)
Serious question: Since they're full of, well, horrible things, why do so many of us like horror movies?
“Horror movies are often a bigger metaphor for the way trauma impacts people; they’re allegorical,” says Elizabeth Lehinger, a postdoctoral research fellow at the UW School of Medicine Department of Psychiatry and Behavioral Sciences and at the UW Center for Anxiety and Traumatic Stress. “They explore the way that things haunt you, and haunting is the way someone might describe how they feel after an extreme stressor.”
Not everyone will get this from watching horror movies, and even if you find horror a helpful way to process negative emotions, there’s no real way to prepare yourself for something truly horrifying. But your mind and body may take you through a smaller version of a horrifying event when you watch scary movies. And there are benefits to being a horror fan: Research has found that horror fans showed more self-reported resilience during the COVID-19 pandemic, a very real, horrifying event.
Now you’re all set for the sequel.
