In which patient should you remove an impaled object?

In which patient should you remove an impaled object?

• A. A pulseless patient with an object in the leg.
• B. A stable patient with a superficial nail in the toe.
• C. A pulseless and apneic patient with a knife impaled in the back.
• D. Leave in place and stabilize.

Answer: (C)

When a foreign object is impaled, the safest move in the field is to leave it in place and stabilize it. Removing it can cause severe bleeding, worsen damage to nerves and vessels, and complicate surgical removal later on. Your goal is to prevent movement of the object, control external bleeding around it, and transport for definitive care. In the scenario of a pulseless and apneic patient with a knife impaled in the back, you do not pull the knife out. You continue resuscitation as needed (CPR and airway/BVM management) while stabilizing the object with bulky dressings and immobilization to prevent movement. Then transport urgently so surgeons can address the injury in a controlled environment.

When a foreign object is impaled, the safest move in the field is to leave it in place and stabilize it. Removing it can cause severe bleeding, worsen damage to nerves and vessels, and complicate surgical removal later on. Your goal is to prevent movement of the object, control external bleeding around it, and transport for definitive care.

In the scenario of a pulseless and apneic patient with a knife impaled in the back, you do not pull the knife out. You continue resuscitation as needed (CPR and airway/BVM management) while stabilizing the object with bulky dressings and immobilization to prevent movement. Then transport urgently so surgeons can address the injury in a controlled environment.