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Impaled object — DIPIMC MCQ

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ModeratePre-Hospital TraumaImpaled objectDIPIMCDipIMC

A man has fallen onto metal railings, with a spike impaled in the lateral chest wall. He is breathing adequately and the object is not obstructing his airway. Bleeding around the entry site is modest. What is the most appropriate management of the impaled object?

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Correct answer: C — Leave the object in place, stabilise it with padding, and transport

An impaled object should be left in situ and stabilised with bulky padding, because it may be tamponading vessels and removal can precipitate catastrophic haemorrhage. Removal or partial withdrawal risks uncontrolled bleeding, and cutting flush may transmit movement to deep structures. The object is shortened by appropriate personnel when essential for extrication or transport. Pearl: the exception to leaving an object in place is when it obstructs the airway or prevents life-saving CPR.

Reference: JRCALC Clinical Guidelines