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Wound Trauma Care - "Impaled Objects"

Updated: Sep 3, 2023


Accidents can happen unexpectedly, leading to various types of injuries. One particularly daunting injury is impalement, where a foreign object becomes lodged in the body. While this scenario might seem rare, knowing how to provide immediate trauma first aid for impaled objects can make a significant difference in preventing further harm and potentially saving a life. This small article aims to provide essential guidelines on how to approach such situations effectively.

Impaled objects present some unique problems in wound management. In many cases, the removal of an impaled object can cause additional internal (and external) hemorrhage, particularly if it is not located on an extremity. The structures at the base of the impaled object may be compromised, depending on the shape of the object, when it is removed.



Assessing the Situation

Encountering someone with an impaled object can be shocking, but it's crucial to stay as calm as possible. Begin by assessing the situation to determine the severity of the injury. Look for signs of consciousness, breathing, and overall stability. Prior to stabilizing a protruding object, the site needs to be exposed and any bleeding needs to be controlled. The exposure usually just requires that the clothing around the site be cut free or removed. If parts are pinned in by the object, then cut the rest of the clothing free.


1. Call for Help

Before taking any action, call for professional medical help. Dial your local emergency number or notify nearby individuals to seek immediate assistance. Impaled objects often require specialized medical attention for safe removal and treatment.

2. Do Not Remove the Object

"Embedded or Impaled Object NEVER remove the object"

It might be tempting to remove the impaled object immediately, but it's safer to leave it in place. The object could be providing pressure to the wound, preventing excessive bleeding. Removing it prematurely could result in severe blood loss and additional damage.

3. Control Bleeding

Gently apply pressure around the wound with sterile gauze or a clean cloth. Avoid pressing directly on the impaled object, as this might worsen the injury. Focus on controlling any bleeding around the wound while keeping the impaled object stable. Direct pressure can be applied at the base of the impaled object, and hemostatic dressings and pressure bandages can be applied, if applicable. Sometimes is difficult to maintain good direct pressure with some impalements, and early consideration to tourniquet application should be considered if bleeding persists and the injury is located on the limbs.

4. Stabilize the Object

If the impaled object is relatively long, it's crucial to prevent it from moving. You can stabilize the object using bulky dressings, clothing, or other materials that won't easily shift. This helps minimize further tissue damage and the risk of internal injuries.

Once the object has been encircled and a base of materials appropriate for the length of the object has been built, the base needs to be secured. This can be done with adhesive seals, like tape or by using cloth strips, cravats, or bandages tied in place to hold the base materials against the impaled object.

Stabilization is generally best done with at least one assistant. While one person keeps the object in position and stable, the other can begin to work around the base of the object.

I was drawing some illustrations for you below in which you can see a method to secure an impaled object using rolled gauze.



5. Keep the Person Calm

Panic can exacerbate the situation, leading to elevated heart rates and increased bleeding. Encourage the injured person to remain as still and calm as possible. Reassure them that help is on the way and that you're there to support them.

6. Observe for Signs of Shock

Shock can set in rapidly after a traumatic injury. Watch for symptoms such as pale skin, rapid breathing, confusion, or fainting. If signs of shock are present, continue to keep the person calm and maintain proper body positioning.

7. Wait for Medical Professionals

Once medical professionals arrive at the scene, they will assess the situation and determine the best course of action. They have the necessary tools and expertise to safely remove the impaled object and provide appropriate treatment.

Conclusion

Encountering a person with an impaled object can be distressing, but with a clear understanding of trauma first aid techniques, you can make a crucial difference in their outcome. Remember to stay calm, call for professional help, control bleeding, stabilize the object and keep the injured person as calm as possible. By following these guidelines, you can provide effective initial care and contribute to a more positive outcome for the injured individual.

Below is also a chart with the main informations in the case of an impaled object trauma.

IMPORTANT!!! When we encounter someone who has something impaled in them(whether a knife, or maybe a construction pole, etc) we always have to remember about safety, so that you as a rescuer don't become the next one injured.

Stay safe!



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