For impaled objects in trauma, what is the recommended action?

• A. Immobilize and leave impaled objects in place
• B. Remove object impaled in face, cheek, or neck if there is total airway obstruction
• C. Move the object to ease airway clearance
• D. Cut the object and remove it immediately

Answer: (A)

When a patient has an impaled object, the priority is to prevent further injury by keeping the object in place and stabilizing it. The object may be tamponading bleeding, and removing it in the field can unleash uncontrolled hemorrhage or damage surrounding structures. So you immobilize the object with bulky dressings and secure it to the patient to prevent movement during transport. Do not cut or remove the object in the field, even if the airway seems compromised. If airway management is required, maintain the airway around the object and rapidly transport for definitive care, but do not extract the object yourself. This approach minimizes bleeding risk and maximizes the chances for controlled definitive removal by the surgical team.