In BLS trauma care, how should an impaled object in the face or neck be managed?

• A. Immobilize and leave impaled objects in place
• B. Remove object impaled in face, cheek, or neck if there is total airway obstruction
• C. Remove the object to secure airway
• D. Remove the object to secure airway

Answer: (A)

When something is impaled in the face or neck, the priority is to immobilize it and leave it in place. Removing it can unleash dangerous bleeding from major neck vessels or the airway itself and can worsen tissue damage. The object often tamponades the bleed, so stabilizing it minimizes movement and helps control hemorrhage during transport. To do this, place bulky dressings around the object to hold it steady and secure the head and neck to prevent any shift. Manage the airway and breathing around the object as needed with standard BLS techniques, but avoid removing the object. This approach reduces the risk of catastrophic hemorrhage and airway compromise while you get the patient to definitive care.