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Straight, No Chaser: Been Stabbed? Impaled?

By Jeffrey Sterling, MD November 17, 2018

This post contains graphic pictures.

impaledkey

Accidents happen. So does penetrating trauma. Would you know what to do if you were stabbed or fell on an object that got stuck? I know what your instincts would be: Immediately evict any unwelcome tenants! Let’s discuss the correct steps to take in the presence of an impaled object.

 impaledpencil

Your first move is your best move. Get out of harm’s way. In those cases where an assailant wants you dead, your injuries/trauma represents an unfinished job. If you can safely remove yourself from the environment, do so.

impaled eyenail

Have someone immediately call 911 or your area’s emergency hotline.

impaled backknife

You’re waiting for this, so let’s address what’s likely to be your first question: In the overwhelming majority of cases, the correct thing to do is to leave the object in place. Do not attempt to remove it. There are possibly vital structures in place (e.g., nerves, arteries, veins), and the fact that you’re not yet dead means your body has successfully adjusted to the presence of the object (well, at least temporarily). Removing it could have the effect of uncorking a dam, meaning you could be releasing a massive flow of blood from a punctured blood vessel.

impaled bigknife

Keep yourself or the affected person as still as possible. You really don’t want to move someone unless there is an obvious and immediate life-threatening situation. If practical, the preferred positioning of the affected person is lying down with arms and legs elevated. This will reduce blood flow to the arms and legs and keep it in the core, where your brain and heart need it.
impaled neckknife
Prepare and be prepared for bleeding. This can occur from nicking a blood vessel or accidentally dislodging the object and producing bleeding. Obtain plenty of clean towels and create a big, bulky dressing around the object. If you have bandages, use them to secure this dressing; you want to keep everything in place as much as possible. It’s also a good idea to remove clothing from around the object as well because it’s likely dirty and will increase the risk of infection.

impaled treelimb

Keep yourself or the affected person as comfortable and calm as possible. Excitement increases your blood pressure, which will increase bleeding. You don’t want this. You only have so much blood, and you don’t want it squirting out of you. This is an example where you don’t want the person to go to sleep, as this could represent settling into shock. Keep the person awake, alert and engaged in calm conversation. Realize that your panic is likely to translate to the person you are trying to help.

impalediron

Your best bet is to wait for the ambulance to arrive. Resist the strong urge to “Don’t just stand there. Do something!” Your efforts at moving and maneuvering the person are likely to be harmful. You want professionals to take the next steps. That said, if you believe the person is deteriorating, or you can’t overcome your panic, attempt to transport someone without moving the object and while keeping the person calm and still as possible.

Of course, I would be remiss if I didn’t suggest the best measure is to avoid the situation in the first place. Whether at home or work, taking the time to assess your environment and be aware of potential risks goes a long way to avoiding these types of accidents.

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