emDOCs / EM@3AM - July 30, 2022 - By Sarah Shaver, Tony Mathew and Dylan Beam
Reviewed by: Alex Koyfman and Brit Long
Pearls:
- Impaled objects resulting in penetrating injuries can be potentially life or limb threatening depending on the location, depth, and involved neurovascular structures.
- EMS should leave the impaled object in place while in the field and during transport to the ED.
- These patients should be treated as trauma patients, and emergency clinicians must perform a thorough primary and secondary survey to ensure all wounds and injuries are identified.
- The majority of impaled objects will require removal in the OR, and all unstable patients due to impaled objects should be expeditiously taken to the OR. Stable patients can first undergo further imaging and evaluation to identify the extent of injury.