Big splinter!
Never remove a penetrating foreign object in the field! (there is always an exception to the rule if you want to play the what-if game). A case of a 30-year-old male who had been cutting down a tree, when he fell 20 feet from the tree and became impaled by a large piece of wood. How would you treat this injury in the prehospital setting? What other concerns do you have given the height of the fall? Would you choose to stabilize the impaled object for transport, or leave it alone? Impalement injuries are one of the severe types of injuries combining effects of both penetrating and blunt trauma leading to crushing injury, wound contamination, and multiorgan damage. These types of injuries are usually a result of fall from height, vehicular accidents, and slip with strong external force. Prompt transfer to a tertiary center, pre-operative planning, and multi-specialty involvement is crucial in the management of such cases. After initial resuscitation, full trauma evaluation should be carried out before attending to local injury. Minimal manipulation, extraction of impaled object in operation theater under direct vision, wound debridement, and administration of antibiotics to prevent wound infection are pearls of the management of impalement injury. Source: medicaltalks