NREMT Paramedic Cognitive ExamTraumaEasy
A 35-year-old male is impaled through his left thigh by a metal rod. The rod is approximately 2 feet long and cannot be easily removed. He is conscious and alert, with stable vital signs. There is moderate bleeding around the entry site. What is the most appropriate initial management for this injury?
- AAttempt to cut the rod shorter to facilitate transport.
- BStabilize the impaled object in place with bulky dressings.
- CApply a tourniquet proximal to the impaled object.
- DCarefully remove the impaled object to control bleeding.
Show answer & explanationAnswer & explanation
Correct answer: B. Stabilize the impaled object in place with bulky dressings.
Impaled objects should generally not be removed in the prehospital setting unless they interfere with airway management or CPR. Removing the object can cause further internal damage and uncontrolled hemorrhage. The most appropriate action is to stabilize the object in place with bulky dressings to prevent movement and further injury.
Why the other options are wrong
- A. Attempting to cut the rod can cause vibration, movement, and further injury to the patient, and should only be done by specialized teams if absolutely necessary for extrication and transport.
- C. A tourniquet is for severe, uncontrollable hemorrhage from an extremity, and may not be appropriate or effective for an impaled object unless the bleeding is life-threatening and cannot be controlled by direct pressure around the object.
- D. Removing an impaled object can cause severe, uncontrolled bleeding and further damage to tissues and vessels.
Impaled Object Management
Prehospital care for an injury where an object is embedded in the body, emphasizing stabilization rather than removal.
- Do not remove impaled objects (unless interfering with airway/CPR).
- Stabilize the object in place with bulky dressings.
- Control bleeding around the object.
Memory trick: Impaled: Immobilize It, Don't Dislodge It.