# Impaled object



## Topher38 (Apr 3, 2008)

How would you position somone with an impaled object (small, like a knife or shard of wood) in thier back. Lets say around the kidney area. You would support the impaled object but how would you position them? Prone? Has anyone had this kind of call before?


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## Jon (Apr 3, 2008)

Prone or in a lateral recumbent position.


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## paramedix (Apr 4, 2008)

It depends on the angle, the length, the type and the force of the object when impaled...

:excl:load&go

Suspected spinal injury??? No - transport in comfortable position for patient after the object was secured in place. Usually it would be as mentioned by Jon in the lateral position.

Suspected spinal injury??? Yes - immobilize the patient, maybe using a small SBB or device that allows for the patient to be on his side. It's going to be tricky, but at the end the patient must be comfortable with the least movement.


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## certguy (Apr 6, 2008)

You'd want to be able to manage the airway the best you can , so lateral recumbent would probably be best after stabilizing the object . You can further stabilize the pt. with rolled blankets , pillows , and additional straps . Pt. will be trendelenburged on the board ( till protocal changes ) with high flow o2 , and an NPA inserted if no indication of head trauma . Is the object through both sides ?

In the kidney area , you'd have massive bleeding possible as well as possible spinal involvement . You'll need rapid but smooth transport . I'd be looking at the possibility of medivacing the pt. out vs. ground . 


Giddy - up , and go . Meet ALS and or chopper on the way unless the hospital's close .


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## Ops Paramedic (Apr 10, 2008)

Should the level of consiousness allow you, i would package the patient prone on the spine board, barring there is no indication that you need to immobolise c-spine (The kidneys are far from the c-spine, and you would be albe to follow the wound tract, as it is not a bullet wound).  If this is the case, it is probibly better prone than lateral, as the spine, close to where the injury is, will still be immobolised, and should be better than lateral.

Yes, i have had a few cases where patients have fallen onto pallisade fencing (A fence constructed from vetically placed angle iron with sharpened edges) and had injuries on the posteririor aspect, and the only way we could get them transported was by packiging them prone...


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