Objects that can impale flesh come in all shapes and sizes, from pencils and screwdrivers to knives, glass, fence posts and even javelins at track and field meets. Proper first aid requires that the object be stabilized. There can be significant internal damage.
Impalement can cause serious injuries. In most locations, an ambulance can be on the scene in 10 to 20 minutes. However, should you find yourself with a victim greater than one hour from medical care, you should know how to care for the victim.
First aid
1. Do not remove. Unless the object is stuck in the cheek, do not move or remove it. Removal or movement of any kind could produce additional bleeding and tissue damage.
2. Expose the area. Remove or cut away any clothing surrounding the injury. If clothes cover the object, leave them in place, since removal could cause the object to move.
Control any bleeding by direct pressure. Straddle the object with gauze. Do not press directly on the object or along the wound next to the cutting edge, especially if the object has sharp edges.
3. Stabilize the object. Place bulky dressings (several layers of gauze, or clean cloths completely around the object. Some experts suggest securing 75 percent of the object with bulky dressings or cloths to reduce any motion.
4. Shorten the object only if necessary. In most cases, do not shorten the object by cutting or breaking it. There are times, however, when cutting off or shortening the object allows for easier transportation.
Be sure to stabilize the object before shortening. Remember that any vibrations that happen while cutting the object will be felt by the victim, and the injury could be worsened.
Impaled cheek
The only time an object can be safely removed is when it is in the victim's cheek.
1. Examine the injury inside the mouth. If the object extends through the cheek and you are greater than one hour from medical help, consider removing it.
2. Remove the object. Place two fingers next to the object, straddling it. Gently pull it in the direction from which it entered. If it cannot be removed easily, leave it in place and secure with bulky dressings.
3. Control bleeding. After removing the object, place dressings over the wound inside the mouth, between the cheek and teeth. These dressings will help control bleeding and will not interfere with the victim's airway. Also, place a dressing on the outside wound.
Impaled eye
1. Do not put pressure on the eye. The eyeball consists of two chambers, each filled with fluid. Do not exert any pressure against the eyeball, since fluid can be forced out of it, worsening the injury.
2. Stabilize the object. Bandage the object in place and secure it. First, cover the eye with a moist, sterile dressing. Next, surround it with a "collar" made from several layers of gauze dressings or a "doughnut-shaped" pad. You can place a protective paper cup over the affected eye to prevent accidental movement of the object.
3. Cover the unaffected eye. Most experts suggest that the unaffected eye should be covered to prevent sympathetic eye movement. This is based on the thought that the injured eye will also move if the unaffected one does, thereby aggravating the injury.
Remember that the victim is unable to see when both eyes are covered and may be anxious about that. Explain everything that you are doing to the victim to relieve their anxiety and fright.
Slivers
Small slivers of wood can be painful and irritating. They can also become infected. Because of their size and usual location in the fingers, easy removal can be done with tweezers. Sometimes, teasing one end of the object with a sterile needle in order to place it in a better position for removing with tweezers is necessary. After removing the sliver, clean the site with soap and water and apply an adhesive bandage strip.