By Chuck Nottingham
Take a note from Viking first-aider Helga. When Hagar the Horrible lumbers home impaled with arrows, she leaves them protruding and calmly asks how his raid on England went.
Potentially catastrophic are initial instincts of many victims and bystanders to yank out objects impaling themselves or loved ones. American Red Cross Community First Aid and Safety states "If an object, such as a knife or a piece of glass or metal, is impaled in a wound, do not remove it."
Impalement isn't just a cut. It's "to pierce through or embed with anything pointed," like when knifes, arrows, antlers, spokes, branches, ramrods, or even pencils run into a portion of anatomy and one or both ends stick out.
The outdoors harbors all sorts of natural and manufactured impalement risks. Any sizable spike of glass, metal, wood, plastic, or horn can impale. Effective even life-saving first aid often goes against our most natural impulses.
First and foremost, resist the tendency to pull an object free. That simple response might provoke uncontrollable bleeding. Two cases in point:
A few months ago, a Montana youngster playing in his bedroom leapt upon a sharpened pencil left lying on his bed. It penetrated his chest, the point in his heart. Parents rigorously guarded the eraser end, pulsing with their 12-year-old's heartbeat, as they awaited the ambulance. EMTs continued to protect the protrusion as they transported him to waiting surgeons. The physician team finally removing the pencil from the boy's heart under proper conditions credit the first aiders and emergency technicians with saving the boy's life. Had the youngster himself or anyone else panicked and pulled the point loose, doctors say he would have died in seconds instead of recovering fully as he did.
On the same day, an elderly Florida woman walking to her neighborhood grocery was randomly stabbed from behind at the juncture of her shoulder and neck. Only the hilt of the long knife protruded. Supposing she had merely sustained a blow by her assailant, the woman went shopping where store security cameras later confirmed she had a knife in her. When she reached home, her daughter pulled the knife free, and the elderly victim began to bleed profusely. Only close proximity to a hospital and timely EMT intervention saved her life.
The Red Cross manual illustrates placing rolls of gauze on either side of the shaft and securing it with pressure bandages.
Of course, small splinters (except in the eye) may be safely removed with tweezers, but true impalement a person speared by a shaft from something too heavy to move or firmly anchored may require even more heroic measures.
For instance, we're bird hunting when one of our party falls on a long spur of wood rising from a tree stump. As she tries to rise, she finds she's impaled. First we have to prevent her from trying to struggle free. While someone attends to restraint and first aid, someone else needs to summon help.
One of us may have to saw off the spur in order to transport her with the giant sliver in place to an ambulance or medical facility.
No incident is the same, but we may prevent tragedy if we:
Prevent removal. We may have to hold or tie a young or panicked victim's hands
Securely bandage the thing as stationary to the victim's body as possible
Call for help or take the injured person to a medical facility.
Additional first aid while waiting or transporting:
As with any bleeding victim, elevate an impaled arm or leg above the heart if possible.
If direct pressure around the wound, elevation, and the thick bandage do not stop bleeding, we may have to apply pressure to arterial points. Never use a tourniquet!
Treat the victim for shock. Cover if he or she is cold, or cool the victim if overheated. If no head, neck, or stomach wound is involved, elevate feet and legs about a foot higher than the torso
Monitor breathing and be prepared to administer CPR.
Oh, yes. It's better for all concerned if we DON'T sing, whistle or hum "Stuck on You."
