Table 1 Principles of management of impalement injury

1)

The pre-hospital providers should leave the impaled object in situ to provide a possible tamponade effect and permit the focus on rapid transport as the goal

2)

The patient should be rapidly stabilized and transported, preferably to a trauma center and

3)

The patient should be rapidly assessed and resuscitated in the emergency department, avoiding any unnecessary tests that delay care, and then transported to the operating room for definitive care.