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People believe that foreign objects in deep puncture wounds should be left in until medical care is available.

Is that belief true?

  • According to the FAQ, Skeptics.SE is for researching the evidence behind the claims you hear or read. This question doesn't appear to have any doubtful claims to investigate. Please edit it to reference a notable claim and flag for moderator attention to re-open (or get 5 re-open votes). – Oddthinking Jun 26 '14 at 10:53
  • The issue of whether movies are making "real" claims has come up before. I don't think a typical action movie purports to demonstrate the most appropriate medical treatment of injuries, and their effects on the human body. – Oddthinking Jun 26 '14 at 12:18
  • FYI "Removing impaling foreign objects from wounds" is described in TV Tropes 'WorstAid' section. – ChrisW Jun 26 '14 at 12:20
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    Even if movies are a poor example, there is a notable chaim that one should not pull things out of a puncture wound. I suggest just editing out the movie reference. – William Grobman Jun 26 '14 at 14:20
  • Hmmm... now the claim has been reversed, we have the opposite problem. Does anyone disbelieve it? But I've reopened it anyway. If you don't like it, offer a close vote. (As for notability: I believe this because I heard this claim in the context of a first-aid training from an experienced paramedic.) – Oddthinking Jun 26 '14 at 16:32
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Yes.

With impalement, the penetrating object remains within the body [...] Such objects should not be removed in the field because they sometimes tamponade injuries to vascular structures and thus prevent exsanguination.

Source: "Penetrating Abdominal Injuries", S.J.A. Sclafani and S. Sheeran, page 382. Chapter 17 of Imaging and Intervention in Abdominal Trauma, ed. R.F. Dondelinger, Springer, 2004. Google Books

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    "tamponade injuries to vascular structures and thus prevent exsanguination." ... translation ... "block punctured arteries and prevent bleeding" – RedGrittyBrick Jun 27 '14 at 13:36
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    Actually I'd translate that to mean "compress major arteries or veins that might otherwise bleed out if the compression is removed". – HappySpoon Jun 28 '14 at 7:16
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Some objects which are not large enough to produce effective compression of blood vessels should also be removed in controlled circumstances.

The most complete and detailed account of arrow wounds and treatments is Dr. Joseph Howland Bill’s “Notes on Arrow Wounds,” which is considered the “definitive work on American arrow wounds.” [1]

If the shaft was left in place, Dr. Bill’s treatment was to make an incision to enlarge the entry wound and slide a finger down the shaft to feel the depth of the wound and determine if the arrowhead is lodged in bone. Without the shaft in place the doctor was forced to search for the arrow by making a larger incision, probing through tissue, causing more trauma, and taking more time. It was much easier for the doctor and patient if the shaft was left intact until a doctor could remove the head and shaft as one piece. Further, there was always the danger that the arrowhead could not be found leaving the “angular and jagged head… buried in bone to kill – for so it surely will.” If, however, the arrowhead is removed properly, the wound was likely to heal naturally.

Not only is there a fear of losing part of the penetrating object, but barbed objects might also cause more damage as they are removed. In this report of a spear gun penetrating the skull of a 9 year old child, they advise that [2]

barbed objects should not be removed by retracing the route of entry

as that causes maximal tissue damage.

Large shrapnel pieces have the same issue as broken off arrow heads, difficult to locate deep inside tissues, and jagged edges causing even more trauma when removed.


References:

[1] http://allthingsliberty.com/2013/05/battle-wounds-never-pull-an-arrow-out-of-a-body/

[2] http://www.turkishneurosurgery.org.tr/pdf/pdf_JTN_378.pdf

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  • It should be noted that the work you cite is dated 1862; one might reasonably question whether it represents the current state of the art. – Nate Eldredge Jun 28 '14 at 15:42
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    @NateEldredge Perhaps that is why I quoted it as the "definitive work on American arrow wounds". This article from 1994 ncbi.nlm.nih.gov/pmc/articles/PMC1294328/pdf/… still quotes this paper as their primary reference. There are this century reports from arrow injuries in Northern India and Papua New Guinea, but they are not free text. – HappySpoon Jun 28 '14 at 22:00
  • The 1994 article you cite does not purport to describe current medical best practices for puncture/impalement wounds, but rather is a historical survey describing 19th-century treatments. "Definitive" is your opinion; but I think readers can more accurately judge the reliability of your sources if they know the context in which they were written. – Nate Eldredge Jun 28 '14 at 22:09
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    No, it's not my opinion, it's from the reference I gave hence the use of quotation marks. The management of this type of wounds during the American Indian conflict most likely gave rise to the idea that objects causing deep penetrating injuries should be left alone. I fully described the context of my answer. If you have any further comments, please take it to chat. – HappySpoon Jun 28 '14 at 22:46
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    @rob I think the notable question really refers to objects which might look to be easily removed by non-medical people, and the dangers thereof. And not tiny objects deeply embedded which require the need for hitech imaging facilities. I don't think many would believes otherwise that these should be left to the professionals. – HappySpoon Jun 29 '14 at 1:23

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