Emergency Medical Technician (EMT) Intermediate Practice Exam

In which of the following circumstances should you remove an impaled object?

1. Metal shard in the cheek and inadequate respiratory effort

2. Wooden splinter in the forearm

3. Glass shard near a joint

4. Cylinder lodged in the abdomen

The correct answer is: Metal shard in the cheek and inadequate respiratory effort

Removing an impaled object is a delicate decision that is generally guided by the principle of ensuring patient safety and managing any life-threatening scenarios. In this situation, the presence of an impaled metal shard in the cheek coupled with inadequate respiratory effort indicates a potentially critical situation. When respiratory effort is compromised, it may be essential to act to relieve any potential airway obstruction or interference caused by the impaled object. If the metal shard is obstructing the airway or impacting breathing, removing it may be the only option to restore adequate airflow. In contrast, the other scenarios involve impaled objects that are not immediately life-threatening to the airway or respiratory function, as they are located in areas where removing the object may cause more harm than good, such as increasing the risk of extensive bleeding or damaging surrounding tissues. In these cases, the recommended approach would typically involve stabilizing the object in place and providing appropriate care while transporting the patient to a medical facility, rather than attempting removal in the field.