Stab wounds present serious threats to life, requiring swift action. These injuries, caused by a sharp object penetrating the body, can cause rapid blood loss and internal damage. Knowing the correct initial actions can significantly improve the outcome until professional medical help arrives.
The Critical Decision: Why to Leave the Object
If an object, like a knife, causes a penetrating injury and remains embedded, it should remain in place. This is because the object often acts as a physical plug, a phenomenon known as the tamponade effect, which helps to slow or prevent blood from escaping the body. Removing the object can disrupt this natural seal, leading to a sudden, severe surge of blood loss (hemorrhage). This uncontrolled bleeding can occur from damaged blood vessels, nerves, or organs that the object was compressing.
Removing a penetrating object can cause more extensive damage as it is pulled out, potentially tearing tissues or blood vessels that were previously intact or compressed. If the object has pierced a major artery, its presence might be the only thing preventing massive, life-threatening bleeding. Medical professionals are trained to safely remove such objects in a controlled environment, like an operating room, where they can immediately address any resulting damage or hemorrhage.
Leaving the object embedded also allows medical personnel to accurately assess the wound’s depth and trajectory using imaging techniques like X-rays or CT scans. This helps them plan the safest and most effective surgical approach to repair internal damage. Preventing rapid blood loss by leaving the object in place is paramount, as the immediate threat from hemorrhage outweighs the short-term risk of infection.
Immediate Actions and First Aid
After ensuring the scene is safe, contact emergency services, such as 911. While waiting for professional help to arrive, control bleeding by applying direct pressure around the impaled object, not directly on it. Use clean cloths, sterile dressings, or bandages to create a barrier and apply firm, continuous pressure to the wound site. If blood soaks through the initial dressing, do not remove it; instead, place additional layers on top and continue applying pressure.
Stabilizing the impaled object is important to prevent further movement and internal damage. Surround the object with bulky dressings, towels, or blankets, then secure them with tape or bandages. Keep the injured person calm and still to minimize blood loss and prevent further injury. Lying them flat is recommended. If the wound is on a limb, elevating it above heart level may help reduce blood flow, unless the wound is in the torso.
Continuously monitor for signs of shock: pale, cold, or clammy skin, a rapid heartbeat, and shallow or fast breathing. If these signs appear, reassure the person and keep them warm with a blanket or coat. Comfort and reassurance can also help keep the individual conscious and talking, allowing valuable information for emergency responders.
Actions to Avoid
Never remove an impaled object from a stab wound. Removing it can cause severe, rapid blood loss, potentially damaging nerves, muscles, or arteries that were compressed by the object. This can worsen the injury and lead to life-threatening hemorrhage.
Do not attempt to clean the wound or push the object further into the body. Cleaning the wound can introduce bacteria or dislodge clots, increasing infection risk. Pushing the object deeper will cause more internal damage to organs or blood vessels. Also, do not give the injured person anything to eat or drink, as this poses an aspiration risk if emergency surgery is required.