title: Management of a massive thoracoabdominal impalement: a case report.
abstract: A 26 year old male was impaled through his chest and upper abdomen with an iron angle, one and half meter long and five centimeters thick. The iron angle entered the chest, through the epigastrium and exited posteriorly just inferior to the angle of left scapula. The patient was transported to hospital with the iron angle in situ. Positioning the patient for intubation proved a major challenge. An unconventional position for intubation allowed a successful airway management. Paucity of time prevented us from gauging the nature and extent of injury. The challenges posed by massive impalement could be successfully managed due to rapid pre-hospital transfer and co-ordinated team effort.
authors.affiliation: Jay Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi-110029, India. drchhaavisawhney@gmail.com
authors.forename: Chhavi
authors.initials: C
authors.lastname: Sawhney
authors.forename: Nita
authors.initials: N
authors.lastname: D'souza
authors.forename: Biplab
authors.initials: B
authors.lastname: Mishra
authors.forename: Babita
authors.initials: B
authors.lastname: Gupta
authors.forename: Subir
authors.initials: S
authors.lastname: Das
mesh_terms: D000328:Adult; D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000503:physiopathology*; D014950:Wounds, Penetrating / Q000601:surgery*