PENETRATING INJURY

Common objects causing injury are knives, arrows, spears, and bullets. The objective of management is to restore normal anatomy or physiology resulting from the stab injury.

Investigations

  • For the majority of cases, the chest radiograph alone is adequate.
  • Specialized investigations are ordered where more detail required.

Management

  • Clean wounds and apply clean dressing to wounds. Tetanus toxoid 0.5ml STAT.
  • Make sure resuscitation measures continue during transportation.
  • If the implement used during stabbing is still in situ, DO NOT remove.
    Advisable this be removed only in a controlled setting like in theatre. For referral, stabilize this by surrounding with heavy dressing or other cloth like material.
  • If available, insert chest tube.
  • Drain pleural collections using chest tube, which will suffice for most injuries.
  • Conduct surgical intervention to stop bleeding that continues, or correct significant anatomical or physiological anomalies. (This is applicable for only about 5% of cases.)