A teenage patient comes into the emergency department with an arrow lodged in his right lower thoracic region. Which of the following should be done until the missile can be safely removed?
1. stabilize the arrow by padding around the wound with gauze rolls
2. slowly move the arrow to the left and right to attempt to dislodge it
3. slowly rotate the arrow to attempt to dislodge it
4. have the patient assume a left side lying position and pull on the arrow to remove it
1
Rationale: If the offending weapon is impaled in the body, it is critical that the object be left in place and protected from further movement until definitive surgical intervention is available. Protective padding can be placed around the object, such as gauze rolls or abdominal pads. The nurse should stabilize the arrow by padding around the wound with gauze rolls. The nurse should not move the arrow to the left and right or rotate the arrow since impaled objects may actually be controlling hemorrhage from damaged structures and removal may precipitate exsanguination. The nurse should not pull on the arrow to attempt to remove it.
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