Emergency Medical Technician (EMT) Intermediate Practice Exam

What should be done when encountering a pulseless and apneic patient with an impaled knife in the center of his chest?

1. Leave the knife in place and start CPR

2. Carefully remove the knife and control the bleeding

3. Apply a dressing and transport immediately

4. Perform chest compressions without removing the knife

The correct answer is: Carefully remove the knife and control the bleeding

In cases of trauma where a patient is found to be pulseless and apneic, especially with a foreign object like a knife impaled in the chest, it is crucial to understand the potential benefits and risks of removing the object. The correct approach is to leave the impaled object in place; removing it can lead to further injury or significant bleeding, as it may be tamponading a major vessel or preventing air from entering the thoracic cavity. Immediate initiation of CPR is essential for patients who are pulseless and apneic, but properly addressing the impaled object is also vital in minimizing additional harm. In this scenario, applying a dressing around the impaled object could help control bleeding and protect the wound until the patient can be transported to a higher level of care. B is not the best answer here because while it highlights the need to control bleeding, it suggests removing the knife. The correct action involves maintaining the knife's position and instead addressing the other critical tasks, such as applying a dressing and starting CPR if necessary. Thus, the focus should be on securing the patient's condition and managing the impalement appropriately according to established protocols.