Impalement & Embedded Objects

Rebar, nails, tools, glass, wood and metal fragments can stab into the body and stay there. The most important rule is simple: do not pull the object out. The object may be plugging a wound that would otherwise bleed heavily, and pulling it can damage nerves, vessels and organs. Stabilize it, control bleeding, and get emergency help.

• Construction Workers
• Farm & Shop Workers
• First Aiders
• Everyone

What to do first

1. Call 911 (or your local emergency number) right away, or have someone call, and say there is an impalement. See Calling 911 & Giving Your Location.
2. Keep the person still. Movement can push the object deeper or shift it. Tell them to stay as calm and motionless as possible, and don't let them walk or climb.
3. Do not remove the object. The exception is an object blocking the airway that you can safely clear, or if you must move the person for CPR and the object prevents it. In nearly every other case, leave it in place for the hospital.
4. Protect yourself: wear gloves if you have them and avoid blood contact. See Bloodborne Pathogens.
5. Check the scene for danger first (falling objects, live power, unstable structures). See First Aid Basics.
6. Watch for breathing and responsiveness and start CPR if needed. See CPR & AED.

Stabilize the object and control bleeding

• Use bulky dressings, gauze rolls or clean cloth to pack gently around the object, so it can't move. Tape or wrap dressings in place with bandages around the object, not over it, to hold it still.
• Apply pressure around the edges of the wound to control bleeding, not directly on the object. If the object is short, you may press on the sides of it.
• Don't press on the object or push it deeper. Don't probe the wound, or wash deep wounds in a way that moves the object.
• If bleeding is severe, see Bleeding Control. A tourniquet may be used for a limb wound with life-threatening bleeding that can't be controlled, applied above the wound.
• Support the object during any movement, such as a transfer to a stretcher, so it doesn't shift.
• If the object is very long or awkward and it must be cut to move or transport the person, leave this to trained rescuers and fire department tools. They stabilize it to prevent movement and vibration, cut it a safe distance from the body and leave the part inside for the hospital. See Crush Injuries for related rescue.

Special situations

• Chest or abdomen: don't remove the object. A chest wound can cause breathing trouble. Keep the person sitting up or in the position they find easiest, and watch for shock. Don't push intestines or organs back in. See Shock.
• Neck or head: keep the head and neck still and call 911. Don't move the person unless unsafe. See Head Injuries and Spinal Injuries.
• Eye: do not remove the object or press on the eye. Cover the object with a paper cup or shield taped around the eye so nothing touches it, and cover the other eye if advised to limit eye movement. See Eye Injuries.
• Hand or foot: leave nails, hooks or other objects in place, stabilize with padding and get medical care. See Puncture Wounds.
• Person impaled on rebar or a fixed object: keep them still and call the fire department and 911. Rescuers will cut the object free with the person attached. Don't try to lift them off. Stay calm and talk to them.
• Children: keep calm and reassure them; they may need to be held still.

Shock and monitoring

• Treat for shock: keep the person lying down if possible (unless chest or breathing problems make sitting more comfortable), cover with a blanket and keep warm, and don't give food or drink. See Shock.
• Watch breathing, color, alertness and bleeding until help arrives. Note the time of the injury and what happened.
• Keep talking and reassure. Stay with the person.
• Tell responders what the object is, how long it has been in and what was done. If the object is a tool, chemical-covered item or contaminated, tell them.

After the emergency

• All embedded-object injuries need medical care and often surgery, a tetanus check and antibiotics. See Puncture Wounds.
• Investigate the cause and fix it: cap rebar, guard sharp objects, clear the site, wear proper PPE and use fall protection. See Incident Investigation and Rebar & Ironworkers.
• Impaled workers, and those who witnessed it, may need emotional support. See Post-Incident Stress.
• Report serious injuries to OSHA when required (in-patient hospitalization within 24 hours). See Recordkeeping & Reporting.

Impalement checklist

• I called 911 and kept the person still
• I did NOT pull the object out
• I padded and wrapped around the object to stabilize it and controlled bleeding at the edges
• I treated for shock and watched breathing until help came
• For an eye injury, I covered the object with a cup or shield without pressing

Last updated: October 5, 2026