Sledge Hammer Impalement: a case report of challenges of managing a patient with a heavy pendant

Highlights

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  This patient suffered an impalement injury by falling on the upright handle of a sledge hammer.

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  The hammer head was too heavy for patient transport hence patient was fixed to small sized but heavy hammer head.

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  Patient had to be moved simultaneously with the sledge hammer.

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  We argue that this meets the definition criteria for transfixion injury.

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  We propose that transfixion injury be defined in terms of weight of the impaling object relative to the weight of the patient and ability to mobilize the patient and not necessarily by size of the impaling object.

Abstract

Introduction

Impalement injuries are well defined. Transfixion injuries involve impalement and are defined in terms of fixation usually to a large object.

Case Report

We report a spectacular case of sledge hammer impalement in the neck where the patient was transfixed, albeit to a small object, requiring movement of the patient and the transfixing object as a single unit.

Discussion

The patient was fixed to the head of the sledge hammer because he was unable to move with the heavy pendant.

Conclusion

We argue that transfixion injuries should be defined in terms of weight of the object in relation to the patient‘s weight and the ability of the patient to move (with) the impaling object.