EMS Tips

Reader Question: Impaled Metal Object, Traumatic Arrest

What would you do?

“A patient has been impaled on a rod on an iron fence which has gone straight through the body. Would it be advised to shock this patient in cardiac arrest with an AED? Or would the shock be contradictory due to the metal object in said patient’s body?”

My Thoughts

1. The patient is not likely to have a shockable rhythm – vfib or vtach.

2. The patient with penetrating trauma as described likely has injuries incompatible with life.

3. Lots of patient’s have metal in their body – surgical plates for fractures, implanted pace makers, bullets not removed from previous injuries, etc. The likely issue is not the metal in the body but the conduction of electricity through the metal rod.

Your Thoughts?

This question is the classic classroom zebra. What would you do? Have you ever heard of an actual case like this?


By Greg Friese

Greg Friese, Stevens Point, Wisconsin, is an author, educator, paramedic, and marathon runner.

Greg was the co-host of the award winning EMSEduCast podcast, the only podcast by and for EMS educators. Greg has written for,, Wilderness Medical Associates, JEMS Magazine, and EMS World Magazine, and the NAEMSE Educator Newsletter.