The patient with penetrating injuries

Penetrating injuries may be arbitrarily divided into wounds caused by sharp instruments, wounds caused by firearms, and impalements. Worldwide, stab wounds cause the greatest number of penetrating trauma casualties. In certain parts of the world, including the United States, the majority of penetrating wounds are caused by firearms [1]. Regardless of their etiology, most penetrating wounds result from interpersonal violence or violence that is self-inflicted. This fact has profound significance to prehospital rescue personnel, who usually have little initial insight into the circumstances surrounding the incident and who may be at considerable risk if the perpetrator(s) remain in the immediate vicinity. Coordination of rescue efforts between and among rescue personnel, law enforcement officials, and others in the community may be required to enable rescue efforts to safely proceed. While Do no harm may be the time-honored rule of trauma care, Protect thyself is always the first rule for the prehospital rescuers, who cannot do their job if they, too, fall victim to violence.