What should be done with a knife impaled in a patient's chest who is unresponsive and pulseless?

When dealing with an unresponsive and pulseless patient who has an impaled knife in the chest, stabilizing the knife and beginning cardiopulmonary resuscitation (CPR) is critical for several reasons.

First, removing the knife could cause further injury and lead to increased hemorrhaging. The knife may be acting as a tamponade, limiting bleeding from the wound; thus, disturbing it could exacerbate the situation.

By stabilizing the knife, you maximize the chances of maintaining some level of control over the bleeding while simultaneously facilitating ongoing resuscitation efforts. The initiation of CPR is essential as the patient is pulseless, indicating a lack of effective cardiac activity. The priority is to provide circulation through chest compressions, which can help deliver some oxygenated blood to vital organs until advanced medical help can be provided.

Other options involve actions that could potentially worsen the condition of the patient or delay critical interventions. For instance, attempting to remove the knife or perform actions unrelated to CPR do not address the immediacy of the patient’s pulseless state and could hinder the chances of survival. Thus, stabilizing the knife and commencing CPR ensures that the two main priorities—controlling the situation and restoring circulation—are effectively