Knives, rebar, glass piercing the body – apply pressure around the foreign object to stop bleeding; do not pull it out

40. Knives, rebar, glass piercing the body – apply pressure around the foreign object to stop bleeding; do not pull it out

Cost: No cost involved. The hard part is resisting the instinct to “pull it out” and instead staying with the injured person until help arrives.

In plain terms: Pulling out the object can cause severe bleeding and makes it harder for doctors to assess the extent of the injury. The correct approach is to call 120, then use your hand or a dressing to apply firm pressure around the object to control bleeding and keep it stable so it doesn’t move. If internal organs are visible through an abdominal wound, do not push them back in; simply cover them with a clean, moist dressing. For chest wounds where air bubbles are escaping, do not seal them with plastic wrap – doing so can cause the lung to collapse.

Benefit: The 2025 International First Aid Guidelines from the International Federation of Red Cross and Red Crescent Societies state: “First aiders should apply pressure around any foreign object (such as a knife) that has penetrated the body and keep it stable; do not remove it.” “Never pull any object out of abdominal or chest wounds – doing so can cause severe bleeding and makes it harder to assess the injury.” “Foreign objects embedded in the body should be kept stable; if they move with the pulse, simply hold them gently in place.” “First aiders must not push protruding organs back into the body.” For open chest wounds with active bleeding, “it is acceptable to leave them uncovered, as sealing them may trap air in the chest cavity and cause partial or total lung collapse (pneumothorax).” All penetrating abdominal or chest injuries require immediate emergency care.

Evidence grade: B

Sources: International Federation of Red Cross and Red Crescent Societies (2025). International First Aid, Resuscitation and Education Guidelines 2025, pp. 256–257, 267–268. <https://www.ifrc.org/sites/default/files/2026-03/IFRC%20International%20First%20Aid,%20Resuscitation%20and%20Education%20Guidelines%202025.pdf>

Notes: This grade is assigned because these actions are widely accepted in official guidelines; however, no randomized trials exist, and it would be unethical to randomly assign patients to “remove” versus “not remove” such objects. The sole exception is when a foreign object blocks the airway and prevents breathing. In such cases, go directly to the emergency triage desk at the hospital and state “penetrating injury.” This falls under the highest priority category – do not wait in line at the registration desk (see Section 24, Item 8). If a penetrating injury occurs, call 120; the ambulance will alert the hospital in advance. For techniques on controlling severe bleeding and applying tourniquets, see Section 12.