You are correct. In the field environment, removal of an impaled foreign body from the extremities is relatively unsafe, due to the risk of additional trauma like a neurovascular injury. It can also cause uncontrolled bleeding, especially in a pt taking an anticoagulant.

The paramedics unscrewed the door handle from the door and transferred the pt to the ED, w/ the handle still attached to the finger. Although it’s been suggested that wound debridement, washout, and exploration should be performed for impaled objects while the pt is under adequate anesthesia in the OR, this pt was treated conservatively in the ED, w/ a digital nerve block, foreign-body removal, and irrigation. His tetanus vaccination was updated, and a prophylactic antibiotic (amoxicillin/clavulanate) was given. The pt regained good hand fxn after PT, and at f/u, the wound had healed unremarkably.

BMJ Case Reports CP 2020;13:e239234