Book contents
- Cases in Simulated Disaster Medicine
- Reviews
- Cases in Simulated Disaster Medicine
- Copyright page
- Contents
- Contributors
- Section 1Introductory Chapters
- Section 2Geophysical Natural Disasters
- Section 3Meteorological Natural Disasters
- Case 9Delayed Blunt Trauma Sustained during Debris Removal after Hurricane
- Case 10Sheltering in the Storm
- Case 11“I Lost My Medications”
- Case 12Tornado Bloodbath
- Case 13Tornado Chasing Gone Wrong
- Case 14Tornado in the Farmland
- Case 15Stranded in the Heat
- Case 16Out Cold
- Case 17An Invisible Killer
- Section 4Hydrological Natural Disasters
- Section 5Climatological Natural Disasters
- Section 6Biological Natural Disasters
- Section 7Technological Disasters
- Section 8Terrorism-Related Disasters
- Section 9Mass Casualty Incident
- Index
- References
Case 13 - Tornado Chasing Gone Wrong
Managing Patients with Impaled Objects in the Emergency Department
from Section 3 - Meteorological Natural Disasters
Published online by Cambridge University Press: 06 February 2026
Book contents
- Cases in Simulated Disaster Medicine
- Reviews
- Cases in Simulated Disaster Medicine
- Copyright page
- Contents
- Contributors
- Section 1Introductory Chapters
- Section 2Geophysical Natural Disasters
- Section 3Meteorological Natural Disasters
- Case 9Delayed Blunt Trauma Sustained during Debris Removal after Hurricane
- Case 10Sheltering in the Storm
- Case 11“I Lost My Medications”
- Case 12Tornado Bloodbath
- Case 13Tornado Chasing Gone Wrong
- Case 14Tornado in the Farmland
- Case 15Stranded in the Heat
- Case 16Out Cold
- Case 17An Invisible Killer
- Section 4Hydrological Natural Disasters
- Section 5Climatological Natural Disasters
- Section 6Biological Natural Disasters
- Section 7Technological Disasters
- Section 8Terrorism-Related Disasters
- Section 9Mass Casualty Incident
- Index
- References
Summary
A 50-year-old storm chaser documenting a tornado faces a life-threatening injury when the tornado propels his vehicle, causing a large metal object to pierce his abdomen. He arrives at the emergency department (ED) with the metal embedded in his abdomen, leading to significant distress and clinical deterioration. Upon arrival, he presents with tachycardia, hypoxia, and hypotension and is diagnosed with a tension pneumothorax, requiring immediate needle decompression and chest tube insertion. In addition to a hemopneumothorax, the FAST exam reveals free fluid in the peritoneal cavity. In the ED, the trauma team must navigate complex challenges, including managing the impaled object, performing a primary and secondary survey, and addressing the tension pneumothorax promptly.
Keywords
Information
- Type
- Chapter
- Information
- Cases in Simulated Disaster Medicine , pp. 98 - 102Publisher: Cambridge University PressPrint publication year: 2026
References
Barlotta, KS, Stack, LB, Knoop, KJ. Impaled foreign body. In: Knoop, KJ, Stack, LB, Storrow, AB, Thurman, R. eds. The Atlas of Emergency Medicine. 5th ed. New York: McGraw Hill; 2021. https://accessmedicine.mhmedical.com/content.aspx?bookid=2969§ionid=250456692. Accessed June 29, 2022.Google Scholar
Muhammad Afzal, R, Armughan, M, Javed, MW, Rizvi, UA, Naseem, S. Thoracic impalement injury: a survivor with large metallic object in-situ. Chin J Traumatol. 2018 Dec;21(6):369–372. doi: 10.1016/j.cjtee.2018.08.002. Epub 2018 Sep 20. PMID: 30348473; PMCID: PMC6354130.CrossRefGoogle ScholarPubMed
Accessibility standard: Inaccessible, or known limited accessibility
Why this information is here
This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.Accessibility Information
The HTML of this chapter is known to have missing or limited accessibility features. We may be reviewing its accessibility for future improvement, but final compliance is not yet assured and may be subject to legal exceptions. If you have any questions, please contact accessibility@cambridge.org.
Content Navigation
Table of contents navigation
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.
Index navigation
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.
Reading Order & Textual Equivalents
Single logical reading order
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.
Full alternative textual descriptions
You get more than just short alt text: you have comprehensive text equivalents, transcripts, captions, or audio descriptions for substantial non‐text content, which is especially helpful for complex visuals or multimedia.
You get more than just short alt text: you have comprehensive text equivalents, transcripts, captions, or audio descriptions for substantial non‐text content, which is especially helpful for complex visuals or multimedia.
Visualised data also available as non-graphical data
You can access graphs or charts in a text or tabular format, so you are not excluded if you cannot process visual displays.
You can access graphs or charts in a text or tabular format, so you are not excluded if you cannot process visual displays.
Visual Accessibility
Use of colour is not sole means of conveying information
You will still understand key ideas or prompts without relying solely on colour, which is especially helpful if you have colour vision deficiencies.
You will still understand key ideas or prompts without relying solely on colour, which is especially helpful if you have colour vision deficiencies.
Use of high contrast between text and background colour
You benefit from high‐contrast text, which improves legibility if you have low vision or if you are reading in less‐than‐ideal lighting conditions.
You benefit from high‐contrast text, which improves legibility if you have low vision or if you are reading in less‐than‐ideal lighting conditions.