A teenage boy sustains a puncture wound where a bicycle kickstand impales his leg. Which method is most appropriate?

• A. Unbolt the kickstand from the bike frame and stabilize it with bulky dressings.
• B. Remove the kickstand immediately and attempt to stop bleeding with direct pressure.
• C. Cut away the kickstand to prevent further injury.
• D. Apply a tourniquet above the wound.

Answer: (A)

The key idea is to prevent further injury by keeping the impaling object from moving. When something is embedded in tissue, you never remove it on the scene because pulling it out can worsen bleeding and damage nearby structures. In this case, unbolting the kickstand from the bike frame reduces any leverage or movement that could cause the object to shift during transport. After freeing the object from that anchor, you stabilize it in place with bulky dressings so it cannot move, and immobilize the limb to limit additional injury. Direct pressure is used around the wound to help control bleeding, but a tourniquet isn’t indicated here unless there is life-threatening arterial bleeding that cannot be controlled by other means.