Impalement injuries result from penetration of fixed elongated objects through the body.
Thoracic impalement injuries are rare but often dramatic in presentation.

People get impaled in vehicular accidents, falls onto elongated objects and by missiles like arrows and spears.

The most bizarre mechanism I have come across is one in which a locally manufactured rifle exploded and ejected its barrel in retrograde fashion to impale the shooter’s chest. The victim was aiming at a bird perched on a tree but when he pulled the trigger, he became the hunted rather than the hunter.

Victims must be transported to a facility where surgery can be performed. Whatever you do, do not remove the impaling object; the victim may bleed to death as a result. Do not believe what you see in the films - heroic measures to extract impaling objects at the site of injury; it's a film of course! You may need to trim the impaling object to facilitate the victims transfer to hospital but go no further.If the victim arrives in hospital, he is likely to live in the hands of a trained thoracic team.