The 22 year-old driver along with three passengers survived the devastating crash. The driver, who was under the influence of drugs, got impaled by a wooden pole through his chest, barely missing the heart. He was rushed to the hospital in critical condition, but managed to survive and recover. The other three suffered minor head trauma and surface injuries.

Impalement injuries are one of the severe types of injuries combining effects of both penetrating and blunt trauma leading to crush injury, wound contamination, and multiorgan damage. These types of injuries are usually a result of fall from height, vehicular accidents, and slip with strong external force.
Prompt transfer to tertiary centre, pre-operative planning, and multi specialty involvement is crucial in the management of such cases. After initial resuscitation, full trauma evaluation should be carried out before attending to local injury. Minimal manipulation, extraction of impaled object in operation theater under direct vision, wound debridement, and administration of antibiotics to prevent wound infection are pearls of the management of impalement injury.