A woman stabbed her boyfriend in the cheek with a dinner fork; you should:

• A. Apply high-flow oxygen via a nonrebreathing mask, carefully remove the fork, and control any external bleeding.
• B. Suction his oropharynx, carefully cut the fork to make it shorter, control any external bleeding, and secure the fork in place.
• C. Carefully remove the fork, suction his oropharynx as needed, and pack the inside of his cheek with sterile gauze pads.
• D. Suction his oropharynx, control any external bleeding, stabilize the fork in place, and protect it with bulky dressings.

Answer: (D)

The key idea is how to handle an impaled object in facial tissue while protecting the airway. Start by keeping the airway clear; suction as needed to prevent blood or secretions from obstructing the airway. Do not remove or cut the fork—the object may be tamponading vessels and its removal could worsen bleeding or cause further injury. Instead, control any external bleeding with direct pressure around the wound, then stabilize the fork in its current position to prevent movement during transport. Protect the area with bulky dressings to immobilize the object and cushion surrounding tissues. This approach preserves airway safety, minimizes additional harm, and safely moves the patient for definitive care.