RT Journal Article SR Electronic T1 Crowbar impalement: the PHEM perspective JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e227293 DO 10.1136/bcr-2018-227293 VO 11 IS 1 A1 Saad Jawaid A1 Dan Cody YR 2018 UL http://casereports.bmj.com/content/11/1/e227293.abstract AB A man in his 50s suffered an impalement on a crowbar after falling from the roof of a domestic shed. A helicopter-based prehospital emergency medical service team was called to assist in the patient’s care. The crowbar had entered from the left-upper quadrant and was tenting the skin of the right iliac fossa. Analgesia and prehospital sedation were provided to facilitate extrication. A series of improvisations were carried out to support the logistics of transferring the patient using an air ambulance to the regional major trauma centre with the crowbar in situ. The patient was taken to the operating theatre without any imaging and a section of perforated bowel was removed. He made a full recovery and was discharged home 9 days postincident.