CONCLUSIONS
• Penetrating buttock trauma is a potentially life-threatening condition and should be treated as such according to local major trauma protocols.
• Initial management should be according to ATLS guidelines. Do not remove the foreign body without ensuring availability of resources to deal with complex abdominal or pelvic haemorrhage.
• Early transfer to a trauma centre is a key management consideration. Do not delay transfer for the sake of investigations which will not impact immediate management or transfer.
• Surgical intervention is a cornerstone for the management of impalement injuries.
• Northern Ireland specific guidance for major trauma transfer include the Call and Send Protocol and also the Major Trauma Triage Tool to reduce unnecessary delays in transfer.