An arrow embedded in a person should not be pulled out in the field. The arrow itself may be plugging a damaged blood vessel, and removing it without surgical support can cause life-threatening bleeding. The correct first response is to stabilize the arrow in place, prevent movement, and get to an emergency room as fast as possible.
This principle has been understood since ancient medicine. The Greek physician Celsus, writing two thousand years ago, devoted an entire chapter to arrow wounds and recognized that yanking an arrow backward through tissue was far more dangerous than other approaches. Modern trauma surgery follows the same logic, with the added advantage of imaging technology to guide the process.
Why You Should Never Pull It Out Yourself
Arrows cause a unique type of injury. Unlike bullets, which travel through tissue and stop, an arrow stays connected to a rigid shaft that transmits every bump and movement directly into the wound. The arrowhead may be resting against bone, sitting near a major blood vessel, or lodged in tissue that will tear further if the arrow is dragged backward through it.
Broadhead arrows, the type used in hunting, have wide cutting blades designed to slice tissue. Pulling one backward drags those blades through flesh a second time, widening the wound channel. Even a simple target point can snag on muscle or connective tissue during removal. The biggest risk is hemorrhage: if the arrow is physically pressing against a damaged artery, it acts like a plug. Remove it without the ability to clamp or repair that vessel, and bleeding can become fatal within minutes.
How to Stabilize an Arrow in the Field
If someone has been struck by an arrow, your job is stabilization, not extraction. Shorten the shaft if it’s long enough to catch on things during transport, but do not pull, twist, or push the arrow deeper. Cut the shaft several inches above the skin using a saw or heavy-duty cutters, keeping the arrow as still as possible while you work.
Pack bulky dressings, clothing, or rolled bandages around the base of the arrow where it enters the skin. The goal is to build a nest of padding that prevents the shaft from shifting in any direction. Tape or wrap the padding firmly in place without putting pressure on the arrow itself. Keep the person as still as you can and call for emergency medical services immediately. If you’re in a remote area, evacuate toward the nearest hospital with surgical capability.
How Surgeons Remove Arrows
In a hospital, the first step is imaging. Doctors use X-rays and CT scans to map exactly where the arrowhead sits, whether it has hit bone, and how close it is to major blood vessels or organs. In some cases, a CT angiogram (a scan that highlights blood vessels) is used to check whether an artery is involved.
Once the surgical team knows what they’re dealing with, they choose one of two approaches: pulling the arrow back the way it entered, or pushing it forward through the body so it exits the other side. The push-through method has been preferred since antiquity because it avoids dragging the arrowhead’s widest point backward through damaged tissue. When pushing through, the shaft is lubricated and pressed firmly from its base. As the tip becomes visible under the skin on the opposite side, a small incision releases it. The surgeon confirms the entire arrowhead has cleared the wound before removing the rest of the shaft.
Pulling back is sometimes the only option, particularly when the arrow hasn’t penetrated deeply or when pushing it forward would send it through dangerous structures. The decision depends on depth, arrowhead type, and what organs or vessels lie in the path. Arrows lodged in or near the skull pose an extreme challenge. In one published case, an arrow entered the skull with its tip resting near the brainstem, making extraction in either direction extraordinarily risky.
If any fragment of the arrowhead is suspected to remain inside the wound after extraction, surgeons place a drain to prevent the buildup of infection.
Infection Risk After an Arrow Wound
Arrow wounds carry a real infection risk. The arrow passes through skin, clothing, and possibly soil or animal matter before entering the body, depositing bacteria deep into tissue where the immune system has a harder time reaching. This is a textbook “dirty wound” by CDC standards.
Tetanus is one of the primary concerns. The CDC recommends a tetanus booster for anyone with a penetrating or puncture wound who hasn’t been vaccinated in the last five years, or whose vaccination history is incomplete or unknown. If you’re treated for an arrow injury, expect the medical team to ask about your last tetanus shot.
Antibiotics aren’t automatically given for every puncture wound that only involves soft tissue. However, arrow injuries often involve deeper structures, contamination from the environment, or tissue damage that raises infection risk above a simple stab wound. When antibiotics are prescribed for penetrating injuries, they’re typically a short course lasting anywhere from 24 hours to several days depending on the severity. Soil contamination, which is common in outdoor hunting accidents, raises the risk of specific bacterial infections that require targeted treatment.
Wound Care After Removal
After the arrow is out, the wound track needs thorough cleaning. The standard approach is irrigation with sterile saline or clean tap water (both are equally safe for wound cleaning) using a large syringe that generates enough pressure to flush out bacteria and debris. The full depth and extent of the wound is exposed and irrigated, then irrigated again after any damaged tissue is trimmed away.
Deep arrow wounds are generally not stitched closed immediately. Sealing a deep puncture wound traps bacteria inside and dramatically increases infection risk. Instead, the wound is packed with dressing material and allowed to heal gradually from the inside out, with regular dressing changes. Shallow entry wounds may be closed once the medical team is confident the wound is clean.
Recovery time depends on what the arrow hit. A wound through soft tissue with no involvement of bone, nerves, or major vessels may heal in a few weeks. Injuries involving organs, joints, or fractures can require additional surgeries and months of rehabilitation.
Removing an Arrow From Game Animals
If you’re a hunter looking to remove an arrow from harvested game, the principles are simpler since you’re processing meat rather than preserving life. For a pass-through shot where the arrow exited the animal, retrieval is just a matter of finding the arrow on the ground. When the arrow is still embedded, push it through in the direction it was traveling rather than pulling it backward. This is especially important with broadheads, which will slice more tissue and potentially damage meat if dragged back through the wound channel. If the arrow hit bone and won’t push through, carefully cut the tissue around the shaft and work the broadhead free. Wear gloves to protect your hands from the blades.