pull the thing out point-first, a whisker from his carotid

[meliss]

"In one house, Dice takes a spear square in the b*ll*cks. Getting him out costs Little Red his ear and a machate dart—a cane arrow with a particularly wicked type of warhead—up under his jaw. We have to cut the head off with iron pliers and pull the thing out point-first, a whisker from his carotid." (The Afghan Campaign by Steven Pressfield)
Hi, maybe I should separate my question in two threads, but I can't figure out the whole process: how was the spear warhead pulling out point-first (its point first?) and what for, if no one can survive with a damaged carotid artery?

 

[Tarheel]

They didn't damage the carotid artery. They did have to be careful though because the arrowhead was so close to the carotid artery. How they got it out point first I do not know.

 

[Skrej]

They likely had to go ahead and push the arrowhead on though the skin the direction it was traveling until they could grab the tip and pull it on out after breaking the head off the shaft. You sometimes have to make an incision to assist the point in breaking the skin. Of course it would be extra dangerous to cut so close to a major artery.

However, it sounds like they were just pulling and yanking, so it'd be real easy to slip and nick the carotid with the arrow head itself.