fish hook back of the neck

EMS Fanatic

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Hello I was curious on how you would handle a call for a 15 year old with a fish hook stuck In the back of his neck. Both barbs penetrated the skin. I'm thinking normal saline to wash injury then 4×4 then wrap with roller gauze. Any suggestions?
 

EMSComeLately

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Yup...stabilize impaled object and transport. Of course, you wouldn't want to wrap kerlex around the kids neck just to stabilize. A pad with tape non circumferential is fine too.
 

chaz90

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Eh, "stabilizing" something as small as a fish hook is likely overrated. You'd likely cause more movement and pain when wrapping it. Position of comfort, wash out contamination if obvious, and transport. Pain meds PRN.
 

Medic Tim

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Remove it. Clean it up, Suture if needed, and bandage. Maybe a tetanus shot and abx. Scheduled a follow up for a couple days or refer to pts doctor for a follow up.
 

NomadicMedic

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It it were my kid, I'd use a pair of dykes to clip the barbs, slide the shank out, put a dab of triple antibiotic and a bandaid on it and keep fishing.

If I was CALLED to this scene, I'd use a KED, pelvic binder, MAST trousers and call for a helicopter.

...Or maybe I'd gently and kindly suggest that mom and dad drive their kid to the urgent care or ER and save a medic unit for people who need one.
 

jgray92

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you forgot the morphine! lol Them fishin hooks are painful.
 

jgray92

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Would you transport though in this situation?
 

Medic Tim

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Barring any complications removing it... This would be a treat and release or a treat and refer for me.
The typical 911 call answer is .... If they want to go you take them.

I would also prefer entonox or ketamine for the sedation... If it was needed.
 

jgray92

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Fair enough, thank you for the answer.
as far as ketamine goes, it is good stuff. I've only ever seen it used once on a combative patient in the ER, they went out pretty quickly.
 

ERDoc

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Pretty much what Medic Tim said. There really is nothing for EMS to do in a case like this. You really don't need much more than some local Lido and a tetanus.
 

DrParasite

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Hello I was curious on how you would handle a call for a 15 year old with a fish hook stuck In the back of his neck. Both barbs penetrated the skin. I'm thinking normal saline to wash injury then 4×4 then wrap with roller gauze. Any suggestions?
wait, through and through (the barbs came in and back out), or are they embedded in the skin?

if through and through, I'd cut the barb off, remove the hooks (hopefully with something I can find in my toolbox), control any bleeding (probably with a bandaid), and transport to the ER for a tetnus shot.

If it was embedded in the skin, cover with a 4x4, maybe some tape, and have the kid walk to the ambulance, and take an nice easy ride to the ER
 

Akulahawk

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Well, a fish hook embedded in the back of a neck is a whole lot better than one embedded in a tongue...
 

gotbeerz001

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The hook was embedded in the skin no barbs showing just the eyelet.
The hospital will push it through, clip the barbs and remove; same as one would on the dock. It can be done with or without a local anesthetic. As mentioned, tetanus shot would be the biggest issue overall... This is a superficial/very minor injury.
 

DesertMedic66

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Ask the kid if he caught anything. Let the parents know my treatment plan "hey mom and dad, I am not going to do anything at all for your kid. I'm just going to act like an expensive taxi and he may go directly to the lobby at the ED. So what would you like to do? We can take him by ambulance, you can drive him to an urgent care, or you can drive him to the ED."
 
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