fish hook back of the neck

If it was my child, I would push it through,cut off the barbs, and clean throughly.


If it was someone else's kids I would inform them of what the hospital would do, in detail (wouldn't tell them to do it, I would just be very descriptive with what they would do), offer transport, but let them know that there's nothing I can do as a medic.
 
C-collar, oxygen, position of comfort, lights and sirens to the hospital. Consider ALS intercept as well.
 
I'm obviously not as experienced as others on here, but since it is the BLS forum I'll throw in my $0.02.

Ensure an open airway and adequate breathing. Is the fish hook preventing this? Seems not. So focus on circulation.

Even though it is shallow, my training is to stabilize in place after controlling bleeding.

If the wound is not bleeding, wipe the area with a BZK wipe or with a soapy gauze followed by a wet gauze.

Don't wrap a bandage around the neck, but rather, alternating armpits with a figure 8. Tie a beautiful bow like you learned in class. :)

Continually reassess.

If the pt is shocky (abnormal VS, pale, cool, not PERL, whatever) strongly consider oxygen and an ALS intercept.

I'd argue against a C collar because it interferes against the C on ABC.

I would not be comfortable releasing this patient but I am hopelessly cautious
 
Lidocaine!

Aka: prep site, infiltrate lidocaine (plain is ok), push hook through skin, cut barb, pull hook back through.

Make sure tetanus is up do date. Apply some polymixin b ointment and refer for follow up.

THIS is why BLS drives me insane. This is about as fricken basic as you can get re fixing the issue....
 
Av8or007 said:
Lidocaine!

Aka: prep site, infiltrate lidocaine (plain is ok), push hook through skin, cut barb, pull hook back through.

Make sure tetanus is up do date. Apply some polymixin b ointment and refer for follow up.

THIS is why BLS drives me insane. This is about as fricken basic as you can get re fixing the issue....
Click to expand...

I'm confused. Why does BLS drive you insane?
 
Because in 90% of cases it is either not beneficial, prolongs the problem, or in some cases can be downright harmful (due to the way it is taught mostly).

Combined with the fact that even for the 'true emergencies' that are relatively rare, they can't do crap to address the problem in most cases.

Add to that the fact that pain control and non emergent symptom relief (e.g. antiemetics) is nonexistent or horrible and yeah...

Stuff that is considered really really basic medicine is considered 'too advanced' - think IM injections as an example.

And on top of all of this, the education for BLS is downright awful..

(BLS in this case is EMT-B/EMR, not a PCP - although pcp has many of the same issues)

In this case, a 10-15 minute procedure would solve the issue once and for all - rather than taking up an ED or urgent care bed.
 
Here's a thought: Removing a fish hook is taught in the Boy Scouts. Simply push the barb through the skin, snip it off, and then pull it out and apply a bandage.

So if it's taught by the Scouts, shouldn't we be able to do the same in EMS? #problemsolved
 
TheLocalMedic said:
Here's a thought: Removing a fish hook is taught in the Boy Scouts. Simply push the barb through the skin, snip it off, and then pull it out and apply a bandage.

So if it's taught by the Scouts, shouldn't we be able to do the same in EMS? #problemsolved
Click to expand...
Agreed. If its in the scope of practice of a bunch on snot-nosed 12 year olds with zero medical training, its definitely in the BLS scope of practice.
 
Ishan said:
I'm obviously not as experienced as others on here, but since it is the BLS forum I'll throw in my $0.02.

Ensure an open airway and adequate breathing. Is the fish hook preventing this? Seems not. So focus on circulation.

Even though it is shallow, my training is to stabilize in place after controlling bleeding.

If the wound is not bleeding, wipe the area with a BZK wipe or with a soapy gauze followed by a wet gauze.

Don't wrap a bandage around the neck, but rather, alternating armpits with a figure 8. Tie a beautiful bow like you learned in class. :)

Continually reassess.

If the pt is shocky (abnormal VS, pale, cool, not PERL, whatever) strongly consider oxygen and an ALS intercept.

I'd argue against a C collar because it interferes against the C on ABC.

I would not be comfortable releasing this patient but I am hopelessly cautious
Click to expand...
We are talking a fishhook and not a boat anchor, correct?
 
Tigger said:
We are talking a fishhook and not a boat anchor, correct?
Click to expand...

Not that I would know the difference, but I imagined a sharp barbed wire kind of thing sticking in one side and out the other
 
redundantbassist said:
Agreed. If its in the scope of practice of a bunch on snot-nosed 12 year olds with zero medical training, its definitely in the BLS scope of practice.
Click to expand...

I agree we need a Better scope.

Although I can, most EMTs can't even give out OTC Meds.

still a bit undecided on the Boy Scouts though.
 
TheLocalMedic said:
Here's a thought: Removing a fish hook is taught in the Boy Scouts. Simply push the barb through the skin, snip it off, and then pull it out and apply a bandage.

So if it's taught by the Scouts, shouldn't we be able to do the same in EMS? #problemsolved
Click to expand...
shouldn't it be? absolutely, as should many other things that are taught in the boy scouts manual (as well as many other common sense things).

Is it? well, show me some documentation showing where I can read it as being in the BLS scope of practice, and I will gladly agree with you
 
A lot of the material for first aid and other stuff, typically infers that you are not in an area with quick medical access and the ability to get help involves that they are already looking for you. Thus Boy Scouts were still being taught tourniquets when they had fallen out of favor in the prehospital environment, simply because there was no quick access to definitive care. When I was in the Boy Scouts we did lots of backpacking, and at times we were a day or more from seeing anybody else, and more than likely at least one to three days depending where we were from even getting to a road to find someone to get help. While some stuff is common sense enough to have in the EMT scope, I wouldn't say everything that is in the Boy Scout Manuel should be a part of the scope.
 
Are there any fans of the string method for removing fish hooks?
 
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