On Wednesday, I put up a video scenario and invited you to consider what you would do. I have to admit, this injury makes my skin crawl just a little. Taking a fishhook anywhere is terrible; taking one through the upper lip is just not fair. Ughhh…
The story behind this #wwydwednesday is that I’ve been teaching myself to fly fish. I figure learning a new skill is good for the brain, much like a cross word puzzle or sudoku. I’m just better at waving a fishing rod in the air than doing math puzzles. I’m positive that the odds of me taking a fishhook during this process are pretty good; not so much if, but when. So, I decided to do a little prep.
At any rate, if you haven’t had a chance to watch the video yet, take a few moments and do so now. Don’t cheat! Only watch until about minute four!
So, what are some things that I notice:
That’s a big hook!
Looks like it caught him on the inside of the lip; I don’t see significant bleeding, and I don’t see tongue involvement.
Looks like fresh water.
So, what are we going to do about this? My first consideration is always airway. In this case, while we are dealing with a foreign object in close proximity to the airway, and since there is the potential for bleeding, there is potential for compromise. Luckily I don’t see any airway compromise at this point. If there was, I’d position the patient probably on his side to allow blood and saliva to drain.
For that, I’m going to give you another video! This guy places four hooks in his arm, and then demonstrates four different ways of removing them; take a look!
So, fishhooks are designed to catch onto fish and not to let go. To that end, they generally have a barb designed to keep the hook from backing out. Removing a hook requires you to defeat that barb. So, now you may watch the rest of the video! These guys go with the “push the barb through the skin and clip it off” technique. Given the amount of tissue between the barb and the surface, this probably wasn’t the worst option.
After the hook is out, we move into wound care. A little bit of pressure with some gauze will stop the bleeding. We also want to clean the area as best as possible; now, we don’t want to pressure irrigate down into a puncture. It may push bacteria down into the wound. I would suggest a mouth rinse instead; either a commercial product or even just some weak salt water.
I would also recommend this guy be seen by a doc for some antibiotics, especially since we don’t know how clean that fishhook was!