Baja Medical Emergency, Hooked in to Help

[Larry]

Great job Lance!

I tell ya, I have a new found respect for RN’s and everybody that work in the medical industry. My 64 year old dad just had a major Pontine Hemorrhagic Stroke over Memorial Day weekend and is still in ICU. Over the past 17 days my family has learned more about strokes and medical industry than ever imaginable. My dad is not doing well which is a long story but it is sure not for the efforts the Doctors and ICU RN’s are putting into his recovery. In fact, I am extremely impressed with the knowledge and professionalism the countless RN’s we have spoken to over the past few weeks…most of which, have been far more helpful than the actual doctors when it comes to describing procedures, conditions, etc. Up until my dad’s issue, we have never had any major medical industry involvement and I never knew how important the RN’s role is in the grand scheme of things. I am so grateful so many talented people pursued careers in that medical industry! Thanks to all of you medical peeps out there!

Oh, I got a big fishhook stuck in my finger when I was a kid. All the way past barb too. The ER cut the hook and pulled through. It hurt like heck.

BTW...you know my buddy Bill from Pueblo. He met you in Moab a few weeks ago. He probably told you about the trip to Canyonlands we had planned the week of 6-7. Well, it was posponded due to my dad getting sick.

 

[Mr. Leary]

Anyways, people have accumulated a lot of knowledge on removing fish hooks. Ask an ER doc or a salt water fisherman if there was an alternate approach.

If there are alternate ways... I don't know about 'em... and I grew up on the coast...

Best way is the most straight forward way... the one Lance employed... Twist the hook through until the barb exits... clip it off... and pull back out... had to do that with a large hook in my foot before...

... and for a perfectly legal and multi use painkiller... Maker's Mark!

 

[1leglance]

Hey Larry,
Sorry to hear about your dad's medical condition, but glad to hear you are being treated well.
Bill is a hoot and was great to travel with, I know he will be a strong part of the DE world.

 

[The BN Guy]

Well done!

 

[jeffryscott]

Great job Lance and thanks for the plug for Respiratory Therapists in your opening remarks

 

[Number 7]

Thanks for the write-up Lance. Very informative and helps raise awareness. We've been looking into some sort of wilderness survival training - good tips on which ones are out there. Thanks again! Diane

 

[gjackson]

Very nice report Lance, thanks for taking the time.

cheers

 

[Superu]

Well done Lance.

Those folks were fortunate to encounter someone as caring and helpful as you.

 

[syke]

Strong work Lance!

I let my EMT-B lapse a few years back..... I better get into one of the wilderness classes to refresh the memory.

 

[Bugspray]

Hook removal

Great job staying cool & being prepared!

There is another method to remove a fishhook. Being a lifelong fisherman from a family of fishermen this was shown to me by my grandfather when I was around 12 or 13.

First locate a length of monofilament line about a foot or so long, you dont need much. The test depends on the size of the barb. For flies use tippet and for those really big hooks use 10-12 lb. test.

Wrap the line around the shank of the hook forming a tight loop, do it again. Now put your a spare finger on the loops. Make about 10-12 loops depending how deep the sucker is. The whole idea is to keep the loops tight and stacked on top of each other along the shank.

When you think you have enough loops built up, push the stack of loops down into the skin with your fingernail until they get underneath the barb.

Now you should be able to back the hook out without too much fuss.

If the hook is too deeply imbedded resort to the cut and push through method.

**Do not try this on your self have someone(sober) do it for you.**

 

[taco2go]

Strong work Lance, especially considering you had a screaming child and no access to local anesthesia or nerve block. Fish hook removals take time, and it sounds like you did good prep. Over the years I have done a handful of hook removals in my clinic and have had to employ a couple of techniques. For deeply embedded hooks with barbs, I’ve found that the push- through method, with pulling retrograde after cutting off the barb, is usually the most effective. From your write up, it sounds like you found it easiest to cut the shank and push on through, given that the point of the hook seemed to be almost through the surface of the patient’s skin. (dull tip notwithstanding)

The string yank is effective too, if the tip is not superficial although it needs more practice/dexterity, and make sure you have protective eyeglasses:Wow1:

As a student many moons ago, I watched a physician‘ trap’ an embedded barb in the bevel of large 18 gauge needle that he inserted right along where the hook went through, After some minute twisting to get the barb to ‘settle’ into the bevel, he extracted the lot out. The hook was in a finger and pushing through may have damaged tendons etc.

One other useful bit of material you may be able to carry along, is a couple of small tubes of topical EMLA .

Again, good job, and kudos on your unique efforts.

 

[Woodsman]

Way to go Lance ! :wings:

 

[RunninRubicon]

First Aid

Great job Lance!
Cool head prevails!
I also have pondered what items to include in my "first-aid" kit. I have cosidered carrying much more then I do. Seems I have driven up on closed head injuries of auto vs bicyclists or roll-overs. Both had closed head injuries (read sub-dural hematomas needing evacuation). Basic assessment and helo evac via a cell-phone call is all I ever really had to do. Ya never know. (On my days off)

Joe G. RN, CCRN,CV-CT, ICU,
Combat casualty care course (C4) taught me alot, but being a paramedic in OKC for 5yrs was more enlightening for roadside emergencies.

 

[SunTzuNephew]

Strong work! Good job!

Sometimes a slight distractor works with kids - a tootsie pop, a plush toy, a tool of some sort.

Also, a little lido (no epi in extremities, of course) in an insulin syringe works too (in Mexico, anyway).

 

[Hltoppr]

Nice work Lance! Given the situation, I think your options were to do exactly what you did the exact way you did it or to stabilize the hook in place and drive to San Felipe.

I think one of the biggest assets was your fluent medical Spanish. The process of removal was all in all straight forward.

Good work!

-H-