THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Sunday, July 14, 1996 TAG: 9607110201
SECTION: CAROLINA COAST PAGE: 40 EDITION: FINAL
SOURCE: Jack Dempsey
LENGTH: 75 lines
Countless visitors to the Outer Banks cut or puncture themselves every day, just like they do at home. And, just like at home, it's not always clear when their injuries deserve medical attention.
It's especially unclear with the beach's unique contribution to human discomfort: the fishhook.
Visitors step on them, sit on them, ``catch'' each other with them at fishing piers or otherwise find themselves attached to the painful and emotionally repulsive contraptions.
It happens daily.
Dr. Daniel Hurley Jr. of the Regional Medical Center's Beach Medical Care reported a recent season-high three extractions in one day this summer. And that's just at one Outer Banks medical center.
Unfamiliarity with fishhooks and emotional alarm at the mere thought of having one entwined in flesh incline some to seek medical care prematurely. Dr. Hurley said he has seen several fishhooks fall out by themselves or come loose with just a gentle tug.
So, try a gentle tug first. If the barb of the hook is embedded deep enough to resist withdrawal, the point of the hook has punctured the flesh deep enough to cause concern about a tetanus or other infection. Seek care for the extraction and get a tetanus shot at least.
First, however, cut fishing line and other attachments off the hook's eye. Do NOT cut the shank close to the skin.
For shallow penetrations, Dr. Hurley demonstrated how he can insert a sterile needle into the crotch of the barb and back it out. With deeper penetrations, sometimes the head of the hook is pointed toward the skin's surface and it can be pushed forward and out, instead of backing it out.
By not cutting the shank at the skin as advised above, you leave the physician something to push through or to grab and pull out.
The most deeply embedded hooks simply must be dug out. Enough said.
In a more general sense, the major problems with cuts and puncture wounds (nails, fishhooks) are swelling, pain, blood loss, infection, scarring and damage deep under the skin, especially to nerves, arteries, veins and tendons.
Minor cuts and scrapes to the skin's surface are frequent and can be treated at home. Elevation and ice/cold packs keep swelling to a minimum. Reducing swelling also diminishes pain. And household pain-killers such as aspirin, Tylenol and Advil help as well.
Minor surface cuts rarely involve excessive blood loss, significant scarring or ``deep'' damage.
Minor infections are common, however. To prevent them, cleanse the area thoroughly, remove debris such as splinters and apply an antiseptic such as rubbing alcohol or one of the antibiotic creams available at a pharmacy. If the person is active, such as a child playing in the sand, place a bandage over the cut.
Cuts below the skin's surface produce the problems above plus pose greater risks of blood loss, major infection, scarring and deep damage. The deeper the cut, the greater the risks.
Dr. Hurley advises seeking attention if you are unsure of the severity of the cut. If you decide to do it yourself, however, here are some suggestions in addition to the measures described above:
Apply pressure to help stop the bleeding. Pull the two sides of the cut together with surgical tape, available at a pharmacy, to speed healing and minimize scarring. Watch for tenderness, inflammation, pus, loss of feeling or any other symptoms that should signal the need to seek care.
Deep cuts require immediate medical attention. Of greatest urgency is excessive blood loss from severed arteries or veins, which can send a person into shock quickly. As described above, elevate the wound above the heart and apply pressure to the source of the bleeding.
If you know how, apply a tourniquet above a deep wound to a limb, but not tight enough to completely stop circulation. Then go see a doctor. MEMO: Jack Dempsey has a doctorate in public health from Johns Hopkins
University and has published two books on health care. Send mail to P.O.
Box 10, Nags Head, N.C. 27959. ILLUSTRATION: To aid in removing a hook, cut the fishing line and
other attachments off the hook's eye. by CNB