X-ray request - indicate on the request form what type of FB you suspect and where you think it is.
Removal of foreign bodies on NO account should be done in the ED unless they are clearly visible or palpable immediately under the skin. Any other (which need removing) should be done in a clean theatre by a Surgeon in a bloodless field. Many small foreign bodies will gradually work to the surface if left and may be easier to remove later.
- Cleanse the area ± lignocaine. (Most cases do NOT require lignocaine)
- Align the shaft of the hook so that it is parallel to skin surface
- Press down on the hook with your index finger to disengage the barb
- Loop a string around the hook
- With a quick in-line pull on the string, release the hook
- This procedure is painless
- Push the point of the hook all the way through
- Snip off eye
- Pull remaining shaft through
- Thread a a green needle along the hook and manipulate to cover the tip of the barb
- Do not use the string technique if the hook is near the patient's eye
- No routine prophylactic antibiotics