Foreign Body


Impalement

Scenario:
Foreign body impalement during mountain biking usually results from meeting a stiff twig at high speed, or falling onto something long and thin.

Description:
Unless you're sure it's just a shallow splinter, foreign body injuries should be treated by the doctor. It's important to assess for deep injury, avoid leaving foreign material behind in the wound, and guard against infection.
This patient shot a finishing nail into his finger with a nailgun. Mountain bikers usually pull the foreign body out at the scene, because it's hard to bike out with a stick poking in your body.
This patient shot a finishing nail into his finger with a nailgun. Mountain bikers usually pull the foreign body out at the scene, because it's hard to bike out with a stick poking in your body.
This sewing needle has penetrated the fingernail. There's a high likelihood that cotton fibers from the thread have contaminated the tissues just under the nail. Infection is certain unless the needle is removed properly and the underside of fingernail is opened and cleaned of fibers.
This sewing needle has penetrated the fingernail. There's a high likelihood that cotton fibers from the thread have contaminated the tissues just under the nail. Infection is certain unless the needle is removed properly and the underside of fingernail is opened and cleaned of fibers.
Concerns:
The puncturing object can injure an artery, nerve, or tendon.

Any time there's a foreign body, there's contamination. These injuries have a high liability for complications.

Immediate care:
If possible, stabilize the foreign body in place. (Remove it only if it's the only way you can get back to civilization.) Squirt Betadine solution around the foreign body. Wad up some roll gauze and place it around the foreign body to stabilize it, then gently wrap the gauze around the extremity. Don't move the object. Go to the doctor or emergency room.

Fish Hook
Scenario:
Yes, believe it or not, bikers can be stuck with fish hooks. Consider the Lake Shore trail at Fish Lake, the Jordan River Parkway in Utah County, and the Provo River Parkway. People are casting, with bikers cruising by behind them.

Description:
A fish hook can often be removed at home, if it's not in a tricky area. After removing the hook, it can be treated as you would any other puncture wound.

To remove a hook at home it must be: AWAY from eyes, lips, ears, and fingernails and on a smooth flat area of skin.
Treble (3-pronged) fish hook in the neck.
Treble (3-pronged) fish hook in the neck.
Ready to pop the fishhook out.
Ready to pop the fishhook out.
To remove the hook, wrap a strong twine around the curve of hook, right where it enters the skin. Make one loop around the hook (so the hook won't fly away when it's pulled out). Hold the string back in the direction OPPOSITE the fish line.

Push down on the shaft of the hook with your finger (this disengages the barb). Keep your finger pressing down firmly over the entire hook while you pull the string back quickly and strongly. The hook should pop right out.

Foreign Body under Nail
Scenario:
During a fall, it's easy to jam a piece of wood under an unprotected fingernail when biking with short-fingered gloves (or no gloves).

Description:
Small foreign bodies under the nail, such as tiny splinters can be removed at home. Large objects are best treated by the doctor.

Tiny sliver under the fingernail. How do you get to it?
Tiny sliver under the fingernail. How do you get to it?
Notching the nail to get at a splinter.
Notching the nail to get at a splinter.
Immediate care:
You'll need to get as close as possible to the nail bed. Notch the nail back with fingernail clippers. Grasp the splinter as close to the skin as possible and gently pull back. After removal, clean the area with Betadine, and dress.

Splinter forceps are extremely sharp and tiny tweezers that cost about $4. It could be the best investment you ever make.

After removal:
Clean the area with Betadine and bandage.

Watch for:
See the doctor if there is redness around the wound, red streaks, swelling, drainage, fever, tender bumps in the groin or armpit upsteam from the wound, or an unexplained increase in pain or tenderness.