Skin Foreign Object

When To Call

Go to ER Now

• Object is deep in the skin (such as a needle or toothpick in the foot)
• Object has a barb (such as a fish hook)

Call Doctor or Seek Care Now

• Object is a BB
• Object is causing severe pain
• You want a doctor to take out the object
• You tried and can't get the object out
• No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
• Wound looks infected (spreading redness)
• Fever occurs
• You think your child has a serious injury
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Deep puncture wound and last tetanus shot was more than 5 years ago
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• You have other questions or concerns

Self Care at Home

• Tiny, pain-free slivers near the surface that don't need to be removed
• Tiny plant or cactus spines or fiberglass slivers that need to be removed
• Minor sliver, splinter or thorn that needs removal. You think you can do it at home.

Care Advice

1. Tiny, Pain-Free Slivers - Treatment:
   • Tiny, pain-free slivers near the skin surface can be left in.
   • They will slowly work their way out with normal shedding of the skin.
   • Sometimes, the body also will reject them by forming a little pimple. This will drain on its own. Or you can open up the pimple. Use a clean needle. The sliver will flow out with the pus.
2. Tiny Painful Plant Stickers - Treatment:
   • Plant stickers or cactus spines are hard to remove. Fiberglass slivers may also be hard to get out. Reason: They are fragile. Most often, they break when pressure is applied with a tweezers.
   • Tape. First, try touching the spot lightly with tape. The stickers should attach to the tape. You can use packaging tape, duct tape or another very sticky tape.
   • Wax Hair Remover. If tape doesn't work, use wax hair remover. Put a thin layer on. Let it air dry for 5 minutes. You can also speed up the process with a hair dryer. Then peel it off with the stickers. Most will be removed. The others will usually work themselves out with normal shedding of the skin.
3. Needle and Tweezers for Slivers and Splinters:
   • For larger splinters, slivers or thorns, remove with a needle and tweezers.
   • Check the tweezers first. Be certain the ends (pickups) meet exactly. If they do not, bend them. Clean the tool with rubbing alcohol before using them.
   • Clean the skin around the sliver briefly with rubbing alcohol. Do this before trying to remove it. If you don't have any, use soap and water. Caution: Don't soak the spot if the foreign object is wood. Reason: can cause swelling of the splinter.
   • Use the needle to uncover the large end of the sliver. Use good lighting. A magnifying glass may help.
   • Grasp the end firmly with the tweezers. Pull it out at the same angle that it went in. Get a good grip the first time. This is important for slivers that go straight into the skin. This is also important for those trapped under the fingernail.
   • For slivers under a fingernail, sometimes part of the nail must be cut away. Use a fine scissors to expose the end of the sliver.
   • Slivers (where you can see all of it) often can be removed at home. Pull on the end. If the end breaks off, open the skin with a sterile needle. Go along the length of the sliver and flick it out.
4. Antibiotic Ointment:
   • Wash the area with soap and water before and after removal.
   • Use an antibiotic ointment (such as Polysporin) once after sliver is taken out. No prescription is needed. This will help to decrease the risk of infection.
5. Call Your Doctor If:
   • You can't get the object out
   • Object is out, but pain gets worse
   • Starts to look infected
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Photos

First Aid - Removing a Fishhook

This method of fishhook removal is sometimes called the Advance and Cut Method.

There are four steps in removing a fishhook:

1. Step 1. Using pliers (or needle drivers) firmly grasp the hook.
2. Step 2. Push (advance) the hook until the tip of the hook pops out through the skin.
3. Step 3. Cut off the tip of the hook and the barb.
4. Step 4. Back out the hook out.

Important Note:

• Use these instructions when you can't get into see a doctor right away. Most of the time, it is best to have a doctor (or other health care provider) remove a fishhook.
• The hook in this drawing has only a single barb at the tip, so the tip of the hook (with the barb) can be cut off and the hook pulled backwards through the skin.
• Some hooks can have more than one barb. In such cases, it is better to cut off the ring at the bottom of the hook and push the hook all of the way through the skin.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

First Aid - Removing a Splinter

You can remove splinters, larger slivers, and thorns with a needle and tweezers. Check the tweezers before you start, to be certain the ends meet exactly. If they do not, bend them until they do. Sterilize the tools with rubbing alcohol or a flame.

Clean the skin around the sliver carefully with rubbing alcohol before trying to remove it. Be careful not to push the splinter in deeper. If you don't have rubbing alcohol, use soap and water, but don't soak the area if splinter is wood. Reason: soaking can cause swelling of the splinter.

Remove the splinter:

• Step 1: Use the needle to completely expose the large end of the sliver. Use good lighting. A magnifying glass may help.
• Step 2: Then grasp the end of the sliver firmly with the tweezers and pull it out at the same angle that it went in. Getting a good grip the first time is very important for slivers that go in perpendicular to the skin or those trapped under the fingernail.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.