Regional emergencies, Bam, Kerman province, Iran Foreign Bodies from the Palm Tree
Journal Title: مجله طب اورژانس ایران - Year 2015, Vol 2, Issue 3
Abstract
One of the most common causes of emergency department (ED) visits in Pasteur Hospital, Bam, Iran, is a foreign body from palm tree fronds entering different parts of body. This town is located in southeast Iran and has many palm tree orchards. Most of its residents are farmers or orchardists and many children play in these orchards. When palm harvest season approaches (about the end of summer), a considerable number of patients are presented to emergency department of this town with complaint of foreign bodies. These foreign bodies called “date thorns” among the locals are wooden and can easily penetrate various body parts due to their needle-like, pointy shape. Some patients manipulate the foreign bodies before going to the ED and cause it to move deeper. Another group, delay going to the hospital and only reach ED a few days after the initiation of inflammation, redness, and evidence of infection. History and physical examination aid in finding the place of the foreign body, but sometimes they are not perceptible and diagnostic imaging is needed. Radiolucent objects such as wood cannot be detected in graphy but are visible in sonograms (1, 2). Removal of these bodies is usually performed under sterile conditions, using local anesthesia or regional nerve blockade, by making an incision and searching the region, finding and removing the foreign body, and finally suturing and bandaging. The procedure gets more difficult in children and patients who do not cooperate and occasionally, procedural sedation and analgesia is required, which leads to side effects such as nausea, vomiting, lethargy, agitation, and respiratory depression. Depending on the site of injury, patients are usually unable to use the affected organ for a few days after the procedure and need daily washing and bandage, and sometimes taking antibiotics.
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