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De-piercers
Nebraska nurse sisters develop kit to quickly remove body ornaments
Hospitals
face dilemmas treating patients with pierced parts
Body
jewelry 101 for the health care professional
Yale
MD Links Piercing to Abscess 12/01
Body
Piercing Gone Awry
Tattooing and Body
Piercing:
Decision
Making for Teens
BP Stories
from the front lines.....
During a Basic Fire Training class on a hot day,
one of my students (male) wanted to cool of so he removed his shirt. Due
to the area we were working in we were not in a "no turnout
area" and I instructed him to put his shirt and coat back on. I was
unaware that he was wearing a nipple ring (it was covered by the
suspender) he was not happy about having to put his gear back on and
removed the suspender with a little more enthusiasm then he should of.
Resulted in a pretty nasty ripping of the nipple and surrounding tissue.
Needing several stitches and allot of ribbing for the rest of the class.
Scott Anderson
This vibrates and has a
battery pack at the bottom of the bar. If the battery is opened in an
accident it may pose a problem.
We had a call one night
to the local police station to pick up a victim from an MVA. The
gentleman was sitting in a chair, c/o pain in the rib area. Seems he had
run his car into a tree, then backed away and drove to the station to
report it.
He had a nose ring, ear rings, eyebrow ring, tongue stud, nipple ring.
All of these we found during survey. My partner commented to him about
them. He told us there was another one that we hadn't seen yet!
Never did find it.
Ewbank
boy, is that c-collar
gonna hurt
  
Nasal Intubation
problem?
 
Body piercings are
obstacles for ER workers
SALT LAKE CITY (AP) - Emergency-room physicians are discovering - and
often have to remove - rings and studs
inserted into areas of the body they never would have imagined.
In a teen-age girl's case at LDS Hospital, physicians found themselves
unable to insert a breathing tube down her
throat because her tongue stud blocked the instrument.
uvula
"One doctor got to the point where he said if you have to rip her
tongue, just do it," said Shari Welch, an emergency-room doctor.
"In a situation like this, seconds count," Welch said. The
patient, who had overdosed on the drug GHB, was on a respirator for 13
hours after physicians were finally able to maneuver the tube past the
stud.
University Hospital also has run into problems with the jewelry.
A young man with a severe head injury from a motorcycle accident also
had a tongue stud blocking an intubation tube.
"None of us knew how to get it out," said nurse Deborah Melle.
"Finally somebody did, but it seemed like it took forever because
he wasn't breathing and it definitely delayed care. In the past year,
it's gotten increasingly worse."
The rings also throw off sophisticated diagnostic machines, like CT
Scans and MRIs.
They can lead to other complications as well, like the key-ring sized
piece of jewelry pierced into the genitalia of a 19-year-old college
student who suffered pelvic fractures after being run over by a car.
 
The ring shredded his urethra. Long after his
pelvic injuries had healed, he had to return to the LDS Hospital
emergency room to have his kidneys drained because he could not urinate
on his own.
"He's probably going to have problems the rest of his life,"
Welch said, "possibly even fertility problems."
Melle had a problem trying to insert a urinary-tract catheter into a
patient who had a ring pierced through the tip of his penis. "It
hurt just to look at it," she said, "not to mention being
difficult to remove."
"It's a pure fashion decision that has potentially life-threatening
complications and profound health issues," said Welch.
Those who work in the piercing industry say infections do happen,
usually when patrons don't follow cleansing recommendations, but the
severe cases that emergency rooms see are rare.
"They work in an emergency room. They always see complications.
That's all they ever see," said Benjamin Salomon, a body piercer at
ASI Tattoo in Sugar House.
Staff at the emergency room at Pioneer Valley Hospital in West Valley
City have been dealing with the problem for nearly a decade and have
become adept at removing the jewelry.
"If the jewelry gets in the way, we just take it out," said
hospital spokeswoman Carol Lindsay. "And if we can't get it out,
we've actually cut it out with wire cutters."
and now they have
"npiple shields" too
or.. your labia
Holes emerging in the
body-piercing trend
Complications, unsafe methods can be fatal
By Lois M. Collins
Deseret News staff writer
Dr. Shari Welch sees medical complications. She is, after all, an
emergency room physician at LDS Hospital. But she's especially bothered
by the ones that result from what she calls "risky youth
behavior."
She's not talking about the kids injured in gang-style gun battles or
high-speed car accidents.
She's talking about body piercing. And while youths and adults have a
right to have their bodies pierced, she said, they ought to at least
know what can happen.
Drawing from both personal experience and case studies she's found since
she started researching body piercing, Welch shares information with
doctors and students about a
young woman who came into the hospital with an overdose, not breathing.
They almost lost her because they had to fight to get her on a
respirator. She had several earrings in her
tongue.
Or the young man who
had a penile ring. He was run over in a terrible car accident, and
because of the tearing done by the ring and the subsequent scarring, he
no longer urinates normally.
She speaks quietly, as well, of the young girl who died last winter. She
was 18 and ended up in the emergency room with a fever and adult
respiratory distress syndrome. She died during the night. Tests showed
the girl had Group A hemolytic strep, traced to having her tongue
pierced just the day before.
Welch said she has also seen nasty cartilage infections that must be
treated differently than other infections. People who want earrings
around the ear shell would be wise to have just the skin pierced, not
the cartilage.
Worse, "because of the intimate nature of some of the pierces, they
may not seek medical attention," she said. Even a body piercer
magazine notes that "the lay public is afraid of getting a doctor's
poor opinion. They know we disapprove. So they are slow to get medical
help," she said.
That's not the worst problem, though. Real crisis arises when medical
personnel, rushing to deal with a medical emergency, have to wrestle
with sometimes complicated jewelry that's piercing various parts of the
body. Now they're asking each other what they'll do "when
the youth being pierced become middle-aged who need defibrillators.
There's no time to get the jewelry out. I guess we will cover it with as
big a piece of hospital tape as we can and just shock them. Some might
lose a nipple but save their life."
Various Web sites promoting body piercing and even some of the people
who do it tell youths that redness, swelling and draining are normal.
Unfortunately, by the time some people seek help, they're very sick,
Welch said.
Welch had her
daughter's ears pierced four years ago. She's had her own done. But the
research has convinced her that she should have approached it
differently. As many as 23 percent of pierced ears get an infection, and
her daughter was no exception. Now she believes that in the case of all
piercing, "you ought to at least be touching base with the family
doctor. He might want to put you on antibiotics. No research says
there's no complication.
"If you get body pierced, it can affect your heart valves if
they're not 100 percent normal. The risk is small, but the results are
so catastrophic. People with cystic fibrosis, diabetes, wound infections
should all be on antibiotics first."
In an ideal world, every body piercer would be backed by a physician,
much like a physician's assistant is, she said. "They should have
to have a doctor behind them if there's any problem. And some things are
a whole lot easier with anesthesia. Let's throw in a little help from
modern medicine. And have every patient give informed consent. Give them
something to read, a video, something that explains what's
happening."
clavicle
When someone has a spinal tap, he talks with the doctor about the risk
and signs a paper that says he understands those risks. That's what
should happen with body piercing, she said.
Welch has visited piercing parlors and mall kiosks that offer simple ear
piercing, as part of her research. When she met with a body piercer,
"it was clear he did not know about sterile technique. Instruments
are sterilized in an alcohol-based foam, while a doctor would be using
betadyne. Gloves were not sterile, and the young man pulled jewelry out
of a dusty drawer."
Still, she's more afraid of kiosks that use a "piercing gun."
The risk of infection is greater than with the old needle-and-cork
method. And the kiosks generally offer less training to employees than
piercing parlors, she said.
Some parlors have medical equipment, like the special table an OB/GYN
uses. "If you saw that, you might think he's properly trained. But
across the country, there's no licensure for body piercers. Anyone can
set up shop. The Health Department checks that some businesses have an
autoclave but doesn't check that it is used or used right.
"Just the three cases were enough for me.
One died, one almost died and the other will never (urinate) right
again. If they had more information, would they make a different choice?
I'm thinking a lot of kids won't. But others might."
Body Piercing Gone Awry
By John Reinan
HealthScout Reporter
SATURDAY, Dec. 30 (HealthScout)
-- Red Sonia wanted a look to die for -- and she got it.
Sonia, whose real name
was Lesley Hovvels, once appeared on British television to show off her
more than 100 body piercings.
But the 39-year-old
Welsh woman died earlier this year of a massive infection caused by her
failure to properly care for the dozens of piercings in her nose, ears,
lips and other body parts.
It's an extreme case.
But doctors warn that recent medical journals have chronicled hundreds
of cases of injury, infection and even death caused by piercings gone
bad.
"In many cases,
it's safe to say, the guy who cuts your hair has more training than the
guy who pierces you," says Dr. Shari Welch, an emergency room
physician at LDS Hospital in Salt Lake City.
"It's pretty scary
stuff," says Welch, who recently saw a 19-year-old woman nearly
suffocate because emergency room doctors had trouble getting a breathing
tube past the piercings on her tongue.
In another incident, a
19-year-old man's urethra was "shredded," Welch says, after a
car accident that ripped loose a small ring from his penis.
"For his life,
he's going to have trouble urinating," she says. "I'm sure he
wasn't thinking of that when he made this fashion choice."
Nobody knows exactly
how many people are pierced in the United States, but the number
certainly is in the millions -- and growing rapidly, as a look around
will tell you.
Piercers often lack
training
Yet many piercers are
poorly trained or not trained at all, leaving their customers at risk of
infection or worse.
"A lot of piercers
don't have skill or care, and that's dangerous," says Elayne Angel,
a New Orleans piercer and board member of the Association of
Professional Piercers. "I see a lot of bad piercing."
"You have to take
care in choosing your piercer," Angel says. "Too many people
think that, just because somebody is charging them money, that person is
a professional."
Sanitation is perhaps
the biggest problem. From Welch's review of the medical literature on
piercing, she estimates that more than one in five body piercings
results in an infection.
Welch also has seen at
least one piercing-related death: an 18-year-old woman whose organs shut
down from infection 10 days after she got her tongue pierced.
Failure to follow
sanitary procedures -- either during the piercing or after -- can lead
to staph, strep, tetanus or hepatitis infections, Welch says. Unsanitary
piercing also can carry a risk of contracting HIV, the virus that causes
AIDS.
Adding to the problem
is the increasing popularity of piercings in areas such as the navel,
ear cartilage, tongue and genitals.
Compared to the
traditional pierced earlobe, these other areas are more difficult to
take care of and more likely to become infected, says Myrna Armstrong, a
professor of nursing at Texas Tech University Health Sciences Center in
Lubbock.
"We did some work
with high school students and found a 50 percent rate of infection in
navel piercings," Armstrong says. "The problem is, the area is
moist, it's irritated by waistbands and it gets fuzzies. And people
don't look at it."
As for the increasingly
popular genital piercings, Armstrong says there's little medical
literature on them.
"Nobody wants to
deal with it," she says. "But certainly we know that genital
piercings are increasing."
Plan to care for
your piercing
Anyone considering a
piercing should be prepared to take care of it for quite some time
afterward.
Piercings in the ear
cartilage, for example, take two to three months to heal and should be
cleaned at least twice daily, according to an advisory report by the
Student Health Service at the University of Pittsburgh at Bradford.
Tongue piercings should
be cleaned a dozen -- yes, a dozen -- times daily for six to eight
weeks. And navel piercings should be cleaned twice a day for nine
months, the report recommends.
Some piercers are
taking notice of the medical concerns. The Association of Professional
Piercers, which represents nearly 500 people who do piercing, is
lobbying state legislatures for tougher health and safety regulations on
piercing.
"I don't feel
under attack. I feel that bad piercers are under attack, and that's as
it should be," says Angel, a member of the association's board and
owner of Rings of Desire in New Orleans.
Angel, who has been
piercing for some 30 years, helped write a comprehensive regulatory bill
that was passed into law this year in Louisiana. Among other things, the
new law covers sanitation, instrumentation, testing and proper
permission for minors.
It's the kind of law
that's needed elsewhere, Armstrong says, noting that only 13 states have
regulations on body piercing.
And as the piercing
trend grows, she says, so does the need for more information on the
health risks. The medical community needs to realize that the piercing
issue is not going away.
"There is a level
of acceptance of piercing in society," she says. "It's not
just the bikers and gang members any more. It's not only the lower
socioeconomic group that's doing this."
"I don't care if
somebody wants to get a piercing," Armstrong says. "That's
their decision. But I'm concerned they at least be informed and know
what they're getting into."
What To Do
If you have any
questions about caring for a piercing, consult your doctor. Meanwhile,
consider this:
- Piercings require a
lot of care. A piercing in the rim of your ear needs to be cleaned
two or three times a day for two to three months. A navel piercing
should be cleaned twice a day for nine months.
- Use Bactine or
peroxide, but be sure to dilute whatever you use with three parts
water. At full strength, these substances can kill not only germs
but also new tissue that's trying to heal. Don't use alcohol for
cleaning; it's too harsh on the new tissue.
- If you pierce your
tongue, you'll have great-smelling breath -- because you should use
antiseptic mouthwash on your piercing at least a dozen times a day
for six to eight weeks.
For more about safe
piercing, visit the Association
of Piercing Professionals online
Yale MD Links
Piercing to Abscess
NEW HAVEN,
Conn. (AP) - Yale medical officials say they have linked a
woman's brain abscess to her tongue piercing.
The woman, in
her mid-20s, developed symptoms of a brain abscess 18 months ago
after removing a stud from her infected tongue. She had
difficulty walking and showed signs of clumsiness.
Brain abscesses
are usually caused by ear or sinus infections, and had not
previously been linked to tongue piercing, said Dr. Richard
Martinello, an infectious disease specialist at Yale-New Haven
Hospital.
``The bacteria
that caused the abscess in this patient were those typically
found in persons' mouths,'' he said.
The woman had
brain surgery and recovered after being treated with
antibiotics.
Martinello said
he believes tongue piecing is fairly low-risk but because it is
impossible to make the mouth sterile, there is always some risk
of infection.
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