A 28-year-old man presents with a puncture wound to his right palm. He was injured while cleaning a fish and got pricked by its spine. He is in pain and the area around the wound is swollen. What are the immediate steps?
Puncture wounds from fish spines can carry a risk of infection, including from water-borne bacteria. After cleaning and irrigating the wound, you should remove any remaining parts of the spine. The wound can be soaked in hot water for pain relief. As the wound was inflicted in a marine environment, empirical antibiotics should be considered, typically ones that cover marine pathogens such as Vibrio species.