Weird and Wild: Piercing Problems, Tongue Rings, and TXA

​Some of our patients are total daredevils. This unique population keeps us on our toes. Our weird and wild series recently discussed laceration repair involving tattoos, but problematic piercings also present to the ED.​Traditional through-and-through piercing of the tongue body without complication. Photo: Creative Commons.An 18-year-old otherwise healthy woman presented to the emergency department with tongue swelling and mouth pain. Your first thought may be that this is an allergic reaction, but you quickly realize this is not the patient you expected. This patient just had her tongue pierced, and something has gone wrong.​Traditional tongue piercing involving the body of the tongue and accidental piercing of the frenulum linguae (left). Ventral tongue anatomy, right. Piercing involving the frenulum or areas of the ventral tongue surface and tongue floor can be complicated and dangerous. Photos: Creative Commons.The patient was tripoding on the stretcher, while her friend soothingly patted her back. The patient's vitals were blood pressure of 140/90 mm Hg, heart rate of 120 bpm, respiratory rate of 30 bpm, temperature of 99.2°F, and oxygen saturation of 98% on room air. She was drooling, and there was scant blood in her sputum. She appeared anxious and teary, and could barely speak.Her physical exam revealed an enlarged tongue with moderate bleeding around the piercing, some bruising to the site, a poorly visualized posterior pharynx, rhinorrhea, and teari...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs