A fishhook that is firmly embedded in a patient needs to be carefully removed.
Steps:
(1) Remove any extraneous material (sinker, bait, fish line, etc).
(2) Characterize the hook (single unbarbed, single barbed, single multi-barbed, double or triple or multiple hooks, etc)
(3) Identify a patient who should be referred to a specialist for hook removal (see above).
(4) Select a method for hook removal and remove the hook..
(5) Manage the patient after hook removal for tetanus prophylaxis, infection and hemorrhage.
|
Removal Method |
Requirement |
Method |
|
push back or retrograde |
unbarbed hook and pliers or hemostat |
Grab the shank of the hook with pliers or hemostat. Pull on the hook and twist the wrist, following the curve of the hook until the point emerges. |
|
push through or advance and cut |
single barbed hook and wire cutter |
Push the barb forward until it emerges from the skin, then cut it with the wire cutter. Then perform a retrograde extraction. Alternatively cut off the shank of the hook and pull on the point (using pliers or hemostat) until it comes out. |
|
needle cover |
single barbed hook at 18 or 20 gauge needle |
Insert the needle parallel to and along the point so that the bevel engages the barb. Push the shank away from the skin, keeping the barb covered by the needle's bevel. |
|
string-yank |
piece of string |
Tie the string to the bend of the hook and pull away from the patient. Disengage the barb by pushing the shank down towards the skin surface. At the same time keep pulling on the string, away and up from the patient. |
|
cut it out |
scalpel or other knife |
If all else fails, then cut it out. If serious surgery is needed then evacuate the patient for definitive care. |
When removing a double or triple hook (2 or 3 single hooks combined) be sure that one of the free hooks does not become embedded in the patient. This is best achieved by cutting the points and barbs off the hook prior to removing the embedded hook.
Specialty: Emergency Medicine, Critical Care
ICD-10: ,
