Fish Hook Removal in the Emergency Department
Techniques
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1) Pull Through Technique
- Grasp shaft of hook with needle driver
- Advance fish hook until the barbed end of hook protrudes through skin
- Clamp a hemostat over the barb and cut the belly of the fishhook proximal to the barbed end with a wire cutter
- Withdrawal fishhook from skin along its original direction of entry
2) String Yank Technique
- Wrap string/suture around belly of fishhook at site it enters skin
- Firmly depress the shaft of hook against skin and firmly pull the string/suture in opposite direction
3) Cut it Out
- only if other methods fail
- make incision with scalpel along the shaft of the hook to the barb
Additional Notes:
- Globe perforation or laceration requires emergent consult with ophthalmologist
- Prior to procedure remember to clean and anesthetize area
- Always wear eye protection when attempting removal
- Do not forget about tetanus prophylaxis
- Antibiotic prophylaxis remains controversial