There are several different types of fishhooks. Most commonly this will be a single hook with a single barb at the end, but there can be multi-pronged hooks and other styles as well. The barb makes removal tricky because it will catch on tissue and prevent you from pulling the hook back the way it went in. Here are some creative techniques to solve the problem:

1. Advance-and-cut or "push through" method:

This is one of the simplest techniques. You'll need good anesthesia of the area, and works best if the barb is close to the skin surface. **Pro-tip: always cover with gauze or towel while you clip the barb - not a good look to have the tiny barb fly across the room (or worse, into someone's eye!)

2. String-yank:

This technique can be useful if the barb is embedded very deep or otherwise unable to advance safely. The goal is to push down on the hook to disengage the barb from the tissue. A string wrapped around the curve will help pull the hook out, removing it with a sharp ’yank’ along its entry trajectory. *Again, careful not to let the hook fly across the room upon removal.

You can also try it without the string, termed the "retrograde pull" technique, but while simpler, this is usually less effective. If you meet resistance, try another method or you can end up causing significant local tissue damage.

3. Needle-cover

Useful for large, shallow hooks – a hollow-bore needle can be used to cover the barb which will prevent it from catchingwhile removing the hook and needle together.

After removal: Irrigate, look for retained forein bodies. Update tetanus if needed. Antibiotics not usually needed unless complicating factors are present, but cousel patients on warning signs and return precautions.

Sources:

1. “FB Removal.” Roberts and Hedges' Clinical Procedures in Emergency Medicine, by James R. Roberts, Elsevier/Saunders, 2014, pp. 697–702.

2. Riveros, Toni, et al. “Trick of the Trade: Fishhook Removal Techniques.” ALiEM, 8 Jan. 2018, www.aliem.com/.

3. Izadpanah, Kayvon, and Amita Sudhir. “Angling for Success: Techniques for Fishhook Removal in the ED.” EMRA, 9 Aug. 2017, www.emra.org/emresident/article/angling-for-success-techniques-for-fishh....