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A simple method for removal of fish hooks in the emergency department
  1. H-P Ma,
  2. A C-M Lin
  1. Emergency Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan;

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    Fishing is a sport enjoyed by millions of people throughout the world. A common fishing injury is the embedment of the fish hook in the skin. All emergency department doctors have experimented with removing fish hooks. It is a challenging procedure because of the hook’s barb, although the external injury is usually minimal.

    The parts of the hook are the eye, shank, bend, point, and barb. The function of the barb is to keep the point embedded in the fish’s mouth, and therefore it is constructed to make its removal difficult. Hooks come in many different shapes and sizes. Some basic strategies of fish hook removal have been described.1 Techniques tried include a simple retrograde technique, a string pull technique, a needle cover technique, an advance and cut technique, and an incision technique. The choice depends on the type of hook embedded and the location of the injury site.1,2 We report a method that is simple to assemble, easy to use, and readily available in the emergency department. It involves the use of a surgical instrument with needle holders only (Aesculap; we used BM012R needle holders). The entry site is first prepared and anaesthetised by injection of 1% lidocaine. The tip of the hook is advanced through the anaesthetised skin. The point and barb of the hook are exposed. The needle holder is used to grasp the point and barb. The barb is cut off using the needle holder which directly depends on the barb’s small diameter (fig 1). The barbless hook is gently withdrawn through the entry site (fig 2).

    Figure 1

     The barb is cut off the fish hook using the needle holder directly.

    Figure 2

     The barbless hook is backed out through the entry site to minimise tissue damage.

    This method is almost always successful even for removal of large fish hooks because of the barbless hook. It can be practiced by anyone, anywhere, and at any injury site except the eye.3 Antibiotics should be considered to prevent infection.4 Tetanus status should be assessed and toxoid administered if needed. However, the doctor must weigh this against the potential harm of the foreign body in its current location.5



    • Competing interests: none declared