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Fish Hook Removal in the Emergency Department Techniques 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
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