Fishhooks in the ED

Impaled by a Fish Hook! Fish hooks are great at snagging fish and fingers. There are a number of novel techniques for their removal. In this situation after performing a digital block (numbing up the whole finger) we used the needle cover technique which is described below from the FPnotebook website. In this case as the fishhook was embedded fairly superficially and only had one barb it was very effective. We also up dated the patient's tetantus and washed out the wound throughly after removal!

Technique: Needle Cover Technique http://www.fpnotebook.com/surgery/der/fshkrmvl.htm

1. Indications
   1. Large hooks with single barbs
   2. Barb superficially embedded
2. Images
   1. Needle Cover Technique
      1. 
3. Technique
   1. See Preparation above
   2. Advance 18 gauge needle along entrance of fishhook
      1. Insert parallel to shank
      2. Bevel pointing toward inside curve of hook
      3. Longer edge of needle matches end of hook angle
   3. Disengage barb by advancing fishhook
   4. Pull and twist hook so hook point enters needle lumen
   5. Back the needle and hook together out of the wound