So far I had only one patient with a fishhook injury, but it was a story to remember! There are four common methods for removing a fishhook, which are explained well in the journal American Family Physician:
- Retrograde: the simplest method, but it only works in some cases.
- String-Yank: usually the least traumatic as it doesn’t create new wounds, but you must be familiar with the method, and bystanders should exercise caution! Watch a 3-min-video here.
- Advance and Cut: the most frequently used one, due to its high success rate.
- Needle Cover: works well for large hooks that are superficially embedded or located in areas of flaccid skin. Watch this 3-min-video.
Before removing a fishhook, ensure it is not located in sensitive areas such as the eyes, neck, genitalia, nerves, arteries, or mucosa. Determine the type of barbs involved by asking the patient to draw them. And don’t forget about lidocaine when needed. Afterwards, examine the wound, wash it regularly, apply antibiotic ointment, and check the patient’s tetanus status. While a 2019 review involving 165 patients showed that oral antibiotics were prescribed in 57% of cases, the MSD Manual and Penninger & Fowler’s (4th Edt) recommend routine antibiotic use only in immunocompromised patients or contaminated wounds.
