How to get a hook out of your hand!

[Matt]

While making bait recently I have had almost full sabikis of live wiggling angry mackerel that seem to have little desire to cooperate in getting themselves off of the hooks. The problem with getting a hook in my hand most often happens when you are removing one of the macks and the others start thrashing extra hard and thus pulling the hook you just removed and putting it in your hand! Let me tell ya that it hurts alot if they get it deep enough, it hurts pretty damn bad even when you dont get the barb through the skin.

But I know alot of fisherman and kayak fisherman in general are fairly new to the sport and have no idea how to properly remove a hook from their hand. So I thought I would write this in an attempt to hopefully ease someone's pain or at least maybe tell of a technique that could help someone. So here it goes!

When you first feel that pin type of prick starting to go into your finger you must first learn to not pull away and actually go towards the pain in an attempt to not get the hook as deep as it can possibly go. The initial normal reaction is to yank your hand away as quickly as possible to avoid the piercing you are about to receive, ya gotta fight that urge and actually go in a reverse motion and go with the hook, this is not always possible but try if you can. If the hook does not go past the barb, it is fairly simple to remove it, just like a splinter, pull it on out. Now if the hook that is going in your hand is attached to 3-5 other mackerel, sardines or any bait fish (pray its not a small bonito) it is a little harder to avoid that hook going in, I try and make sure to grab the remaining sabiki and get a firm hold of it so as to not let the other fish "dance" or wiggle the free hook into your hand. Once you have control of the remainder of the sabiki, check your hand and see how deep the hook is in, more often than not the barb will not have entered the hand and you will be ok. However if the hook has gone past the barb it is now a much more difficult situation, if it is a sabiki, I quickly cut the remainder of it off to free the hook from the remaining part of the line and the fish attached to it. Now comes the hard part removing the hook! There are several different techniques that can be used but the article below does a much better job of describing it than I can so the following is being quoted from the American Academy of family physicians, http://www.aafp.org/afp/20010601/2231.html.

Now please use common sense, and do not panic, if you feel that the hook is in a very dangerous place call the coastguard or lifeguards and let your tax money work for you!!The above advice I have given is from experiences I have had, I am not a doctor or a medical professional just a fisherman trying to give ya some help, so if you do get a hook stuck go see your physician or go to an ER if you are shaky in anyway shape or form about doing it yourself. Also an up to date tetanus shot is probably going to be needed so go to the Doc if you have any hint of "Maybe a DR. should be doing this?"

Fishhook Removal

Fishing is a common recreational sport. While serious injuries are uncommon, penetrating tissue trauma involving fishhooks frequently occurs. Most of these injuries are minor and can be treated in the office without difficulty. All fishhook injuries require careful evaluation of surrounding tissue before attempting removal. Ocular involvement should prompt immediate referral to an ophthalmologist. The four most common techniques of fishhook removal and injury management are described in this article. The choice of the method for fishhook removal depends on the type of fishhook embedded, the location of the injury and the depth of tissue penetration. Occasionally, more than one removal technique may be required for removal of the fishhook. The retrograde technique is the simplest but least successful removal method, while the traditional advance and cut method is most effective for removing fishhooks that are embedded close to the skin surface. The advance and cut technique is almost always successful, even for removal of large fishhooks. The string-yank method can be used in the field and can often be performed without anesthesia. Wound care following successful removal involves extraction of foreign bodies from the wound and the application of a simple dressing. Prophylactic antibiotics are generally not indicated. Tetanus status should be assessed and toxoid administered if needed. (Am Fam Physician 2001;63:2231-6.)

Angling is a popular sport worldwide, and fishhook injuries are common in recreational and commercial fishing settings. Persons with fishhook injuries may not present to the office or emergency department because removal of embedded fishhooks can usually be accomplished in the field. However, some embedded fishhooks cannot be removed in this manner and require evaluation of the injury and exploration of the wound for the presence of a foreign body. Four techniques for removing embedded fishhooks are described in this article.

FIGURE 1. Types of fishhooks. (A) Simple-single barbed fishhook. (B) Multiple-barbed fishhook. (C) Treble fishhook.
Patient Evaluation
Most fishhook injuries are penetrating soft tissue injuries to the hand, face, head or upper extremity but can involve any body part. These injuries usually do not involve deeper tissue structures because of the linear forces applied along the fishing line to the fishhook that drive the point parallel to the skin and keep it from deep penetration.
Many different types and sizes of fishhooks are available (Figure 1). When examining the hook, it is important to note if the fishhook is single, multiple or treble, whether the hook is barbed, and the number and location of the barbs--these details will help determine the best removal technique. Often, persons will know the type of hook they were using and may be able to provide a sample for inspection.
Occasionally, more serious tissue trauma occurs from fishhook injury. While not routinely performed, radiographs may aid in determining the type of fishhook and the depth of penetration in difficult cases.1 Neurologic and vascular status, proximal and distal to the wound, should be assessed. Any fishhook injury that may involve deeper structures such as bone, tendons, vessels or nerves requires careful evaluation before attempting removal.
In attempting to remove an embedded fishhook, the retrograde and string-yank methods are generally the initial procedures of choice because these methods result in the least amount of tissue trauma.
Cases of penetrating eye trauma secondary to fishhook injury have been reported in the literature.2-5 One such injury even included intracranial trauma.3 Fishhooks that penetrate the orbital area or are embedded in a location in which removal may injure the eye should be covered with a metal patch or cup and the patient should be sent immediately for ophthalmologic consultation.6 Permanent vision damage may occur with removal of the fishhook although minimal vision deficit was evident on initial presentation.
Principles of Removal
Four primary techniques have been described for the removal of fishhooks: retrograde, string-yank, needle cover, and advance and cut. Each method and some modifications to these techniques are described in detail in this article. The method selected to remove an embedded fishhook is usually based on the judgment of the physician, the anatomic location of the injury and the type of fishhook.
Most embedded fishhooks can be removed with minimal surgical intervention. Generally, the retrograde and string-yank methods should be the first techniques attempted because they result in the least amount of tissue trauma. The more invasive procedures, such as the needle cover and advance and cut techniques, are reserved for more difficult fishhook removal.7 Sometimes multiple techniques must be attempted before the fishhook is successfully removed.

FIGURE 2. Retrograde technique. Downward pressure is applied to the shank of the fishhook while it is backed out along the point of entry.
Most removal methods require the administration of a local anesthetic or a nerve block. Superficially embedded hooks may not require anesthesia if they can be backed out or removed easily by the string-yank method.
Local care typically involves cleaning the site with povidone-iodine or hexachlorophene solution before attempting removal of the fishhook. Saline irrigation may be required. Fishhooks with more than one point (i.e., treble fishhooks) should have the uninvolved points taped or cut to avoid imbedding these during the removal procedure. A local anesthesia should be administered before attempting removal of any barbed fishhook. All items attached to the hook (i.e., fish line, bait and the body of the lure itself) should be removed. The physician and bystanders should take care not to be struck by the hook on removal. Eye protection should be worn, especially when performing the string-yank method.


Part 2 is below in the reply

[Matt]

Part 2

Retrograde Technique
Retrograde technique is the simplest of the removal techniques but has the lowest success rate. It works well for barbless and superficially embedded hooks. Downward pressure is applied to the shank of the hook. This maneuver helps rotate the hook deeper and disengage the barb, if present, from the tissue. The hook can then be backed out of the skin along the path of entry (Figure 2). Any resistance or catching of the barb during the procedure should alert the physician to stop and consider other removal methods.
String-Yank Technique
The string-yank technique is a highly effective modification of the retrograde technique and is also referred to as the "stream" technique. It is commonly performed in the field and is believed to be the least traumatic because it creates no new wounds and rarely requires anesthesia.8 It may be used to remove any size fishhook but generally works best when removing fishhooks of small and medium size. This technique also works well for deeply embedded fishhooks, but cannot be performed on parts of the body that are not fixed (e.g., earlobe).9 Physicians should be familiar with the concepts of this method because improper technique could cause further tissue damage.

FIGURE 3. String-yank method. (A) Wrap a string around the midpoint of the bend in the fishhook. (B) Depress the shank of the fishhook against the skin. (C) Firmly and quickly pull on the string while continuing to apply pressure to the shank.
FIGURE 4. Needle cover method. (A) Advance an 18-gauge or larger-gauge needle along the fishhook until the needle opening covers the point. (B) The fishhook and needle are then removed at the same time. A string, such as fishing line, umbilical tape or silk suture, should be wrapped around the midpoint of the bend in the fishhook with the free ends of the string held tightly (Figure 3). A better grip on the string can be achieved by wrapping the ends around a tongue depressor.1 The involved skin area should be well stabilized against a flat surface as the shank of the fishhook is depressed against the skin. Continue to depress the eye and/or distal portion of the shank of the hook, taking care to keep the shank parallel to the underlying skin. A firm, quick jerk is then applied parallel to the shank while continuing to exert pressure on the eye of the fishhook. The fishhook may come out with significant velocity so the physician and bystanders should remain out of the line of flight. A commercial fishhook removal device, based on this technique, is available. (Minto Research and Development Inc., Redding, Calif.)10
The physician should always use protective eye wear when removing embedded fishhooks, especially when using the string-yank method.
Needle Cover Technique
The needle cover technique requires dexterity on the part of the physician. It works well for the removal of large hooks with single barbs but is most effective when the point of the fishhook is superficially embedded and can be easily covered by the needle. After skin preparation and administration of local anesthesia, an 18-gauge or larger needle is advanced along the entrance wound of the fishhook (Figure 4). The direction of insertion should be parallel to the shank. The bevel should point toward the inside of the curve of the fishhook, enabling the needle opening to engage the barb. It is important to have the bevel pointed in the correct direction so that the longer edge of the needle matches the angle of the fishhook point. The physician should advance the fishhook to disengage the barb, then pull and twist it so that the point enters the lumen of the needle. The physician can then back out the fishhook (the same way as in the retrograde technique), taking care to move the needle along the track with the fishhook.
A modification of this technique involves sliding a no. 11 scalpel blade along the wound to the point of the fishhook. The fishhook may then be backed out because the incision allows room for the point. This modification may also be used in combination with the needle cover technique for more difficult fishhook injuries.

FIGURE 5. Advance and cut method: single-barbed fishhook. (A) The fishhook is advanced through the skin. (B) The barb is then cut off and (C) the remaining hook is backed out through the entry wound.
FIGURE 6. Advance and cut method: multiple-barbed fishhook. (A) The fishhook is advanced through the skin. (B) The eye of the fishhook is then cut off and (C) the remaining portion of the fishhook is pulled through the exit wound created by advancing the point. Advance and Cut Technique
One advantage of this traditional method of fishhook removal is that it is almost always successful, even when removing larger fishhooks; however, additional trauma to the surrounding tissue is a disadvantage. The advance and cut technique is most effective when the point of the fishhook is located near the surface of the skin.9 It involves two methods of removal: one for single-point fishhooks (Figure 5) and one for multiple-barbed fishhooks (Figure 6). Infiltration with a local anesthetic is performed over the area where the fishhook has penetrated the skin. Using pliers or needle drivers, the point of the fishhook (including the entire barb) is advanced through the skin. The point is then cut free with the pliers or another cutting tool, allowing the rest of the fishhook to be backed out with little resistance.
For multiple-barbed fishhooks, the area should be anesthetized and the fishhook advanced. Instead of removing the point, the eye of the fishhook is removed. The physician can then continue to pull the fishhook in the same direction as the point was advanced.
Although it may produce additional tissue trauma, the major advantage of the advance and cut technique when removing an embedded fishhook is that it is almost always successful.
Post-Removal Wound Care
After removal of the fishhook, the wound should be explored for possible foreign bodies (e.g., bait). It is usually sufficient to leave the wound open, then apply an antibiotic ointment and a simple dressing. Tetanus toxoid should be administered to persons for whom more than five years has elapsed since their last tetanus booster. Well-conducted, controlled studies do not exist that support the need for systemic antibiotics in these cases; they are generally not indicated.7 Prophylactic antibiotic therapy may be considered for persons who are immunosuppressed or have poor wound healing (e.g., patients withdiabetes mellitus or peripheral vascular disease). Prophylactic antibiotic therapy may also be considered for deeper wounds that involve the tendons, cartilage or bone. Follow-up care should be performed to ensure adequate healing and the absence of infection.
MATTHEW GAMMONS, M.D., and EDWARD JACKSON, M.D. Michigan State University College of Human Medicine, East Lansing, MichiganREFERENCES

1. Lantsberg L, Blintsovsky E, Hoda J. How to extract an indwelling fishhook. Am Fam Physician 1992; 45:2589-90.
2. Aiello LP, Iwamoto M, Taylor HR. Perforating ocular fishhook injury. Arch Opthalmol 1992;110:1316-7.
3. Swanson JL, Augustine JA. Penetrating intracranial trauma from a fishhook. Ann Emerg Med 1992;21: 568-71.
4. White MF, Owens SD, Dooley CD, Kimble JA, Witherspoon CD. Fishing related eye injuries: a report of 27 cases. Invest Opthalmol Vis Sci 1990; 31:21.
5. Deramo VA, Maus M, Cohen E, Jeffers J. Removal of a fishhook in the eyelid and cornea using a vertical eyelid-splitting technique. Arch Ophthalmol 1999;117:541-2.
6. Morris JA, Swiontkowski MF, Merrmann HJ. Wilderness trauma emergencies. In: Auerbach PS, ed. Wilderness medicine: management of wilderness and environmental emergencies. 3d ed. St. Louis: Mosby, 1995:342-62.
7. Doser C, Cooper WL, Ediger WM, Magen NA, Mildbrand CS, Schulte CD. Fishhook injuries: a prospective evaluation. Am J Emerg Med 1991;9: 413-5.
8. Haynes JH. Fishhook removal. In: Pfenninger JL, Fowler GC, eds. Procedures for primary care physicians. St. Louis: Mosby,1994:128-32.
9. Diekema DS, Quan L. Fishhook removal. In: Henretig FM, King C, eds. Textbook of pediatric emergency procedures. Baltimore: Williams & Wilkins, 1997:1223-7.
10. Rudnitsky GS, Barnett RC. Soft tissue foreign body removal. In: Roberts JR, Hedges JR, eds. Clinical procedures in emergency medicine. 3d ed. Philadelphia: Saunders, 1998:623-4.

Copyright © 2001

[kayaker]

Thanks Matt!

This is something you'd hope people won't ever need, but sure is good to know if and when it happens. And it does happen rather often.

[Matt]

Worst one I ever heard of was an iron getting caught in a guys neck!!!!! The story is just gnarly, but James is fine and still a fish catching machine, I also saw my bro in law catch a big old iron in his leg and have to go to the hospital then immediately on an overnighter for albacore....IRONMEN to say the least!!!

[Siebler]

Iron in the face at the 08 Moyer tournament wasn't pretty either.


Ive seen a few that sucked when I was on the boats, but nothing as bad as what I've seen on the kayaks. Go figure.


Thanks for the write up Mr. Matt

['tailpursuit]

im a big wussy when coming to sticking myself or hurting myself in any way