Fish Hook Removal

Much easier and painless to simply put umbilical tape through the hook, push down on the tail of the hook (disengaging the barb and then jerk. The hook pops out painlessly. Best get someone to show you first :)

I've found using an 18g needle to help the barb come through the skin works well. Lightly pushing the skin down around the point of the hook as the point comes through the skin allows it to come through without much difficulty.

I agree with Chuck S. M.D. I was taught the umbilical tape removal technique in medical school in 1975 by a resident who had spent time in the public health service in Alaska and have used it for the past 40+ years with greater than 90% success. Painless, no anesthetic required and takes a few seconds and I have used it "in the field" while fishing. I even made a video and sent it to EMRap but it was never shown. The method shown above should be a last resort.

Was confused with the tape/string method until I saw it in several youtube videos. It definitely looks so much easier than this method.

Agree that the technique shown would be option #3 for me. Least elegant and highest risk. The main benefit for the average ER doc is that is easy to understand and teach. You don't need a video; you just numb it up - push it through and cut one end or the other. The ones below take a bit of practice.

In Mammoth Lakes, CA - primarily smaller hooks though as trout fishing - the "string technique" as others have called the umbilical tape technique works great. Absolutely must stabilize the body part and I do use 3 fingers - middle one to keep shank down and outer 2 to provide some counter traction to skin. You have to leave slack in the string and pull once HARD. I aim parallel to shank and down a bit. No local required. Must see it to understand. Takes practice/guts to do the first time and likely nobody who works in non-fishing areas will learn. I also do a simple knot to attach the string to the hook so it does not go flying. I have only had it fail twice. Once in a kid who didn't stabilize/hold his finger steady and once in a dog with a very big and deep hook (it worked but took 3 tries).

#2: Alternate technique is to pop the hook out backwards. Local first. You then advance the needle slightly and then quickly rotate hook down and back. Often pops out if you get the angle right.

If it gets stuck with #2 - you use an 18 gauge needle and enter the entrance wound/slice along the hook and cut the string of tissue that is caught on barb. You pull up on the hook to tent the skin upwards as you slice and when the tissue is cut, it pops out. Books describe the "sheath the barb with a needle" technique but that's just silly - but its how I learned this technique....

The string technique is fastest, avoids use of local, and is often painless.

The pop out and 18 gauge assist avoids having to push the hook through the skin, limits use of extra shots of anaesthesia and doesn't create a second wound or enlarge the entrance wound usually. You also avoid pushing a dirty hook through more tissue. It can also be tough to cut a hook without a good wire cutter (many hospital tools are very challenging to cut a hook with). The flying projectile that goes missing is a sharp too.