Fish Hook Removal: Procedure Demonstration

00:01 Now we're going to begin the procedure.

00:04 So you're going to have the patient in a comfortable position for them, as well as a comfortable position for you to be able to get at the hook.

00:11 The first thing that you're going to want to do is you're going to want to irrigate the area with saline. So I have some saline already drawn up here, and I'm going to clean the area here.

00:24 Okay. We've cleaned the entry points on both sides, so that should be good.

00:29 And then at this point we're going to take a chlorhexidine wipe.

00:33 And I'm going to clean the outer edges areas around the wound because we're going to need to do a field block. So I'm cleaning all the way around the wound, being sure that I have enough area.

00:48 And as you can see, the wound is very superficial.

00:51 So it's not deep. So we'll be okay to perform this procedure.

00:55 Make sure you keep your clean field your sterile field clean over here.

01:00 So next you're going to draw up your lidocaine with your 1% lidocaine with epi.

01:08 You can refer to our digital block video to learn more about digital blocks as well.

01:14 We're going to go in here and we're going to let the patient know that they're going to feel pain and burning.

01:20 But this is normal. But this will help when we're removing the fishhook.

01:25 You want to make sure that you're checking to make sure that you don't have any blood return. And then you're going to push forward and you're going to slightly pull back, and you're going to go in the opposite direction, and you're going to push about 1 to 1 and a half cc's of lidocaine.

01:42 Again, you're pulling back to make sure no blood return and moving forward.

01:47 We're going to pull out.

01:48 We're going to go above the wound.

01:50 Again, you're going to do the same steps.

01:53 You're going to put the needle in.

01:55 You're going to withdraw back.

01:57 Make sure no blood return.

01:59 And you're going to push forward 1 to 1 and a half cc's.

02:02 Again we're going to slightly withdraw.

02:06 You're going to go to the other side and you're going to do the same thing again withdrawing back, making sure no blood return and pushing forward.

02:18 Now that the patient is fully anesthetized again, you're going to put this back on your clean field in case you need more later.

02:27 And you never want to cap a needle holding it.

02:33 Now we're going to wait 5 or 10 minutes, and we're going to make sure the patient's fully anesthetized. It's been that long.

02:40 And we're going to check by pricking their skin.

02:43 We're going to let them know they'll feel the pressure, but they shouldn't feel the pinch or any pain.

02:50 The patient's not feeling any pain at this point.

02:53 So now we only have the barb at the far end of the hook.

02:59 So we want to control the hook by managing from this side.

03:04 So we're going to use our needle driver to hold the needle.

03:08 And then on the other side we're going to take our wire clippers.

03:11 And so this is why you want eye protection.

03:15 And now that you have the needle driver in place you're going to cut the barb.

03:21 Here you go. So we have the barb.

03:22 So we want to make sure this is on a secure location so nobody gets hurt with it.

03:26 So we're going to place that over there.

03:28 And then you're going to place the needle driver in your dominant hand.

03:33 And we're going to back out this hook.

03:37 So you're going to hold on to the patient's skin and you're going to back out with the hook. Great. The hook has now removed.

03:45 You're going to make sure that you obtain homeostasis here for a minute.

03:49 Make sure it's not bleeding.

03:54 So now we are going we have the hook removed.

03:57 And now we're going to irrigate the wound.

04:03 And now we're going to look for any fragments that may be here.

04:07 I do not see any fragments at this time.

04:11 And so now we're going to assess for pain and, and see how comfortable they are.

04:16 And we're also going to assess for bleeding.

04:19 So we're going to use our gauze.

04:20 If there's any bleeding here, we're going to dry off our area as well.

04:24 And then we're going to apply antibiotic cream to the area.

04:30 There we go. Put this over the area here.

04:36 And then we're going to apply our dressing.

04:42 And you would want to make sure to tape this and then give your aftercare instructions to your patient.