What is Fishhook Injury?

• A Fishhook Injury is a type of penetrating injury that occurs when a fishhook gets stuck in the skin, soft tissues of the hand or face. In most cases, the peculiar barbed end of a fishhook makes its removal difficult
• Fishhook Injuries are more common among individuals who are into recreational fishing. Generally, the condition is not serious, but if the fishhook gets embedded near the eye, pierces a cartilage/tendon, or severs a blood vessel or nerve, then it may be complicated
• The removal technique depends on the type of fishhook involved. Some fishhooks are simple/single hooked with multiple barbs, while others are treble hooked (more than two “U” shaped hooks) with multiple barbs

What are the Causes of Fishhook Injury?

Fishhook Injuries are caused by the following factors:

• Inexperienced individuals handling fishing rod, hook, and bait
• Injury occurring while swinging the fishing rod (which may affect the individual himself/herself or bystanders)
• Sorting through fishing nets, angles, and other associated equipment, especially using bare hands
• Walking barefoot by the side of a lake or river or waterbody, where angling is common

What are the Signs and Symptoms of Fishhook Injury?

The signs and symptoms of Fishhook Injuries include:

• Bleeding
• Pain that is localized to the affected site
• In many case, only the skin may be involved and deeper tissues are not affected
• In some cases, the pointed fishhook sticks out of the skin; while sometimes, it stays embedded in skin tissue
• The affected site can be the hand (fingers or palm), face (cheek, chin, lips, tongue, nose, or ears) or neck, legs in rare cases
• Swelling may be observed after the fishhook is removed

How is First Aid administered for Fishhook Injury?

First Aid tips for Fishhook Injuries:

• Cut the fishing line and remove any bait attached to the fishhook
• Prior to removal of the fishhook, ensure that your hands are cleaned using soap and water
• Wash the site of the fishhook with clean water
• Apply icepack to slightly numb the area (if available)
• The removal of a fishhook should be performed by a healthcare provider (preferred method). This depends on the location of the injury and the type of hook involved

Removal techniques: When the involved part is a finger, hand, of even the face (but not the eye). 

• If the hook is on the face, protection of the eye is essential while removing it
• Fishhook without barbs are rarely encountered, and these may be easily removed by pulling along the profile of the fishhook (unless they are rusted)
• If the barb has not penetrated the skin, then the fishhook is also easily removed by carefully pulling it away from the body part
• If the barb is into the skin tissue, then the hook may be removed using the string-pull method
• If the barbed end of the fishhook is nearly protruding out of the skin, then push the hook further inside to openly expose the barbs completely. After this, cut the hook with a pair of suitable cutting pliers (or wire cutters), and then retract the fishhook
• Call 911 (or your local emergency number), if the fishhook has affected the eye or is very near to the eye, or if it is deeply embedded in skin, muscle tissue or bone, refractory to easy removal
• If the fishhook is in the region of the eye, ensure that no further injury takes place by suitably protecting the site

If the hook is embedded deep into the tissues, the removal technique usually involves the administration of a local anesthesia. There are a variety of methods of fishhook removal that a qualified healthcare expert may employ. The 4 main methods include:

• Retrograde technique: It is performed for barbless hooks that are superficially embedded
• String yang technique: It is a modified retrograde fishhook removal technique. It is usually used for small and medium sized hooks
• Needle cover technique: It is usually done for large hooks that are superficially embedded 
• Advance and cut technique: This technique is typically an invasive procedure often used for hooks that are deeply embedded or when other less invasive techniques fail. This technique can be used for single point or multiple barbed fishhooks. The procedure is generally performed under local anesthesia. Due to the invasive nature of the surgical procedure, careful wound care and appropriate follow-up visits are necessary

Following removal of the fishhook, the following steps should be considered:

• Wash the area with clean water
• Apply gentle pressure on the wound with a clean cloth to stop any bleeding
• Place a loose dressing over the wound (leave it open to air); apply an antibiotic cream
• DO NOT close the wound with a firm sterile bandage
• Tetanus prophylaxis: If you are unsure of the last tetanus shot, check with your physician for a booster dose
• In some individuals, prophylactic antibiotics may be necessary, depending on the overall immune status of the individual including diabetes

Seek immediate medical assistance, if the wound is too deep/wide, bleeding does not stop, or there are any signs of infection including redness, swelling, pain, and purulent (pus) drainage.

Who should administer First Aid for Fishhook Injury?

First Aid can be administered by the affected individual themselves, or by any person near them. In case of fishhooks near the eye, in the tongue, genitalia, or deeply inserted into the body, a qualified healthcare professional must be sought.

What is the Prognosis of Fishhook Injury?

• The prognosis of Fishhook Injury is usually good with suitable first aid treatment. However, one should carefully monitor the site for any signs of infection
• Very rarely, if the eye is involved, then removal of the fishhook may be complicated. It may also lead to vision being affected (rarely)

How can Fishhook Injury be Prevented?

A Fishhook Injury may be prevented by considering the following:

• Learn the correct techniques of fishing and handling fishing gear
• Be careful while using fishing hooks, since these objects are sharp and pointed
• Do not permit children to use fishhooks and bait, unless adult supervision is present

What are certain Crucial Steps to be followed?

• Use the correct fishhook removal technique
• Clean the wound
• Tetanus prophylaxis
• Monitor for infection signs