Emergency Medical Minute

Contributor: Megan Hurley, MD Educational Pearls: Assess first: confirm the hook isn't near vital structures. Automatic subspecialty consult for eye involvement or proximity to carotid artery, radial artery, peritoneum, testicle, or urethra Barbed hook: cannot be pulled back through the entry without disengaging the barb Removal Techniques String-Pull: best for superficial, single-barbed hooks Depress shank and eye of hook to disengage barb and then pull string taut and jerk suddenly along the long axis Can only be used when the hook is in a body part that can be firmly secured so it won't move during the procedure Little or no anesthesia needed Push-Through & Snip: best choice when barb is near the skin surface Anesthetize first and advance the hook forward until the barb emerges. Cut off the barb and then back hook out Small exit wound, no sutures needed Needle Cover: for larger hooks that are superficial Anesthetize first and then slide an 18 or 20-gauge needle along the hook until the bevel