When Hooks Get in Humans

Quick extraction can save a trip, and lots of pain.

By Mark Rustemier, M.D.

Originally published in the April 2008 print edition.

String-yank method, shown with a treble hook plug. Note other hooks on the plug have been removed or secured.

If you fish long enough, it is inevitable that you or one of your fishing buddies will find yourself on the wrong end of a fishhook. Knowing how to safely remove a hook can salvage a trip, offshore or in. With just a little knowledge you can relieve pain and suffering in your fellow fisherman, avoid an expensive trip to the emergency room, make a friend for life, and just as importantly get back to fishing! So pay attention.

Of course, prevention is always the first goal. When fishing with young children, use single hooks and consider crimping the barbs down. This may allow you to remove the hook more easily from your leg as well as theirs.

However, when all of your best preventative efforts have failed, then we get down to the business of hook removal. First you need to decide if this is a removal you want to attempt yourself or is it better off handled in the emergency room. If the hook is embedded in the skin, or the soft tissue below the skin, and away from sensitive structures, you can do the removal yourself. However, injuries involving areas around the eyes, ears, mouth or groin or those that have deep penetration into bone, joint or nerves should be punted to the professionals. Fortunately the majority of these “hook ups” are uncomplicated, and can be handled on the water.

When the barb is buried in the skin use the “string-yank method.” You need a couple feet of 30- to 80-pound-test line, with heavier line for larger hooks of the sort used offshore. (Double lighter lines if you don’t have the heavy stuff.)

Cut the running line or leader to the hook. If it’s a lure, it’s best to get the offending hook off the plug, though this may be impossible due to pain it causes the victim. Clipping other hooks off the lure is also a good idea where possible; the last thing you want to do is jerk one hook out and another into the victim.

Position the victim sitting or lying down, and stabilize the involved area on a flat surface. Tie the ends of the pulling line together, forming a loop, and then place the loop around the bend of the hook. An alternative is to tie one end directly to the bend of the hook. Hold the loop firmly around your wrist or in your hand.

With the other hand, bring the shaft of the hook down parallel to the skin, then press the eye of the hook against the skin and toward the bend of the hook. Hopefully this releases the barb. While pressing the eye of the hook into the skin, firmly and quickly jerk the line directly away from the shank, following through while popping the hook out.

I’ve learned it helps to tell the victim you will pull on “three,” then actually pull on “two,” which avoids flinching. Keep bystanders out of the flight path of the hook/plug, or you may have another hook removal to do. Remember to pull hard. Failing to disengage the hook on the first effort ups the pain ante tremendously.
If the hook has come completely through the skin, then you’ll need to cut off the barb to get it out. Some prefer this method anyway, and if the hook is close to coming back out through the skin, they will bite the bullet and push it through. Of course, in the emergency room you get some local anesthesia for this! The only materials needed are a good pair of pliers with cutters. Positioning of the victim is the same, and you do not have to worry about the other hooks. Push the barb through the skin with a twist of the pliers; it will hurt, but done quickly the pain does not last.

Now use the wire cutters to cut the barb off at the skin level, covering the tip with a rag to prevent getting hit with the flying point. The hook can then be backed out and removed. The challenge can come with larger diameter hooks, when the cutters on your pliers may not be up to the job. Keeping heavier duty wire cutters or small bolt cutters on board can be worth every penny in this situation.

While everyone breathes a sigh of relief once the hook is out, clean the wound and apply topical antibiotic ointment, covered with an adhesive bandage to keep out the salt water and other contaminants. If the wound is otherwise clean, just observe it a few days for persistent pain, swelling or redness, and seek medical care if this occurs. A tetanus booster is also recommended within 72 hours, if the victim has not had one in 10 years or more. FS