, part 2) The remainder of the hook can then be withdrawn along its original path of entry ( Fig 130.42A , part 3) String removal ( Fig 130.42B ) When the fish hook lies too deep to force through a second wound, an alternate method can be used Explain the procedure and restrain the child as necessary Cleanse the area with antiseptic solution Achieve local anesthesia by injecting 1% lidocaine needle into the surrounding skin Loop a piece of string around the hook (part 1) With the nondominant hand, depress the shaft of the hook against the skin (part 2) Grasp the end of the string with the dominant hand and pull sharply (part 3) This action should disengage the barb, and the hook can be removed through the entry wound Following removal, cleanse the area and apply a dressing Give active or passive tetanus immunization as indicated Consider antibiotic prophylaxis in immune-compromised patients