A fisherman's prank almost killed him after the Dover sole he had just caught jumped down his throat when he posed with it over his mouth.
The 14cm (5.5in) fish completely blocked the 28-year-old's airway, stopping him from breathing and causing him to go into cardiac arrest.
Just minutes before, the man - who has not been identified - had been joking around with his catch and putting it over his mouth, but it wriggled free and managed to jump down his throat.
When paramedics arrived at the scene at Boscombe pier in Dorset, they found the angler in a "desperate" situation and their initial attempts to get the man breathing again proved futile.
"It was clear that we needed to get the fish out or this patient was not going to survive the short journey to Royal Bournemouth Hospital," Martyn Box from South Western Ambulance Service said.
The paramedics then used a pair of forceps to extract the lodged fish from the man's throat.
"I was acutely aware that I only had one attempt at getting this right as if I lost grip or a piece broke off and it slid further out of sight then there was nothing more that we could have done to retrieve the obstruction," Mr Box explained.
He added he was further worried that the fish's barbs and gills would get stuck on its way out, but on his sixth attempt, Mr Box managed to remove the fish in one piece.
"To our amazement it was a whole Dover sole," he recounted.
Paramedic Matt Harrison added he had "never attended a more bizarre incident and don't think I ever will - but we're all so glad the patient has no lasting effects from his cardiac arrest, which could so easily have had such a tragic and devastating outcome".