Podcast 807: Ring Removal Tricks

Podcast 807: Ring Removal Tricks

Contributor: Jared Scott, MD

Educational Pearls:

  • If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal.
  • Ring cutters and trauma shears with specialized ring cutters can be attempted but will destroy the ring and some materials may be resistant to cutting.
  • 2 alternative options are presented which aim to reduce edema above the ring to assist removal:
    • Move the ring as proximally as possible. Wrap large size suture from the ring distally beyond PIP joint. Slide the ring over the suture and off the finger.
    • Wrap a tourniquet from distal to proximal including over the ring. Have the patient hold the tourniquet in place while they elevate their hand above the head for 15 minutes. Take down the tourniquet then remove the ring.

References

Asher CM, Fleet M, Bystrzonowski N. Ring removal: an illustrated summary of the literature. Eur J Emerg Med. 2020;27(4):268-273. doi:10.1097/MEJ.0000000000000658


Walter J, DeBoer M, Koops J, Hamel LL, Rupp PE, Westgard BC. Quick cuts: A comparative study of two tools for ring tourniquet removal. Am J Emerg Med. 2021;46:238-240. doi:10.1016/j.ajem.2020.07.039

Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

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Mental Health Monthly #16: Psychosis in the ED Part II

Mental Health Monthly #16: Psychosis in the ED Part II

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Episode 854: Tranq (xylazine) with Heroin

Contributor: Aaron Lessen, MD Educational Pearls: What is Tranq? Tranq is the street name for xylazine, a sedative drug typically used in veterinary medicine. Xylazine has recently emerged as a re...

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Contributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors:  Epinephrine - nonselective beta- and alpha-adr...

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Podcast 852: Angioedema After Thrombolysis

Podcast 852: Angioedema After Thrombolysis

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22 Touko 20232min

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Podcast 851: High-Dose Nitroglycerin in SCAPE

Contributor: Aaron Lessen MD Educational Pearls: SCAPE (Sympathetic Crashing Acute Pulmonary Edema), formerly known as flash pulmonary edema, is a life-threatening condition due to a sudden sympathet...

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Podcast 850: Cardiac Arrest - Entertainment vs. Reality

Podcast 850: Cardiac Arrest - Entertainment vs. Reality

Contributor: Travis Barlock, MD Educational Pearls: Sudden Cardiac Arrest (SCA) is defined as when the heart suddenly stops beating. Immediate treatment for SCA includes Cardiopulmonary Resuscitation ...

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Mental Health Monthly #15: Psychosis in the ED: Part I

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Contributors: Andrew White MD & Travis Barlock MD In this episode of Mental Health Monthly, Dr. Andrew White, a practicing psychiatrist with an addiction medicine fellowship, and Dr. Travis Barlock, a...

3 Touko 202331min

Podcast 849: Large Vessel Occlusions

Podcast 849: Large Vessel Occlusions

Contributor: Travis Barlock MD Educational Pearls:  Large Vessel Occlusion (LVO) is a condition where a clot blocks one of the major blood vessels in the brain, leading to a stroke. What are the vesse...

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