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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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...

1 Touko 20233min

Podcast 848: Non-Traditional RSI

Podcast 848: Non-Traditional RSI

Contributor: Meghan Hurley, MD Educational Pearls: Two main reasons to choose non-traditional RSI Anatomically challenging airway Physiologically difficult patients: hypoxia, metabolic acidosi...

24 Huhti 20235min

Podcast 847: ECMO CPR

Podcast 847: ECMO CPR

Contributor: Aaron Lessen, MD Educational Pearls: Extracorporeal Membrane Oxygenation (ECMO) has been attempted as an adjunct to CPR during cardiac arrest but few studies on outcomes exist One prior...

6 Helmi 20233min

Podcast 846: Early Repolarization vs. Anterior STEMI

Podcast 846: Early Repolarization vs. Anterior STEMI

Contributor: Travis Barlock, MD Educational Pearls: Early repolarization a benign EKG pattern that can mimic an anterior STEMI Can be seen in the anterior leads typically in young male patients Can d...

30 Tammi 20232min

Podcast 845: Hyperkalemic Cardiac Arrest

Podcast 845: Hyperkalemic Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including ...

16 Tammi 20234min

Podcast 844: Dental Infections

Podcast 844: Dental Infections

Contributor: Meghan Hurley, MD Educational Pearls: Educational Pearls: Dental infections can be categorized into two main groups Infections of the gums Pericoronitis Tooth eruption leading to infl...

10 Tammi 20234min

Podcast 843: Commotio Cordis

Podcast 843: Commotio Cordis

Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest A national registry, US Commotio Cordis Registry, repor...

9 Tammi 20234min

Podcast 842: "History of Wound Care"

Podcast 842: "History of Wound Care"

Contributor: Chris Holmes, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided ...

4 Tammi 20234min

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