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 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 Jan 20234min

Podcast 841: Wound Care

Podcast 841: Wound Care

Contributor: Aaron Lessen, MD Educational Pearls: Wound care in the emergency department aims to prevent future infection Copious wound irrigation is the important step in preventing wound infection ...

3 Jan 20233min

Podcast 840: Abnormal Pediatric Vitals at Discharge

Podcast 840: Abnormal Pediatric Vitals at Discharge

Contributor: Aaron Lessen, MD Educational Pearls: Pediatric patients frequently have vital signs considered abnormal for age at discharge Large multicenter study recently evaluated if pediatric patie...

29 Dec 20223min

Podcast 839: Causes of Pancreatitis

Podcast 839: Causes of Pancreatitis

Contributor: Travis Barlock, MD Educational Pearls: The causes of pancreatitis can be remembered with the mnemonic: "GET SMASHED" G: Gallstones (Most common cause of pancreatitis overall) E: Ethan...

19 Dec 20223min

Podcast 838: Sternoclavicular Septic Arthritis

Podcast 838: Sternoclavicular Septic Arthritis

Contributor: Aaron Lessen, MD Educational Pearls: Septic arthritis of the sternoclavicular joint is uncommon accounting for Immunosuppression and IV drug use increases the risk  Can account for up ...

13 Dec 20224min

Podcast 837: Snakebites

Podcast 837: Snakebites

Contributor: Meghan Hurley, MD Educational Pearls: Venomous snakes in the United States include species from the family Elapidae and subfamily Crotalinae In prehospital setting, elevate the bitten ex...

12 Dec 20226min

Podcast 836: Humming to get EJ

Podcast 836: Humming to get EJ

Contributor: Jared Scott, MD Educational Pearls: Two conventional ways to aid in external jugular vein (EJ) catheter placement are Trendelenburg's position and Valsalva's maneuver by patient One stu...

6 Dec 20223min

Podcast 835: Syncope Review

Podcast 835: Syncope Review

Contributor: Meghan Hurley, MD Educational Pearls: Syncope is defined as a loss of consciousness with an immediate return to baseline Differential is broad Cardiogenic Structural (aortic stenosis, ...

5 Dec 20226min

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