Podcast 807: Ring Removal Tricks

<p><strong>Contributor: Jared Scott, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">If a patient is in significant pain, a digital block can be helpful. Pain management alone may allow for manual ring removal. </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">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. </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">2 alternative options are presented which aim to reduce edema above the ring to assist removal: </span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">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. </span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">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. </span></li> </ul> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Asher CM, Fleet M, Bystrzonowski N. Ring removal: an illustrated summary of the literature.</span> <em><span style="font-weight: 400;">Eur J Emerg Med</span></em><span style="font-weight: 400;">. 2020;27(4):268-273. doi:10.1097/MEJ.0000000000000658</span></p> <p><span style="font-weight: 400;"><br /></span><span style= "font-weight: 400;">Walter J, DeBoer M, Koops J, Hamel LL, Rupp PE, Westgard BC. Quick cuts: A comparative study of two tools for ring tourniquet removal.</span> <em><span style="font-weight: 400;">Am J Emerg Med</span></em><span style="font-weight: 400;">. 2021;46:238-240. doi:10.1016/j.ajem.2020.07.039</span></p> <p> </p> <p><em