Ring Removal: Assessment and Methods

00:00 Hello, my name is Glenna Lashley.

00:03 I'm a family nurse practitioner.

00:05 Here at Lecturio, we realize that many students don't always get a chance to see or talk through advanced skills during their clinical rotations.

00:13 Unfortunately, fingers sometimes can become entrapped by rings in several situations and need your help to be removed by force.

00:22 Some examples are a digit could be traumatically jammed, there may be significant swelling secondary to organ disease or during the dying process.

00:33 Depending on the age and the extent of the entrapment, there are different approaches to removing the ring.

00:39 Before you do anything, you first need to assess the situation.

00:44 First, you want to evaluate the neurovascular status, including capillary refill the sensation, whether they're able to move the finger or not. Second, you want to measure the digit circumference proximal and distal to the ring. Third, you want to document the time of the entrapment onset and previous removal attempts. So finding out what your patient's already tried before they come to see you.

01:10 And fourth, you want to assess for signs of trauma, infection or severe edema.

01:17 Evidence-based protocols recommend that we start with conservative approaches first.

01:22 So that's going to be using an ice pack, elevation and some manual decompression.

01:28 Second method is going to be using something like dental floss to do the string method.

01:34 And the third would be using a ring cutter.

01:37 There is also a newer method that you can use which uses a digital compression device.

01:42 But we are not going to be doing that today because that's not available everywhere.