Just a quick post in reply to the post on Academic Life in Emergency Medicine where Michelle Lin and colleagues described how to remove a Tungsten ring by crushing it – they’re strong, but brittle apparently.
Anyway, whilst this is fine I do find that patients really don’t like their wedding rings destroyed. There is no joy in cutting off the wedding ring of a lady whose husband died recently. I’ve seen it done and it just seems wrong.
However, we do need to take rings off. Commonly when there is finger trauma or limb swelling from an injury further up the arm.
So, how is it that I’ve pretty much never cut a ring off? It’s not ‘never’ but it’s certainly a lot less frequently than many of my colleagues. Click here to watch and learn the undertakers trick.
1. Don’t try this if there is a wound on the finger – you would have to cut it off then.
2. It will only work if you are reducing a soft tissue obstruction. Obviously if there is a bony block, e.g. osteoarthritis of the PIPJ then it won’t work.
3. If you give it a try then it’s at your own risk. We do this in the ED as if it fails we always have the option of ring cutters.
4. This can be painful. If your patient cannot tolerate it, or if they do not want to try then fair enough. Again you would then need to cut the ring off.
So, in reality it does not work every time, but so long as the caveats above are met then it may well be worth a try.
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8 thoughts on “The undertaker’s ring method. St.Emlyn’s”
We have disposable tourniquets at work which do the job too. I usually start from the tip of the finger (I do the same to exsanguinate a finger prior to exploration in the department) and come proximally. It’s not as clever when you get to the sliding under the ring bit, but also not as uncomfortable (I guess) as the tourniquets are a bit broader. Sometimes a digital nerve block can help….
As a complete aside I use the deposable tourniquets for other things as well- the most useful probably being to reduce a paraphimosis (for those days when it looks like there are not enough sports on the planet to discuss). Works a treat, though you really shouldn’t leave the patient, it does give you a chance to write up your notes as it works.
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Agree re disposable tourniquets- add a little lube and it works brilliantly. They are slimmer, broader, cheaper, slippier and not manchester 🙂
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This video saved my ring! Saved my finger and pride a trip to the ER also, thank you very much. We used a latex strap from face mask and astroglide along with a rigorous yank. Thank you!
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