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Ring/Constricting Band Removal, Emergency Medicine

Reviewed 06/2017



  • Primary constricting band: A band tightened around an appendage causes swelling and pain (e.g., a hair knotted around a toddler's toe).

  • Secondary constricting band: Injury or disease ...


Signs and Symptoms

  • A constricting band with swollen tissue and skin of an appendage, most commonly involving a finger

  • Other locations include wrist, ankle, toe, umbilicus, earlobe, nipple, sep...



Remove rings and other potential constricting bands before development of tourniquet syndrome: 
  • Particularly in regions of extremity trauma

Initial Stabilization/Therapy

Pain manage...



Admission Criteria

  • Neurovascular compromise or injury requiring surgical repair

  • Concomitant infection or necrosis

  • Investigation of abuse and or neglect

Discharge Criteria

Successful ba...

Pearls and Pitfalls

  • Failure to completely examine the fingers, toes, and genitalia of the irritable infant

  • The hair causing a hair tourniquet may be obscured by edema and heaped up tissue and skin.

  • Ring...

Additional Reading

  • Hoffman  RJ, Wang  VJ, Scarfone  RJ. Fleisher and Ludwig's 5-minute Pediatric Emergency Medicine Consult. Lippincott Williams & Wilkins; 2011.

  • O’Gorman  A, Ratnapalan  S. Hair t...



  • 959.5 Finger injury

  • 959.7 Knee, leg, ankle, and foot injury


  • S60.448A External constriction of other finger, initial encounter

  • S60.449A External constriction of unspecified finger, initial ...

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