Apply a blood pressure cuff to the affected extremity and inflate it to the patient's systolic blood pressure plus 100 mmHg. Tightly wrap a Penrose drain or 1 inch elastic band (eg, intravenous tourniquet) from the tip of the digit proximally and elevate the extremity above the heart for 15 minutes. Assess for reduction of edema and reapply the elastic wrap, if necessary. Keep the blood pressure cuff inflated while attempting manual removal. Total tourniquet time should not exceed two hours.
Reproduced with permission from: Fuchs SM. Ring removal. In: Textbook of Pediatric Emergency Procedures, 2nd ed, King C, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2008. Copyright © 2008 Lippincott Williams & Wilkins.
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