Bryan I. Fagan
丁香诊所 急诊科
丁香诊所全科培训课程 13:四种实用方法 助患者移除戒指

丁香诊所全科培训课程 13:四种实用方法 助患者移除戒指
  • 手外伤

当因手指外伤、需做手指检查或 X 光线或者出现环止血带综合征而无法拔出戒指时,需要移除戒指。可以通过冰水浸泡法、使用润滑剂、绕线法、使用氧气面罩橡皮筋、切割机等方法移除戒指。移除无法拔出的戒指时,可能会疼痛,所以可能需要阻滞神经(即麻醉)。Bryan I. Fagan 详细介绍了几种移除方法:

冰水浸泡法:适用于手指轻微肿胀。冰水浸泡 5-10 min,再适量使用医用润滑剂再取出。

绕绳法:此方法由于会疼痛,需要对手指进行麻醉。选择较细的绳子(如牙线);将绳子从手指远端开始绕到手指近端,再用镊子或止血钳将细线的近端绕过戒指;向远端拉细线的近端,将戒指带出。另外,若手指肿胀厉害,需要从手指最远端开始缠绕。

氧气面罩的橡皮筋绕线法:由于这种橡皮筋产生压强更大,因此相对于绕线法效果更好。

切割机:若想不伤害手指,最好用此方法,也无需神经阻滞。两步操作即可:切割机穿过戒指勾住戒指,割掉戒指。只割戒指一处时,用止血钳撑开戒指并取出;或者可以切割戒指两处。

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封面图片来源:shutterstock 网站

Bryan I. Fagan

丁香诊所 急诊科

Bryan I. Fagan,马里兰大学医学院附属医院急诊科医生助理(PA)、PA学校带教老师。

EDUCATION:
2002-2004 Bachelor of Science, University of Nebraska, College of Medicine-Interservice Physician Assistant Program (U.S. Army)
1996-1997 Associate of Science, George Washington University, Health Laboratory Sciences

EMPLOYMENT:
2013-present: Physician Assistant/US Army Maryland National Guard officer (65D) Care and treatment of military personnel.
2010-present: Physician Assistant, Bel Air Center for Plastic and Hand Surgery/Ramon A. de Jesus, MD, LLC; evaluation and treatment of patients with upper extremity problems/trauma and plastic/reconstructive needs.
2004-present: Physician Assistant, Dept. of Emergency Medicine, Upper Chesapeake Health System- under the direction of the attending physician, assessment and treatment of acute illnesses and injuries in the urgent care and main emergency department. I have been the Lead PA/Director of MLPs since 2012.
1995-2006: US Army Reserve, (Honorable Discharge 02/16/2006) Team member in US Army Medical Department NCO and Commisioned Officer
1998-2004: Medical Laboratory Technician, Johns Hopkins Hospital processing and evaluation of routine and STAT clinical medical specimens in microbiology, virology, hematology, immunology, and clinical chemistry.

CERTIFICATIONS and LICENSES:
Physician Assistant-Certified, NCCPA (recertified 11/2010)
Maryland State License
Maryland CDS
National DEA
BLS
ACLS
PALS
ATLS trained

MEMBERSHIPS:
American Academy of Physician Assistants

COMMITTEES:
Allied Health Review Committee
Meditech (hospital interface) introduction team Forerun and Dragon (voice -recognition EMR) introduction team
Clinical preceptor to PA students from Towson/CCBC and Anne Arundel Community College PA programs
Department peer review team
High Risk Patient management team
Emergency Department leadership

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