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Trusted Care: Duty to Speak Up to Make a Difference

JOINT BASE ANDREWS -- An elderly patient came to the Emergent Care Center  at Malcolm Grow Medical Clinics and Surgery Center on Joint Base Andrews.  She complained that she could not take off her rings and her finger was very swollen.
 

This patient, who had recently buried her husband who was a WWII POW vet, said she started wearing one of his rings in memory of him, in addition to the four rings she already wore. Unfortunately, this fifth ring contained nickel, causing an allergic reaction and severe swelling in her. This prevented her from taking off any of the rings and risked cutting off all circulation to her finger.

The patient and her daughter attempted to remove the rings at home with hot water and petroleum jelly, but were unable to remove them due to the swelling. She was hesitant to come to the Emergent Care Center knowing that the rings would likely have to be cut off.

She stated that each ring had significant sentimental value to her and she did not want them cut, but knew that she didn't have any options left. Once she was seen by Capt. (Dr.) Drew Shiner, 779th Medical Group Emergency Care Center physician, he instructed Staff Sgt. Daniel Shimanski, 779 MDW medical technician, to grab the ring cutter and cut the rings off.

But Shimanski remembered seeing a video of a person taking off a ring using tooth floss.

“I quickly looked up the video and offered to try the technique to remove the rings,” he said.

 Shiner, not afraid to let his technician try something outside of the box, told him to “Go for it!”

“I had the patient stick her finger in ice water to reduce the swelling. After several minutes I then got some packing gauze (due to its narrow size) I wrapped her finger tightly to reduce the swelling even more. After that, I threaded the dental floss through the ring and wrapped it around her finger below it. I applied some bacitracin and then slowly unraveled the dental floss while easing the ring off. Five minutes later I had every single ring off and a very happy patient,” said Shiner.  

Shimanski and Shiner incorporated several trusted care principles in their approach that day: Duty to Speak Up; Respect for People; Zero Harm, and Maximize Value for the Patient. Each member of the medical staff here strives to be a valued team member. Working together they are making all the difference.

But it doesn't end there. The technique worked so well that it will be incorporated into training for all the capital medics at the 779th Medical Group. One more tool in their bag to do their job better.