Hair Tourniquet Syndrome
Author: Dr S Knapp & Dr R Rowlands
From: Leicester Royal Infirmary
Presented as a Poster at #RCEM15 (Manchester)
Objective
To assess the effectiveness and safety of our hair depilatory cream protocol in the treatment of hair tourniquet syndrome.
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Introduction
The use of depilatory cream has been previously described to aid the removal of hair tourniquet in children [1].
We have introduced a nurse led protocol to allow treatment to begin at triage.
This is the first case series in the literature describing the use of hair depilatory cream.
Methods
All children coded with diagnosis of ‘Hair Tourniquet Syndrome’ were obtained from the Emergency Department Information System (EDIS) since the introduction of the protocol.
All staff were asked to email details of patients they treated to attempt to capture those who may have incorrect coding.
Table 1
Results
There were 21 cases of Hair Tourniquet Syndrome between December 2012 and May 2015 (Table 1).
Hair depilatory cream was successful 71% of the time.
Hair depilatory cream was well tolerated and caused no documented side effects
Instrumentation removal was equally effective but there were 2 examples of failure resulting in iatrogenic tissue damage requiring theatre and further follow up.
Conclusions
Hair Depilatory Cream is safe, cheap and effective
It can be safely implemented with a nurse led protocol
Why risk unnecessary iatrogenic injury?
Acknowledgements
Special thanks to Julia Bragg, Paediatric ENP who helped in the original data collection
Photo: James Heilman, MD / CC-BY-SA-3.0
References:
- O’Gorman, A. Ratnapalan, S. Hair Tourniquet Management. Pediatr Emerg Care 2011;27:203-204
