Cutting off a hard metal ring

(A) Hard metal rings made of steel or titanium that are causing ischemia, nerve deficit, or are associated with a deep wound, fracture, or dislocation must be cut off by a power tool with a hard blade such as a dental drill, Dremel saw, or air-driven grinder. Dentists, firemen, machinists, or other personnel may have greater experience with these devices and may be the best primary operators of these tools.
(B) During the procedure, the patient, provider, and any other personnel in the room should wear industrial eye protection. The patient's skin and is covered with wet gauze to prevent burns and cuts from sparks and filings and hemostats or a metal laryngoscope blade is placed under the cutting site to prevent patient injury. The blade and ring should be placed in ice water for a few minutes prior to cutting.
(C) During cutting, cold ice water should be dripped over the saw and ring to prevent overheating. Cuts should be made through the ring 180 degrees apart on the volar and dorsal aspect of the digit.