Hair tourniquet

Background

• Also known as hair thread tourniquet syndrome
• Prompt diagnosis needed as ischemia can result

Clinical Features

• Crying infant
• Typically involves toes but can be located on fingers or genitals
• Constricting band with edema and/or redness distally

Differential Diagnosis

Crying Infant

• Occult infection
  • Sepsis
  • Meningitis
  • UTI
  • Otitis media
  • Pneumonia
• GI
  • Intussusception
  • GERD
  • Incarcerated hernia
  • Milk protein intolerance
  • Anal fissure
• Ophtho
  • Corneal abrasion
• Occult trauma
  • Hair tourniquet (on extremities, penis)
  • Non-accidental trauma
  • Diaper pin
  • Insect bites
  • Burns in mouth
• Misc
  • Colic
  • Scorpion envenomation
  • SVT
  • Testicular torsion
  • Drug exposure/overdose (commonly methamphetamine or cocaine)
  • Neonatal abstinence syndrome, drug withdrawal

Evaluation

Workup

• Typically not indicated

Diagnosis

• Typically a clinical diagnosis

Management

[[File:Hair Tourniquet.jpg|thumb]

• Simple removal with scissors
• Depilatory agent can be used if skin is intact (Nair)
  • Apply for 8 minutes and rub agent and hair off
  • Not effective on cotton or synthetic materials
• Consider dorsal slit for cases where skin is broken and tourniquet is too tight for other methods

Disposition

• Discharge home

See Also

• Crying infant