More and more health care professionals are facing challenges related to body piercing and jewelry. Infections and allergies are commonly seen in the office setting, but what about at the scene of an accident or in an emergency room? Patients with relatively minor injuries often do not know how to remove their jewelry for imaging or procedures; those with more significant injuries are often not in a position to be of any help. Common issues faced by professionals on the front lines are: intubation with oral jewelry in place, MRI’s while the patient has jewelry ‘who knows where’, surgical procedures where the patient is either unable or unwilling to remove their jewelry.

As a piercer and a nurse, I have noticed unexpected shifts in the type of clients I see on any given day. It is difficult to tell who has piercings and where they are. For example, my average client seeking a nipple or below the waist piercing is often over the age of 30, works in a conservative field, has been married for a while and has children, typically they have no other piercing aside from ear lobes. I do an average of 4-8 of these each week in my practice, they are more common than most might think. It is wise with an unconscious patient to look everywhere even if you do not suspect a piercing before procedures such as MRI’s. Some patients are unaware of the consequences of wearing hidden jewelry during an MRI that is scheduled, and need to be made aware if it’s importance.

Body piercing and jewelry becomes to most, an important part of who they are, they are reluctant to remove it if they see no clear reason to do so, consequently there is a high rate of non-compliance with jewelry removal for scheduled procedures. I often get clients who are angry because their doctor wants earrings removed for foot surgery. After I explain to the client that if electrical cautery is needed during surgery, it will ground via their jewelry and leave them with an unnecessary burn or injury, suddenly a light comes on and they understand. By knowing why, compliance is improved.

I would like to see jewelry removal implements in every emergency room, on each ambulance, in each crash cart, in each O.R. In an emergency, where seconds count, when patients are often not in a position to be of help, quick and effective jewelry removal is less frustrating for staff, faster and safer for the patient. While cutting jewelry out is a solution, it can be time consuming, difficult with thick jewelry, and cause injury to the patient.

Body jewelry is referred to in terms of thickness, diameter and type. The thickness is referred to as the gauge. The numbers run just the opposite as what one would think, the larger the number, the thinner the wire. Most jewelry runs from 20g (the thickness of an ear ring), to 00g + (about 3/8 of an inch). The diameter is measured in inches. For example an average navel ring is 14g 3/8”. Silver colored jewelry is made of surgical steel (usually 316L or LVM) and is very hard to bend. Colored metals are generally titanium or niobium and are a bit softer. Some jewelry is made of gold (solid 14k or 18k). Plastics such as Lucite are also used.

There are two major types of body jewelry in which removal can be a problem, the barbell and the captive bead ring. There are many variations among these types of jewelry as well.

The barbell comes in many different shapes and sizes, you are likely to find this piece of jewelry anywhere from the tongue, to the navel, in ears, eyebrows, nipples and below the waist. Barbells have a ball on either end of either a straight, circular or curved post. On most barbells, both balls screw off and on. One ball will go one direction and the other is the opposite, unscrewing a barbell is much like unscrewing a bolt from a nut. Firmly grasp each ball with gloves on to add traction and twist in opposite directions. Once one ball come loose simply back the post out of the piercing.

Labret studs only have one removable piece, the ball portion. These are generally found in the lower lip, but can be worn anywhere. Use hemostats to grasp the post of the jewelry to keep the entire piece from rotating while turning, unscrew the ball and pull the post through the piercing. Usually the flat disc is not removable. (hemostat ends)

Perhaps the most challenging piece of jewelry to remove is the captive bead ring. Generally it requires tools for easy removal. There is a small gap in the ring where a bead is generally held in by pressure from the two ends of the jewelry.

Traditional tools found in the medical industry are of little help in their removal. In piercing studios, a tool called opening pliers is generally used. A similar tool can be found at any hardware store with a good selection of automotive tools. A heavy duty pair of snap ring pliers is generally all that is required for most captive bead rings up to a 10 or even 8 gauge piece of jewelry.

Snap ring pliers have a pointed tip, and the tip is inserted into the center of the ring. When the handle of the pliers are squeezed, it places pressure on the inside of the ring, opening it to a semi-circle, the bead falls out and the semi-circle is then backed out of the piercing. For thicker gauge jewelry, professional piercing pliers may be required. Professional pliers are available via any piercing supply company and are readily available from companies who sell via the internet.

Should you have any questions or are in need of finding any supplies that might aid you in body jewelry removal, I can be e-mailed at: piercing@att.net Thank you for taking the time to review this, it is my sincere hope that this be helpful when every second counts.

Emily Cahal