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[HAIR TOURNIQUET SYNDROME - A DISCREPANCY BETWEEN INCIDENCE AND DOCUMENTATION AND A DISCREPANCY BETWEEN COMMON
Noa Martonovich1, Maher Khatib1, Michael Assaf1
1Department of Orthopedics "A", Galilee Medical Center.
Introduction:
Hair tourniquet syndrome, AKA hair thread tourniquet or hair strangulation occurs among infants. A human hair or a thread strangulates a body appendage, resulting in obstruction of blood and lymph flow. If not recognized early it may cause tissue necrosis and rarely, require amputation.
Aims:
Revealing the discrepancy between incidence and documentation in practice. Understanding the challenges standing in the way of the clinician while admitting a patient.
Methods:
A retrospective study. The hospital's archive was searched for the period between the years 2008 to 2018. According to the ICD9 system this phenomenon is termed "external constriction caused by hair". Upon questioning, doctors had admitted having trouble finding the right diagnosis while digitally documenting a patient. The archive was searched twice - firstly, by the correct ICD9 code. Secondly, a general search was performed reviewing all 0-1 year-old patients' files.
Results:
By researching the ICD9 code, 7 files were found. On the second search, 41 files were found, among them only 5 files were documented properly according to the ICD9 system.
Conclusions:
The majority (87.8%) of patients suffered from hair strangulation syndrome were not documented properly. Lack of documentation is a result of the digital difficulty finding the right diagnosis.
Discussion:
Hair strangulation syndrome is not as rare as may be concluded basing on existing data. Clinicians must include it in the differential diagnosis when admitting a patient with the relevant symptoms or an agitated infant with no clear cause. Adjusting the digital systems in Israeli hospitals should be considered.
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