8802-26 - Surgical Tourniquet Safety

A tourniquet is a constrictive or compressive device used to control venous and arterial circulation to an extremity. Pressure is applied circumferentially upon the skin and the underlying tissues of a limb. This causes the blood vessels under the tourniquet to become temporary occluded. In surgical settings, a tourniquet is used to establish and maintain a relatively dry operative field, to minimize blood loss, to aid in identification of vital structures, and to expedite the procedure. Modern surgical tourniquets are pneumatic tourniquets that compress ambient air to inflate tourniquet cuffs. They have safety features, such as alarm systems: to warn of a possible kinked or blocked hose, a disconnected hose, or a leak in the system; to detect unusual increase or decrease in cuff pressure; and to indicate elapsed inflation time and alert staff when a pre-selected maximum tourniquet time has been exceeded. Although tourniquet technology has been improved a great deal over time, and despite the well-documented benefits of modern surgical tourniquets, their use can be associated with potential adverse local and systemic consequences. Patient safety should always be a priority with tourniquet use. Therefore, perioperative nurses need to be educated in tourniquet systems and be aware of the content of the current AORN recommended practices. The purpose of this continuing education activity is to provide comprehensive information about surgical tourniquet use, such that its effectiveness and patient safety are maximized while labor and errors are minimized. This document will cover: a brief overview of the advancement in tourniquet technology; mechanisms of tourniquet-related injuries and preventative measures; components of a pneumatic tourniquet system; criteria for cuff selection and application; benefits of using limb occlusion pressure; safety concerns during tourniquet use; and safety aspects of reprocessing tourniquet cuffs.