About TLai

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So far TLai has created 25 blog entries.

Personalized Scalp Tourniquets

Alopecia (hair loss) is a common consequence of cancer treatment known to have a profound impact on quality of life.  Tourniquet technologies have been investigated from the mid-1960s to early 1980s as a strategy for preventing chemotherapy-induced alopecia (CIA) but their ambiguous results precluded incorporation into any standard of treatment [1].  Fundamental advances inherent in [...]

Personalized Blood Flow Restriction (BFR) Rehabilitation

Why is it crucial to use personalized restriction pressures in blood flow restriction (BFR) rehabilitation? Problems in current BFR rehabilitation practice Blood Flow Restriction (BFR) applied to a limb during low intensity exercise has been shown to increase muscle size and strength across different age groups.  However, a review of BFR rehabilitation literature shows that inconsistencies [...]

Personalized BFR Rehabilitation for Patients with Possible Prior Nerve Injury

A question was raised recently as to whether it is safe and reasonable to conduct personalized BFR rehabilitation on a patient who may have a prior nerve injury.  After consideration of the evidence-based clinical literature, and in consultation with experts in neurology and orthopedic/arthroscopic surgery, the following information is provided in response: There is no [...]

Pediatric Tourniquets

Pediatric patients are different from adult patients in that they have smaller limb circumferences and limb lengths, different mass of muscle and other soft tissues, and different physiological characteristics such as blood pressures and heart rate. These characteristics can vary greatly within the pediatric population from neonatal to adolescent patients. To ensure safe and effective [...]

Military and Pre-Hospital Tourniquets

There are two types of tourniquets used in military and pre-hospital settings: Pneumatic tourniquets, Non-pneumatic (non-inflatable) tourniquets While both types of tourniquets can be used to stop bleeding in military and pre-hospital settings to save a life, pneumatic tourniquets provide greater safety to the limb because they can occlude arterial blood flow at lower pressures, [...]

Maintenance, Cleaning, and Reprocessing

Tourniquet instruments, tourniquet cuffs, tubings and connectors should be inspected and maintained after every use in order to maintain good tourniquet safety, performance and reliability. Accordingly, the 2015 Recommended Practices for the Use of the Pneumatic Tourniquet in the Perioperative Practice Settings (RPs) of the (US) Association of periOperative Nurses (AORN) recommend that the pneumatic [...]

Limb Occlusion Pressure (LOP)

What is Tourniquet “Limb Occlusion Pressure” (LOP)? Many studies and reviews published in the clinical literature have shown that higher tourniquet pressures and higher pressure gradients are associated with higher risks of tourniquet-related injuries, e.g. [1-7].  Studies have also shown that lower tourniquet pressures are associated with lower complications and pain, e.g. [8-9].  Therefore, when [...]

Intravenous Regional Anesthesia (IVRA)

What is Intravenous Regional Anesthesia? Intravenous regional anesthesia is a tourniquet-related alternative to general anesthesia for limb surgeries. It is inexpensive and widely used for both adults and pediatric patients, with the frequency varying by the type of surgery and practice patterns [1]. In IVRA, a dual-bladder cuff or two single-bladder cuffs are applied proximal [...]

Hazards of Narrow, Non-Pneumatic Tourniquets

Hazards, injuries and death associated with high tourniquet pressure levels and gradients A recent report of a serious injury and a death associated with the use of an elastic, non-pneumatic tourniquet provides motivation for reviewing the underlying mechanism of tourniquet-related hazards and injuries, and for establishing tourniquet safety guidelines for minimizing the probability of such [...]