Patient Assessment The perioperative staff should assess the patient preoperatively for potential contraindications and risks [1]. The final decision on whether or not to use a tourniquet rests with the attending physician. Potential contraindications for tourniquet use Perioperative staff should screen the patient preoperatively for the following potential contraindications [1]: Venous thromboembolism, Impaired circulation or [...]
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 [...]
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 [...]
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 patients need pediatric tourniquets because infants and children 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 tourniquet [...]
There are two types emergency 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, [...]
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 [...]
What is Tourniquet “Limb Occlusion Pressure” (LOP)? Limb Occlusion Pressure (LOP) is the minimum pressure required, at a specific time in a specific tourniquet cuff applied to a specific patient’s limb at a specific location, to stop the flow of arterial blood into the limb distal to the cuff. Many studies and reviews published in [...]
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 and injuries associated with elastic ring tourniquets A recent report of a serious injury and a death associated with the use of a non-pneumatic, elastic ring tourniquets 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 injuries. Elastic, [...]