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and the anesthesia provider to determine an appropriate cuff pressure, based on limb occlusion pressure or systolic blood pressure, and to then add a safety margin. There's evidence that surgeons tend to use standard tourniquet pressures for all patients, rather than basing pressure on individual factors. Establish policies that explain how to determine minimal pressure settings and that empower nurses to speak up.
4. Are tourniquets necessary? Shorter procedures, such as routine knee arthroscopies, can be performed adequately without tourniquets. We also found 4 meta-analyses that explore the efficacy of tourniquets in foot-and-ankle, total knee replacement, and upper limb surgeries. Our new recommendations encourage nurses to confirm whether pneumatic tourniquets will be used, rather than assuming they will be, and to participate in the discussion about the patient's care.
— Bonnie Denholm, MS, BSN, RN, CNOR
Ms. Denholm (bdenholm@aorn.org ) is a perioperative nursing specialist for AORN.
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shape, letting you use lower pressures. They fit better, because unlike straight cuffs, which are designed to accommodate cylindrical limb shapes, they can be adapted to a wide range of non-cylindrical (or tapered) limb shapes. Recently created cuff designs for pediatric and bariatric limb sizes and shapes have also been shown to be effective
3. Reduce soft tissue
injuries
Along with the wide variety of potential internal injuries posed by tourniquets, high pressures, high-pressure gradients and shear forces
can also injure skin and soft tissue. Your best bet: limb protection sleeves consisting of double-layer material specifically matched to the limb size and cuff size. Studies show they protect skin and tissue
