6 0 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E A U G U S T 2 0 1 5
Not only is this method costly and complex, but it's also highly dependent on
the sensitivity, precision and noise immunity of the technique for detecting and
montoring arterial pulsations, as well as on the caregiver's skill, technique and
consistency. A new automatic technique for measuring LOP has been developed
in an effort to overcome these limitations. It involves using a tourniquet cuff with
a continuous pneumatic passageway surrounding the limb as a dual-purpose
patient sensor and pneumatic effector. This circumvents the need for a distal
sensor, a limiting factor in prior adoption of LOP measurement.
Advances in tourniquet technology that let you measure LOP automatically
have reduced the risk of nerve-related injury in recent years. These advances use
distal sensors, placed on the digits, to automatically measure the individual's LOP.
While this method reduces the dependency on the operator's skill, technique and
consistency, it is still costly and complex. Furthermore, it affects the preparation
z GOLDEN RULE Keep the tourniquet inflation
pressure to the minimum effective pressure.
Pamela
Bevelhymer,
RN,
BSN
Avoiding Tourniquet Complications
Over-pressurization of the cuff
• Associated with a higher probability of compression injuries to
blood vessels, nerves, muscles, or skin.
• May cause pain at the tourniquet cuff site, muscle weakness or
extremity paralysis.
Under-pressurization of the cuff
• Associated with the leakage of arterial blood distally and anesthetic
agent proximally in Bier blocks.
• May result passive congestion of the limb, shock, and hemorrhagic
infiltration of a nerve.
