Suggested Guidelines for Pneumatic Tourniquet Use
- Maintain an adequate selection of cuff sizes.
Typical sizes are 8 or 10, 12, 18, 24, and 34 inches.
- PREVENT FIRE—NEVER use O2 or N2O as an inflation
- Look for cracked tubing and loose connectors.
- Check adequacy of the inflation source for
gas-powered units (e.g., >500 psi tank pressure).
- Test inflate and deflate the cuff(s), verify the function of each
control, and check for leaks.
Carefully route the tourniquet controller's cuff tubing, source tubing, or
electrical line cord to avoid accidental contact by personnel. Keep cuff tubing off the
NERVE DAMAGE may result from excessive tourniquet pressure and/or extended
- Determine and use the minimum occlusion
pressure—NEVER EXCEED 500 mm Hg.
- Frequently monitor cuff pressure, especially
when repositioning the limb.
- Notify the surgical team when elapsed inflation
time reaches 60 minutes.
- Remove the cuff immediately after deflation.
The patient record should indicate the time of inflation and deflation,
the inflation pressure(s), and the site of cuff placement.
When performing intravenous
- Attach the dual-bladder cuff to the patient and
determine an effective occlusion pressure either by pulse palpation or
by using an ultrasonic blood-flow detector. Check the occlusion with
each bladder and use the higher pressure.
- Confirm the immediate availability of the
appropriate drugs for treating adverse systemic effects of the regional
anesthetic in the event of pneumatic tourniquet failure.
- Inject the anesthetic slowly and as distal from
the cuff as possible.
- After injection, do not simultaneously deflate both bladders for at
least 20 minutes.
Connect the tourniquet controller to a mercury manometer or gauge, and
verify pressure accuracy at 300 mm Hg every month.
Include pneumatic tourniquets in a routine documented equipment inspection
program. A six-month inspection interval is recommended.