Cause of Device-Related Incident
*Not stated

Clinical Specialty or Hospital Department
Anesthesia; Clinical/Biomedical Engineering; OR / Surgery; Orthopedics

Device Factors
*Not stated

Document Type

External Factors
*Not stated

Mechanism of Injury or Death

Support System Failures
*Not stated

Tampering and/or Sabotage
*Not stated

User Errors
*Not stated

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 source.

Before patient use:

  • 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 floor.

NERVE DAMAGE may result from excessive tourniquet pressure and/or extended application time:

  • 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 regional anesthesia:

  • 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.

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