Review on pneumatic tourniquet safety

Editor's Note

Procedures involving pneumatic tourniquets can be associated with an increased the risk of complications and injuries such as postprocedural skin complications. A recent review of evidence-based practices for safety during surgery when using a pneumatic tourniquet published in the November issue of AORN Journal.

This article provided an overview of safety practices in the AORN Guideline for Pneumatic Tourniquet Safety, covering important safety practices, such as preoperative assessment, and tourniquet inflation, intraoperative monitoring and postoperative assessment. One key point in the guideline review article discussed the importance of documenting and communicating postoperative assessment findings. A case report discussed in the article highlighted this safety strategy for a patient who reported in postoperative care about feeling new tingling, numbness, and a burning sensation from the tourniquet site to his fingers as well as total weakness of the right operative limb. Two weeks after surgery, a nerve conduction study confirmed pneumatic tourniquet injury with abnormal right median, ulnar, radial, and musculoskeletal electrical responses, which required physical rehabilitation and pharmacological therapy to resolve.

Several other examples of safe care practices for pneumatic tourniquet use were described in the review article. For example, patient-specific initial tourniquet pressure was suggested to be reviewed instead of using a uniform inflation pressure for all patients. Additionally, safety measures taken while the pneumatic tourniquet is inflated were discussed as part of efforts to protect the patient from injury, such as ensuring activation indicators and pressure settings remain visible to the entire perioperative team.