Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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1 0 2 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 4 today's most modern tourniquet systems. It lets you test cuffs, tubing and connectors for potentially hazardous leakage. By pressing a single button in the system, the cuff will inflate by itself and perform a test to see if there is there a leak. The system will find even a pinhole leak that's not easy for the naked to eye detect. This technology can be used during sur- gery as well as before and after procedures to let you know whether the cuff is working or will work properly. While a slow leak itself isn't likely to harm patients, it can indicate a more serious potential failure of the cuff, which would cause blood to suddenly enter the surgical field and create challenges for the operative team. 2. Alarms to detect cuff depressurization failure. It's extremely important for a cuff to depressurize entirely when deflation is intended. But this doesn't always happen. The surgical staff may think the cuff is completely deflated, but if depressurization fails, it will likely remain inflated for an extended — and unnecessary — period of time. If the cuff is at a pressure below the limb occlusion pressure (LOP) — essentially the minimum required pressure to occlude blood flow into the limb — there will be arterial occlusion but not venous occlusion. This results in blood being pumped into the limb, but since there's still pressure left in the cuff, no blood can get pumped out of the limb. As a result, there could be limb engorgement. To ensure cuff depressurization, some tourni- quet instruments now include an alarm that sounds when the technology detects failure, informing staff of the need to investigate and remove the cuff. 3. Limb protection. Studies have shown that without proper limb protection, high pressures, high-pressure gradients and shear forces applied to skin and soft tissues underneath a tourniquet cuff can lead to skin and soft tissue injuries. It's not uncommon to use cast padding or T O U R N I Q U E T S OSE_1403_part2_Layout 1 3/5/14 10:53 AM Page 102