Pneumatic Tourniquet Safety

Clinical Protocol / Procedure Page 4 of 6
FSC OR / JDH OR Unit Practice Manual
John Dempsey Hospital – Dept. of Nursing
PROTOCOL FOR:
Pneumatic Tourniquet Safety
occur upon deflation of a lower extremity cuff
5. The patient should be monitored continuously with special
consideration to pain and temperature while the tourniquet
cuff is inflated:
a. pain should be assessed and managed; after inflation of
the pneumatic tourniquet for 30 to 60 minutes, patients may
experience "tourniquet pain," accompanied by an increase in
heart rate and blood pressure;
b. The patient's temperature should be continuously
monitored during use of a pneumatic tourniquet;
c. care should be exercised to avoid overheating the
patient while the tourniquet cuff is inflated, particularly
in pediatric patients.
6. Nursing, surgery and anesthesiology should collaborate to
monitor the patient continuously for 15 minutes after
deflation of the pneumatic tourniquet for potential
sequelae:
a. decreased blood pressure,
b. decreased O 2 saturation and increased end tidal CO 2 ;
c. decreased core body temperature after deflation of a
lower extremity tourniquet cuff; and
d. less likely sequelae are increased intracranial pressure
and embolism release.
7. The immediate postoperative evaluation should include, but
not be limited to:
a. vital signs, including oxygen saturation;
b. skin condition under the tourniquet (eg, temperature,
color, integrity);
c. pulses distal to the tourniquet cuff; and
d. temperature
8. Any intraoperative complications should be reported to the
surgeon and anesthesia care provider and discussed during
the hand off of care to other caregivers, including use of
tourniquet; complications that develop in PACU should be
reported to the surgeon/service:
unit 17/comb/pneumatic tourniquet safety