Pneumatic Tourniquet Safety

Clinical Protocol / Procedure Page 5 of 6
FSC OR / JDH OR Unit Practice Manual
John Dempsey Hospital – Dept. of Nursing
PROTOCOL FOR:
Pneumatic Tourniquet Safety
a. injury to skin, muscle, nerves, and vessels underneath
the tourniquet cuff;
b. hematoma / edema / wound effusion;
c. circulatory impairment distal to the tourniquet cuff,
venous congestion, or emboli;
d. damage to nerves distal to the tourniquet cuff;
e. compartment syndrome;
f. pulmonary embolism
9. Documentation should include:
a. pneumatic tourniquet system identification serial number
b. cuff pressure
c. skin protection
d. location of tourniquet cuff
e. skin integrity under the cuff before and after use of
the pneumatic tourniquet
f. personnel placing tourniquet cuff
g. time of inflation and deflation with total duration
h. assessment and evaluation of the entire extremity
EQUIPMENT:
PROCEDURE:
Electronic pneumatic tourniquets
Tourniquet cuffs, disposable and reusable, of varying lengths
and widths
Action
Points of Emphasis
1. Inspect the pneumatic tourniquet unit,
cuffs, and tubing prior to use.
2. Assess patient for considerations
related to tourniquet use, including:
a. planned location of the cuff;
b. relative contraindications
c. size and shape of extremity;
d. condition of skin under and distal
to the cuff site; and
e. peripheral pulses distal to the
cuff.
3. Provide cuff or selection of cuffs of
proper length and width for the
operative extremity. Use clean reusable
or single-use cuffs. Cuffs and
1. Clinical Engineering performs required
testing of electronic units, per
manufacturer’s recommendations.
2. Contraindications include but are not
limited to extremity infection, open
fracture, tumor distal to tourniquet,
sickle cell anemia, impaired
circulation, previous
revascularization of extremity,
extremities with dialysis access,
venous thromboembolism, increased
intracranial pressure, and acidosis.
3. As wide a cuff as possible with an
overlap of 3” to 6” is ideal to avoid
damage to underlying tissues. Too much
overlap causes increased pressure; too
unit 17/comb/pneumatic tourniquet safety