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Do you know the application of the tourniquet and the prevention of related complications?
Data: 2021-10-08
tourniquetThe application and prevention of related complications we understand?
1. Restlessness istourniquetCaused by pain. If the tourniquet inflation pressure is too high for too long, especially during brachial plexus anesthesia and epidural anesthesia, it has been reported that more than 66% of these patients have pain in the tourniquet area. Generally in the tourniquet inflation 30~60 min after the emergence of patients with unbearable, irritable, that is, the use of sedatives, analgesics are difficult to control. Studies have shown that skin and deep tissues, such as blood vessels and muscles, can cause tourniquet pain after compression and post-ischemic edema after ischemia-reperfusion injury. The tourniquet should be inflated after the anesthetic effect is complete. The pressure of the tourniquet should not be too high and the time should not be too long. Regularly inform the surgeon to prepare for hemostasis. After releasing the tourniquet for 5~10 minutes, it can be inflated again and timed again.
2.tourniquetShock. The tourniquet shock is a shock caused by rapid filling and redistribution of blood, insufficient blood volume, sudden reduction of effective circulating blood volume, bleeding or exudation from the surgical incision after the tourniquet is relaxed. In addition, when the tourniquet is released, the blood-draining limb vascular bed suddenly expands, and anaerobic metabolites circulate through the vein, and "tourniquet shock" may also occur ". In orthopaedic limb surgery, the changes of blood pressure and pulse should be closely observed before and after loosening the tourniquet to supplement blood volume. Before loosening the tourniquet, the speed of infusion and blood transfusion should be accelerated appropriately. Lower limb application of the tourniquet, in the relaxation of the tourniquet should pay special attention to slow decompression relaxation, to prevent sudden congestion. At the same time to pay attention to oppression wound hemostasis.
3. Nerve injury Nerve injury is characterized by postoperative limb paralysis, loss of pain, heat, cold and pressure in the skin, and slow or loss of limb autonomy. The common cause of nerve injury is the mechanical pressure of the tourniquet to the local nerve and the hypoxia of the local and distal nerve of the tourniquet, which causes the sensory and motor nerve conduction to slow or even stop. Prevention and treatment is to strictly grasp the pressure and time of the application of the tourniquet, and correctly select the binding position of the tourniquet.
4. The tourniquet buffers the skin blisters unevenly, and wrinkles appear after inflating and compressing the skin; in skin disinfection, 3% iodine tincture and 75% ethanol are traditionally used, and the excess disinfectant flows and accumulates under the edge of the air bag, causing chemical burns. Preventive treatment, with medical sleeves or socks instead of bandages, slightly cut a section of width
The tourniquet 3cm. During upper limb surgery, put the short sleeve on 1/3 of the upper limb, and then tie the tourniquet. The sleeves with a width of 1.5cm on both sides are rolled up to the edge of the tourniquet to protect the skin from direct contact with the tourniquet; the socks on the lower limbs are the same as those on the upper limbs. 0.5% iodophor for skin disinfection, because of its tissue, no stimulation, no allergy, no corrosion, with disinfection and sterilization function. The excess disinfectant was wiped dry with sterile gauze. The balloon tourniquet plays an important role in orthopedic limb surgery, and it is also an important guarantee for the smooth operation. The use of airbag tourniquet requires professional training. Users should strictly abide by the operation rules of the balloon tourniquet, master the relevant knowledge, and prevent the occurrence of complications.
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