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Ten steps to use a tourniquet
Data: 2020-08-20
1. According to the patient's age and weight, the surgical site is upper or lower limbs (upper limbs: short and narrow; lower limbs: long and wide).
2. The cuffs should not directly contact the skin, wrap them with paper towels, and then tie the cuffs tightly.
3. The upper limb should be selected at the upper 1/3 segment of the humerus. The lower limb is at the root of the thigh (because the upper limb avoids the radial nerve, the lower limb can easily directly compress the femoral artery, but there are also reports that the tourniquet, the wider the cuff, the smaller the limb circumference, the lower the pressure required to block blood flow, and the more comfortable the user is. It is recommended to place a tourniquet above the ankle during toe surgery)
4. Connect the trachea, check whether the joint connection is tight, and whether the airbag in the cuff leaks.
5. Set pressure value: In order to avoid local tissue damage and nerve trunk crush injury, and achieve the ideal hemostasis purpose, the set pressure of the tourniquet should be determined according to the local tissue thickness, the age of the patient, the circumference of the limb and the local arterial systolic pressure. The upper limb is 1.5 times the systolic blood pressure, the lower limb is 2 times the systolic blood pressure
6. Setting time: upper limb is generally not more than 60 min, lower limb is not more than 90 min. If the operation time is long, limb blood flow should be restored for 10~15 min, and then blocked.
7. Pressure: before the tourniquet pressure, raise the limb for about 3 minutes, accelerate venous blood return, reduce limb blood volume.
8. Record the inflation time in time, pay attention to strengthen the monitoring of respiratory and circulatory function of patients during operation.
9. When you hear the prompt, prepare to deflate (the wound must be bandaged under pressure to prevent bleeding. Before deflation, those who have potential effects on blood pressure, such as anemia or excessive blood loss, should use a small dose of ephedrine 1 10~15 mg prophylactically to prevent the occurrence of tourniquet shock, and appropriately speed up the fluid infusion to supplement and Maintain effective blood volume.
10. When deflating, the affected limb should be properly raised.
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The upper limb should be selected at the upper 1/3 segment of the humerus. The lower limb is at the root of the thigh (because the upper limb avoids the radial nerve, the lower limb is easy to directly compress the femoral artery, but there are also reports that the tourniquet, the wider the cuff, the smaller the limb circumference, the lower the pressure required to block the blood flow, the more comfortable the user is. It is recommended to place the tourniquet above the ankle during toe surgery)
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