AST Guidelines for Best Practices for Safe Use of Pneumatic Tourniquets

23 that have an IVRA safety lockout embedded that prevent the unintentional deflating of both bladders during a dual-cuff procedure. 51 Inflating the distal cuff may also provide the patient with additional comfort since the tissues under the distal cuff have been anesthetized. 51 Guideline IV Documentation of the use of the tourniquet should be included in the patient’s OR record. 1. Documentation should include the following: A. Site of cuff placement. 6.50 B. Name of person who applied the cuff. C. Type of skin protection that was applied. D. Systemic reactions to ischemia and reperfusion. 58 E. Initial blood pressure of the patient after the cuff is inflated. F. Beginning/original cuff inflation and limb occlusion pressures. 50 G. Preoperative and postoperative assessment of the integrity of the skin. H. Description of adverse events that occur with the tourniquet system or patient. 1) If an adverse event occurs, the time the patient’s symptoms began and ended should be documented. 2) The patient’s symptoms should be documented. 3) If a malfunction of the tourniquet system is the cause of a patient injury or death, the information should be reported to the manufacturer and U.S. Food and Drug Administration (FDA) according to the requirements of the Safe Medical Devices Act of 1990 (Public Law 102-629). 96 I. HDO’s identification number and manufacturer’s serial number and model number. J. Preoperative and postoperative assessment of the extremity including pulses distal to the tourniquet. 58 K. What time the surgeon was informed of how long the cuff has been inflated. Times cuff was inflated and deflated, including intraoperative deflation and inflation times. 50 The length of the intraoperative deflation should be recorded as well. 96 Guideline V Non-disposable (reusable) cuffs and tubing should be cleaned and decontaminated between patient uses according to manufacturer’s instructions and central sterile supply department policy. Additionally, the tourniquet system with all components should be properly stored after disinfecting and between uses. 25,97 1. If the cuff cannot be adequately cleaned it should be discarded. 97 2. The cuff should be cleaned with an EPA-registered intermediate-level tuberculocidal disinfectant solution in lukewarm water. 97 If there are dried blood and/or body fluids on the cuff a soft hand brush should be used to remove the infectious matter to prevent cross-contamination. 97 The cuff should be thoroughly rinsed of the cleaning agent to protect the patient’s skin from irritation, prevent