AST Guidelines for Best Practices for Safe Use of Pneumatic Tourniquets

27 Competency Statements Competency Statements Measurable Criteria 1. CSTs are knowledgeable of the contraindications, patient hazards, risks and safety factors associated with the use of pneumatic tourniquets. 2. CSTs are qualified to assist the surgeon and/or anesthesia provider in the application of the tourniquet. 3. CSTs are qualified to apply the padding and tourniquet cuff to the patient’s extremity under the supervision of the surgeon and/or anesthesia provider. 4. CSTs are qualified to operate the pressure device by establishing the pressure setting. 1. Educational standards as established by the Core Curriculum for Surgical Technology . 102 2. The didactic subject of pneumatic tourniquets is included in a CAAHEP accredited surgical technology program. 3. Students demonstrate knowledge of the pneumatic tourniquet during clinical rotation. 5. CSTs complete continuing education to remain current in their knowledge and skills in the safe use of pneumatic tourniquets. 100 CST® is a registered trademark of the National Board of Surgical Technology & Surgical Assisting (NBSTSA) . Glossary Bier block : See intravenous regional anesthesia. Compartment syndrome : Muscles are organized into compartments and the walls of the compartments are formed by fascia. After an injury or use of a tourniquet fluid can accumulate in one or more compartments. The fibrous fascia does not easily expand the pressure increases within the compartment(s) preventing adequate blood flow that leads to ischemia and possible severe tissue damage or necrosis if not immediately treated by performing a fasciotomy surgical procedure. Exsanguination : The act of removing blood and tissue fluids from an extremity. Intravenous regional anesthesia : A type of regional anesthesia whereas an extremity is exsanguinated, a tourniquet is applied and the cuff inflated the anesthesia provider injects a local anesthetic into the extremity; also called a Bier block. Knee arthroscopy : A surgical procedure that involves the intraarticular insertion of an arthroscope to view the anatomical structures of the knee joint for diagnostic purposes and/or performing minimally invasive surgery such as a meniscectomy. Limb occlusion pressure (LOP) : A definition of LOP is the minimum pressure required to stop the flow of arterial blood into the limb distal to the cuff.