AST Guidelines for Best Practices for Safe Use of Pneumatic Tourniquets

28 Pneumatic tourniquet : A device that uses air or nitrogen to inflate a compressing device called the cuff that is used to compress the arteries and veins of an extremity to produce a bloodless surgical site. Total knee arthroplasty : A surgical procedure whereby the damaged or diseased knee joint is replaced with prostheses. Several cuts are made with a saw on the end of the femur and the femoral component is placed; the end of the tibia is cut to create a “shelf” and the tibial component is placed; and if the underside of the patella is damaged, a plastic “button” is positioned. The prostheses may be uncemented or cemented. References 1. FDA Product Classification. 2018. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID= KCY . Accessed February 27, 2018. 2. McEwen JA, Kelly DL, Jardanowski T, Inkpen K. Tourniquet safety in lower leg applications. Orthopaedic Nursing . 2002; 21(5): 55-62. 3. Azis ES. Tourniquet use in orthopaedic anaesthesia. Current Anaesthesia & Critical Care . 2009; 20(2): 55-59. 4. Committee on Complications of Arthroscopy, Association of North America. Complications of arthroscopy and arthroscopic surgery: results of a national survey. Arthroscopy . 1985; 1(4): 214-220. 5. Odinsson A, Finsen V. Tourniquet use and its complications in Norway. The Journal of Bone and Joint Surgery . British Volume . 2006; 88(8): 1090-1092. 6. Pennsylvania Patient Safety Authority. Strategies for avoid problems with the use of pneumatic tourniquets. Pennsylvania Patient Safety Advisory . 2010; 7(3): 97- 101. 7. Kalla TP, Younger A, McEwen JA, Inkpen K. Survey of tourniquet use in podiatric surgery. The Journal of Foot & Ankle Surgery . 2003; 43(2): 68-76. 8. Klenerman L. The tourniquet manual - principles and practice . London, England: Springer-Verlag London Limited; 2003. 9. Estebe J, Davies JM, Richebe P. The pneumatic tourniquet: mechanical, ischaemia – reperfusion and systemic effects. European Journal of Anaesthesiology . 2011; 28(6): 404-411. 10. Sharma JP, Salhotra R. Tourniquets in orthopedic surgery. Indian Journal of Orthopaedics . 2012; 46(4): 377-383. 11. Kumar K, Railton C, Tawfic Q. Tourniquet application during anesthesia: “what we need to know?” Journal of Anaesthesiology, Clinical Pharmacology . 2016; 32(4): 424-430. 12. Johnson DS, Steward H, Hirst P, Harper NJ. Is tourniquet use necessary for knee arthroscopy? Arthroscopy . 2000; 16(6): 648-651. 13. Kirkley A, Rampersaud R, Griffin S, Amendola A, Litchfield R, Fowler P. Tourniquet versus no tourniquet use in routine knee arthroscopy: a prospective, double-blind, randomized clinical trial. Arthroscopy . 2000; 16(2): 121-126. 14. Tetro MA, Rudan JF. The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty. Canadian Journal of Surgery . 2001; 44(1): 33 – 38.