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GENERAL INFORMATION
PRECAUTIONS IN USE
System Handling:
•
The tourniquet system must be kept well calibrated and in operable condition. Accessories should be checked
regularly for leaks and other defects.
•
The tourniquet cuff must never be punctured; therefore, towel clips used near the system must be handled with
special care.
•
When cleaning, carefully follow the cleaning and assembly instructions for the tourniquet cuff and instrument,
refer to Section 3 Maintenance.
Patient Considerations:
•
When using a tourniquet on patients with sickle-cell disease or trait, severe post-use pain may result in the applied
limb which may be caused by sickling of cells. Test for hemoglobin type and level before using a tourniquet on
patients with sickle cell anemia. When the tourniquet is used for these patients, the limb should be carefully
exsanguinated and the PO2 and pH should be closely monitored.
•
Prolonged ischemia may lead to temporary or permanent damage to tissues, blood vessels, and nerves. Prolonged
tourniquet time can also produce changes in the coagulability of the blood with increased clotting time. In severe
cases, pooling of blood in the edemic limb may cause cardiac arrest and death. Rhabdomyolysis may develop in
patients following orthopedic cases where tourniquets have been inflated for extended periods of time (over 90
minutes). Always minimize tourniquet time.
•
Tourniquet paralysis may result from excessive pressure. Insufficient pressure may result in passive congestion of
the limb with possible irreversible functional loss. Always use the minimum effective tourniquet pressure, as
described in the medical literature.
The following clinical conditions have been cited in published medical literature as factors that should be carefully
considered before use of a tourniquet during surgical procedures
• Severe atherosclerotic disease and presence of calcified vessels
• Severe brain injury
• Proven or suspected deep vein thrombosis
• Tumor on the surgical site
• Abscess or other limb infections
• Rheumatoid arthritis and other immune disease with vasculitis
• Poor cardiac reserve
• Fragile skin and soft tissue
• Compartment syndrome
• Hemoglobinopathy
• Previous revascularization of the extremity
• Extremities with dialysis access (e.g. arteriovenous grafts, fistulas)
• Acidosis
• Medications (e.g. antihypertensives) and supplements (e.g. creatine)
• History of pain or weakness in muscles or bones in extremities
• Increased intracranial pressure.
Delfi recommends that users regularly review published medical literature for other factors that warrant careful
consideration before use of a tourniquet during surgical procedures.
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GENERAL INFORMATION
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