Comparing Patient Systolic Blood Pressures with Tourniquet Inflation pressures and the Effects on Estimated Blood Loss. (A retrospective chart review)

During surgical interventions of upper or lower extremities, one of the methods in which blood loss can be decreased is through application of the pneumatic tourniquet. A bloodless field provides important advantages for the surgeon, and the pneumatic tourniquets provide a relatively good bloodless field to minimize intraoperative blood loss. (Naglehout & Elisha, 2018). Recent literature supports the use of personalized tourniquet inflation pressures (PTIP) as opposed to universal tourniquet inflation pressures. (UTIP) The purpose of this DNP project was to investigate what systolic blood pressures were measured on patients undergoing lower extremity surgeries prior to tourniquet inflation, what tourniquet inflation pressures were being used, and determine whether these tourniquet inflation pressures conform with PTIP, or UTIP standards, and further determine their effects on estimated blood loss (EBL), and other tourniquet related complications. This project comprises of a retrospective review of patient charts. A total of 186 electronic anesthesia records were reviewed and 75 patients were included in the DNP project. Identification of a project site was the first step. Approval was sought from the health facility and the various internal review boards (IRBs). A retrospective chart review was conducted to examine three full months of surgeries involving the lower extremities which required the use of pneumatic tourniquets. Data was collected and subsequently analyzed by use of Microsoft Excel. This data included the systolic blood pressures of patients prior to tourniquet inflation, tourniquet inflation pressures, ASA physical status, patient BMI, age and Gender. By completion of this retrospective chart review, it has been discovered that 75 patients received lower extremity surgeries with the use of pneumatic tourniquets. Of the 75 patients, tourniquets were inflated to 275mmHg on 57 (76%) of them regardless of their systolic blood pressure (SBP). 63 patients (84%) had a recorded EBL less than 100mL. No tourniquet related complications were recorded. Only one patient (1.3%) had a tourniquet inflation pressure greater than 300mmHg, with EBL recorded at 10mL.

Creator

• Dzigbordi, Anthony

Language

• English

Stichwort

• Tourniquet inflation pressure
• estimated blood loss
• systolic blood pressure

Date created

• 2023

Resource type

• Research Paper

Rights statement

• http://rightsstatements.org/vocab/InC/1.0/