How to Apply a Tourniquet
Most of you have probably never heard of a tourniquet before! It is a device that we use on surgery of the upper or lower extremity, which prevents excessive hemorrhaging and allows us to keep a dry surgical field while we operate. They come in various color-coded sizes, as shown. Typically, we exsanguinate the extremity (wrapping the extremity in a retrograde manner to squeeze all of the circulatory fluids out) before inflating the tourniquet. The pressure on the cuff is usually set to 250 mm Hg for upper extremity surgery, and 350 mm Hg for lower extremity surgery.
It took me about 10 times when I was first learning to get it on smoothly without fumbling around with my hands too much. Another pearl is to not apply it too tight when you first wrap and tie it on, otherwise, you will create a venous tourniquet (where the pressure around the arm is high enough to allow for inflow but not allow for outflow). Let the insufflation of the cuff create the pressure, not your initial tie!
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