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INSTALLATION AND OPERATING INSTRUCTIONS
SURGEON DECISIONS
The surgeon’s discretion will be used to determine the following:
•
What pressure to apply
Refer to
PRESSURE set-point system test
under the
Manual Tests and Checks
section for how to set the
target pressure set-point. For each patient, the surgeon determines if the Tourniquet pressure required to occlude
blood fl ow to the operative site should be set to the Recommended Tourniquet Pressure (RTP) derived from the
Limb Occlusion Pressure (LOP).
•
When to infl ate the Tourniquet
•
How long to apply the Tourniquet
Refer to
TIME set-point system test
under the
Manual Tests and Checks
section for how to set the target cuff
infl ation time set-point. The Tourniquet time depends greatly on the patient’s anatomy, age, and absence of vascular
disease. In many operating rooms, it is customary to prominently note the time of infl ation, and to warn the surgeon
after a certain time has elapsed. This will allow the surgeon to assess the need for further Tourniquet time.
•
Whether and when to allow for intermittent aeration of tissue by defl ating the cuff for 10 to 15 minutes.
There is a general medical practice that, for reasonably healthy adults, 2 hours should not be exceeded without
releasing the Tourniquet to allow the underlying tissue to breathe. During this time, the limb should be elevated to
about 60 degrees, and steady pressure should be applied to the incision with sterile dressings
•
When to release the Tourniquet in an operative procedure.
PATIENT PREPARATION
Prepare the patient in accordance with your established procedures and cuff instructions. The
Precautions In Use
detailed above under
General Information,
as well as the following, are offered as a guide to assist in this process.
•
In most cases, a Tourniquet cuff should be applied to the widest part of the limb to allow as much tissue as
possible to lie between the cuff and any nerves or vascular structures susceptible to damage.
•
The optimum positions are the upper arm and the proximal third of the thigh.
•
In certain cases of fore-foot surgery, the Tourniquet cuff can be applied around the calf or to the area proximal to
the malleoli.
•
For emergency surgery of the hand, a suffi ciently small Tourniquet can be fi tted around the wrist.