Zimmer 60-1200-101-00, Руководство оператора и сервисное руководство

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(such as Webril) the fibers may become embedded in the
contact closures and reduce their effectiveness. As an under
padding, a section of stockinette may be used.
The deflated
cuff and any underlying bandage or protective sleeve
should be completely removed as soon as tourniquet
pressure is released. After the cuff has been fully deflated
and removed from the patient, the unit can be set to
STANDBY.
Even the slightest impedance of venous return
may lead to congestion and pooling of blood in the
operative field.
◆
If skin preparations are used preoperatively, they should
not be allowed to flow and collect under the cuff where they
may cause chemical burns.
◆
Whenever the tourniquet cuff pressure is released, the
wound should be protected from blood surging back by
applying pressure dressings and, if necessary, elevating the
limb. Transient pain upon tourniquet pressure release can be
lessened by elevation of the limb. If full color does not return
within 3 to 4 minutes after release, the limb should be placed
in a position slightly below body level.
◆
Whenever IVRA Bier Block anesthesia is used, it is
recommended that the tourniquet remain inflated for at least
20 minutes from the time of injection.
◆
WARNING: Cuffs will not deflate in STANDBY
mode. Ensure cuffs are fully deflated before setting the
unit to STANDBY.
1.5 ADVERSE EFFECTS
A dull aching pain (tourniquet pain) may develop throughout
the limb following use.
Pathophysiologic changes due to pressure, hypoxia,
hypercarbia, and acidosis of the tissues occur and become
significant after about 1.5 hours of tourniquet use. Symptoms
of tourniquet paralysis are motor paralysis and loss of sense
of touch, pressure, and proprioceptive responses.
Intraoperative bleeding may be caused:
1. By the slight impeding effect exerted by an
unpressurized cuff (and its padding, if used), which
prevents venous return at the beginning of the operation;
2. By blood remaining in the limb because of insufficient
exsanguination;
3. By inadequate tourniquet pressure (between systolic and
diastolic blood pressure of the patient), or slow inflation
and deflation, all of which allow arterial blood to enter
while preventing venous return;
4. By blood entering through the nutrient vessels of the
long bones, such as the humerus.
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A.T.S. 1200 TOURNIQUET SYSTEM