Have any of you ever left a tourniquet on a patient after an iv start?

marie.rn2419, RN · Oct 25, 2015

AnnieOaklyRN â€“ I have not had to document tourniquet removal at my hospital, either. But, I have heard of a couple hospitals (in PA, I believe?) doing so. I am a human being and a nurse as well, and I have made my own mistakes. It seems like my post really upset you, and for that, I apologize. Do you think that the bright orange tourniquets have helped at all where you work?

marie.rn2419, RN · Oct 25, 2015

Man, I would think that unless the patient is neurologically NOT intact - that they would complain about having a tourniquet tied on for any length of time. OUCH!

Aw, you got me on that one. :banghead: Neurovascular!

hawaiicarl, BSN, RN · Oct 25, 2015

I had a phlebotomist call me from the lab once asking if I had seen her tourniquet .... yup right where you left it on my pt's arm ... ah well pins and needles, a little blue, but it matched their other limbs so all good.

Cheers

AnnieOaklyRN, BSN, RN, EMT-P · Oct 25, 2015

AnnieOaklyRN â€“ I have not had to document tourniquet removal at my hospital, either. But, I have heard of a couple hospitals (in PA, I believe?) doing so. I am a human being and a nurse as well, and I have made my own mistakes. It seems like my post really upset you, and for that, I apologize. Do you think that the bright orange tourniquets have helped at all where you work?

You post didn't per say upset me, I just felt like it was very derogatory towards the OP, especially for something many of use have done, even if you didn't mean it that way.

I actually don't work at that hospital, it is just one of the hospitals we drop patients off in the ER when I work on the ambulance. I am sure it has, they are like hunters orange, so it is hard to miss them. I am very surprised more facilities do not switch to them. I wonder if there are any studies out there?

Annie

MSNMBA · Oct 26, 2015

I was working as an LPN thru an agency many moons ago. This hospital where I worked did not allow LPNs to chart, give meds, draw blood, or even do glucose sticks! I did bedside care and dressings. Well, one night, an RN drew blood on a pt. and left the tourniquet in place. I came along 45 minutes or so later and notice the pts. arm a cool, dusky purple. I alerted the charge nurse and the RN tried to pin her error on me!! She was busted and had to recant, as well as apologize when I told her of all the things the hospital did not allow me to do as an LPN.

As an RN, I put the tourniquet on the outside of the gown or sleeve to minimize that annoying pinching sensation, and to assure that it indeed has been removed. I offer that rational to the new grads, too.

imintrouble, BSN, RN · Oct 26, 2015

Sometimes I think I've made every mistake a nurse can make. The good news is I rarely make them twice.

Yes, I've left a tourniquet on a patient. it was in the very early years.

sailornurse · Oct 26, 2015

This happened to my mom this year when she got her portacath placed for chemo. I did not notice it until I walked into the recovery room and noticed her original IV one liter bag was still pretty full (Only about 200 ml had infused). That's when both the nurse taking care of her & I both looked down at her arm simultaneously to see the tourniquet still on her arm covered by the sleeve of the gown. It was a snap gown that had not been completely snapped and the fabric from the sleeve covered up the tourniquet. Still, the procedure took about 3 hours from start to finish. Someone should have noticed. The first nurse could not get her IV, so another nurse came in to help.

I like the idea of Bright Orange tourniquets. (why didn't I think of that)

IVRUS, BSN, RN · Oct 26, 2015

Thank you so much to all your replies! More info, I did an incident report, ER doc was called and told of incident. Patient is fine, just wanted some outlook, I know we all make mistakes.

One of the things I tell my students to do is this: Our IV start kits come with the tourniquet tightly rolled up with a small rubberband around it. Once you remove the tourniquet from the IV kit, and remove the rubberband, place the rubberband around your finger. Then, proceed as usual and once the entire procedure is complete and you are at your sink re-washing your hands, you'll think, ahhh this rubberband is still on my finger ~ IS that tourniquet still on too???

Mursechico · Oct 26, 2015

Oh that is a long time! I'm sorry to hear that!

NanaPoo · Oct 26, 2015

Haven't done it myself but I have found tourniquets left on by others...be it a phlebotomist or other nurse that recently started an IV. It's not a horribly uncommon mistake to make but one, as with most mistakes, that you learn from and likely will never make again.

OneDuckyRN · Oct 26, 2015

I've done it a couple of times. Both times the patient asked if I could take it off before I ever got out of the room, thankfully. Now, I add that to my mental list of things to make sure I have in my throw-away pile: chux pad, leftover tape, flush syringe, tourniquet, angiocath(s) and cap(s), various wrappers. It all gets wrapped up in the chux and tossed in the trash (except the sharps, of course!)

It happens. Like PPs have said, live and learn. Find a system so that you remember it in the future.

sugarwahine10 · Oct 26, 2015

I usually don't use them when I do IV starts--I have better luck getting my sticks without tourniquet.