Tourniquet Time

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Specializes in Operating Room.

I hope someone can clarify the following scenario for me:

A surgeon was performing an arthroscopic acl reconstruction and deflated the tourniquet while preparing the graft. When it was time to re-inflate the surgical tech asked if I cleared the tourniquet prior to re-inflating. My response was no. I explained that I document the times that the tourniquet is deflated and inflated during the procedure but the machine isn't cleared until after the procedure. The tech went on to argue that it should be cleared each time it is deflated so the surgeon's tourniquet time will be accurate. I didn't clear the machine and continued with my circulating duties. At the end when the surgeon requested the total tourniquet time I answered by what the machine read. The tech subtracted the first time of 40 minutes from what the machine read and said that was the correct tourniquet time. Who was correct in this situation??

Thanks!

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Specializes in Operating Room.

If I'm reading your post correctly, you were correct, as long as you started the case with a cleared machine. Our charting doesn't really have a spot for multiple inflates/deflates. I do note these in the nurses notes just because I'm anal about my charting. Ultimately, it's the total tourniquet time that's going to matter. I'm not sure why the tech would have subtracted the first 40 minutes....the tech needs to step back and let you do your job, IMHO.

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Specializes in CCU, OR.

I agree with Squirrel- The total TQ time is the total amount of time up and should not be reset until the end of the case, once you've recorded your total time.

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I also agree with the 2 above me it is TOTAL TQ time! But with our TQs we have to reset it each time we deflate or it messes up. We just add all the times and as far as our documenting we do the same thing as Squirrel. Its your license not the techs.

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HI Bettyboop,

It also depends which tourniquet machine you are using. Some tourniquets pause the time when you deflate and then resume it when you inflate the tourniquet again. Therefore the tourniquet displayed would be the correct tourniquet time. Most ATS sytems by Zimmer and the PTS sytems by Delfi all do this. They also count up while others count down... If you really want to know go back to the manufacturer specs and double check.

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I also agree with the 2 above me it is TOTAL TQ time! But with our TQs we have to reset it each time we deflate or it messes up. We just add all the times and as far as our documenting we do the same thing as Squirrel. Its your license not the techs.

HI Karebear...

What do you mean it messes up? Which machine are you using?

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An ortho doc I work with likes to dictate first T-time and second T-time but I don't reset the machine. Instead, I do the math for him and write it down.

What you need to ask yourself is: "What would a lawyer ask me if there were any post-op complications?" IMO, he would want to know how long blood flow was being constricted (first time/second time/third time) from the extremity which equates to TOTAL tourniquet time.

If you separate the times on paper, how can you prove which time caused the complication? It just doesn't matter.

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Specializes in Operating Room, Ortho, Neuro, Trauma.

Our machine calculates total time the machine was inflated at the end-no matter how many times we deflated and went back up, 2 or 3 times. Time is time. I agree with everyone else...you are signing the intraop.

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