Tourniquets?

[KittyForman]

Howdy!

I am a new nurse in the OR. About 6 months experience. We use pneumatic tourniquets for extremitiy surgery.

So, today the patient got to PACU with the tourniquet still on, but NOT inflated. Think of it like an extra deflated BP cuff on the pts thigh. The pacu nurse flipped out! It was an easy oversight, but I don't know why the pacu nurse got so up in arms. There was no patient harm, it was not on tight and not inflated.

Please advise, nurses don't apply the tourniquet in the first place, and usually the doc takes them off. It was just simply overlooked today. We nurses, however are the ones that are blamed.

Thanks

[Rose_Queen, BSN, MSN, RN]

It's possible that the PACU nurse overreacted; however, part of prudent patient care in the OR is assessing the tourniquet site prior to the patient leaving the OR.

But it also shows how things vary from facility to facility- in mine, unless the tourniquet is placed within the sterile field, it is placed and removed by the circulator.

[TakeTwoAspirin, MSN, RN, APRN]

Having been both a circulating nurse and PACU nurse, I have to admit I would have flipped also.

Even though the cuff was not inflated, when you place a cuff on an extremity you put it on the extremity as snug as you can so that it doesn't slip during positioning/draping prior to inflation. Even though this cuff was not inflated it is likely that it was to some degree interfering with circulation, especially given post-operative swelling/edema. Had the PACU nurse not spotted it there could have been considerable damage done to the patient - nerve, vascular, compartment syndrome problems etc.

In instances like this, "we nurses are blamed" because actually as a circulator you were to blame for this even if you didn't put it on and even if someone else at the field usually takes if off. Being the last line of defense for your patient is the circulator's primary role and responsibility in the OR. It is your job to intervene, even if it isn't your job. I know this sounds harsh, especially as you are new, but instead of getting ticked off about being blamed for this you should be thankful that it was caught and no harm was done. Lear from this experience!

[KittyForman]

Thanks for the input. I was merely trying to understand how this could have caused harm to the pt. I understand now. I was not ticked off. I was confused.