DOI: 10.1093/bjs/znad258.112 ISSN:

494 The Safe Use of Intraoperative Tourniquets

Z Elmenawy, T Hassan
  • Surgery



This quality improvement project has been conducted aiming to review the adherence to standards of practice as per the guidelines set out by ''British Orthopedic Association'' for the safe use of tourniquets. Additionally, aiming to generate data for future quality improvement projects relating to the field of surgery.


In a retrospective review of the month of July 2022, a total of 146 cases (collected through electronic patient records - Chameleon+E-Trauma) were found to have orthopedic-related surgical procedures. Following the application of our inclusion and exclusion criteria, 54 cases had surgery that relevantly involves the application of an intraoperative tourniquet. These patients were thoroughly reviewed for compliance rates against the following set standards of practice relating to Tourniquet Time, Pressure, and Method of Exsanguination.


Tourniquet time and pressure documentation compliance rates were both less than 50%. In almost cases where TQ pressures were documented, many surgeons use “standard” set pressures without considering the patient’s systolic blood pressure. In 2 cases of tourniquet time exceeding 120 minutes, there was no reason stated in the surgical documentation. Very low compliance rates on the method of exsanguination In all cases.


Tourniquet use is highly prevalent in several surgical procedures; therefore their safe use needs to be implemented in order to decrease related long-term complications. There is a significant lack of compliance rates regarding the use of intraoperative tourniquets and for that reason, it is quite imperative that education and awareness strategies relating to their use need to be proposed to improve reported results.

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