678 The Safe Use of Intraoperative Tourniquets in Orthopaedic Procedures
D C S Chien, Ad Adewale, X Li, V Ramsingh- Surgery
Abstract
Aim
The use of intra-operative tourniquets in orthopaedic procedures is required to provide bloodless fields, enabling surgical procedures to be performed with improved quality, accuracy, and safety. Documentation of tourniquet use is necessary for optimising patient safety, as this provides an essential medico-legal role, as well as ensures the continuity of care for patients.
Method
All patients who had orthopaedic procedures in the local hospital in November 2022 were reviewed. There were a total of 123 procedures. 40 procedures required intra-operative tourniquet use were included in our study. The primary outcome is the documentation of tourniquet use, which includes the site of the tourniquet applied, the pressure, and the duration of tourniquet use. The secondary outcome is compliance with tourniquet use according to the national guidelines set by BOA Standards for Trauma and Orthopaedics (BOAST). This states the maximum authorized pressure, depending on the age (below/above 16), and the type of procedures (upper/lower limb).
Results
All procedures (N = 40) recorded the site of the tourniquet attached. 68% (27/40) of procedures recorded the length of the tourniquet use and 63%(25/40) recorded the maximum pressure applied. From the recorded procedures, the length of tourniquet use (N = 27) and maximum pressure applied (N = 25) is compliant with the national BOAST guideline regardless of the age group and type of procedures.
Conclusions
Overall this study highlighted the importance of documentation of tourniquet use for medico-legal purposes while demonstrating high compliance with the BOAST guidelines. This could ultimately overcome the challenges associated with intra-operative complications, thus optimising patient safety.