The following commended practices ...

The following commended practices were developed by the AORN commited Practices Committee and have been approved by means of the AORN Board of Directors. They were not awayed as proposed recommended practices for annotates by members and others. They are effective Jan 1 2002

These commited practices are intended as achievable recommendations representing what is believed to be an optimal on a level of practice. Policies and actions will reflect variations in practice settings and/or clinical situations that determine the station to which the recommended practices can be implemented.

AORN recognizes the numerous stamps of settings in which perioperative cherishs practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive performances may be performed.

Purpose: These make acceptableed practices provide guidelines for use of pneumatic tourniquets, which primarily are used to occlude progeny flow and obtain a near bloodles field for extremity surgery Pneumatic tourniquets also are used to confine a bolus of local anesthetic in an extremity during IV regional anesthesia (IVRA [ie, Bier's block]) These make acceptableed practices provide information for testing, applying, cleaning, and documenting the use of pneumatic tourniquet equipment. Pneumatic tourniquets consist of an inflatable beat pressure source, pressure regulator, connective tubing, and squeezing display. These recommended practices provide general guidelines for developing policies and conducts for tourniquet use in the practice setting. appropriate to the variety and complexity of circulating tourniquet equipment, policies and conducts will reflect considerations for the specific tourniquet method being used.

praiseed PRACTICE I

Personnel should demonstrate in use of pneumatic tourniquets in the practice setting.

1 Perioperative personnel should be instructed in the formal operation of pneumatic tourniquets before use. Instruction and recur demonstration of proper use of a pneumatic tourniquet brings the risk of patient injury and expands the life of the pneumatic tourniquet.

2 Personnel should participate in ongoing assessment and educational activities that will facilitate acquisition of knowledge and skills that affect patient consequences (1)

RECOMMENDED PRACTICE II

Pneumatic tourniquets should be cleaned, inspected, standarded and maintained before and after use according to manufacturers' written instructions.

1 Preoperatively, the entire tourniquet scheme should be checked. Before each use, pneumatic tourniquets should be inspected for cleanliness and proofed for integrity and function. chiefly electric tourniquets automatically self-test and calibrate on the subject of activation. The cuff, tubing, connectors, gauges, and crushing source should be clean and kept in working order. The strike and tubing should be inspected for cracks and leaks. Patient safety demands that all tourniquet parts function suitably before a procedure. Connectors should be fastened securely to the tourniquet hurry source to prevent accidental deflation of the box during use. Unintentional pressure los can arise from loose tubing connectors, deteriorated tubing, stopcock leaks, beat bladder leaks, or worn blow closures. (2)

2 Reusable boxs and bladders should be cleaned, rinsed, and dried between patient use according to the manufacturers' instructions and AORN's "Recommend practices for high-level disinfection." (3) The blow and bladder should be rinsed thoroughly because cleaning solution residue may increase the chance of allergic reactions and decrease the life of the beat and bladder. All tubing should be wiped with an US Environmental Protection Agency (EPA) high- or intermediate-level tuberculocidal disinfectant and dried before storage. Care must be taken to hinder introduction of solutions into the pon Water in the ports contributes to microbial development Subsequent deflation of wet bladders may cause minute droplet of solution to be forced into the tourniquet regulating mechanism, causing damage. (4)

3 If offspring or other body fluids originate in contact with tourniquet ingredients more extensive cleaning with an enzymatic solution and an EPA high- or intermediate-level tuberculocidal disinfectant capable of inactivating bloodborne pathogens is necessary.

4 The commonness method, and criteria for pneumatic tourniquet testing should be established according to manufacturers' written instructions. A pneumatic tourniquet management program assists in identifying equipment point to be solved [i]or[/i] settleds that may have adverse meanings on patient safety. (5)

5 Documentation should meditate the biomedical equipment and/or serial number, date of inspection, preventive maintenance, and status of all equipment. Records of equipment failure and preventive maintenance assist in identifying equipment performance point to be solved [i]or[/i] settleds or hazards and minimize clinical and physical risks. (6)