Document Detail


Tourniquets and occlusion: the pressure of design.
MedLine Citation:
PMID:  23756019     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
METHODS: Sixteen volunteers self-applied and had tourniquets applied to their thighs and arms (CAT and SWAT-T, random order, then blood pressure cuffs).
RESULTS: Occlusion (Doppler signal elimination) pressures were higher than predicted (p < 0.0001), highest with the CAT (p < 0.0001), and often lower than completion pressures (completion median, range: CAT 360, 147-745 mm Hg; SWAT-T 290, 136-449 mm Hg; cuff 184, 108-281 mm Hg). Three CAT thigh and 9 CAT arm completion pressures were >500 mm Hg. Pressure decreases and occlusion losses occurred over 1 minute (pressure decrease: CAT 44 ± 33 mm Hg; SWAT-T 6 ± 8 mm Hg; cuff 14 ± 19 mm Hg; p < 0.0001; loss/initially occluded: CAT 17 of 61, SWAT-T 5 of 61, cuff 40 of 64, p < 0.01). CAT pressures before turn did not have a clear relationship with turns to occlusion.
CONCLUSIONS: Limb circumference/tourniquet width occlusion pressure predictions are not good substitutes for measurements. The wider SWAT-T has lower occlusion and completion pressures than the CAT. Decreases in muscle tension lead to decreases in tourniquet pressure, especially with the nonelastic CAT, which can lead to occlusion loss.
Authors:
Piper L Wall; David C Duevel; Mohamed B Hassan; John D Welander; Sheryl M Sahr; Charisse M Buising
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Military medicine     Volume:  178     ISSN:  1930-613X     ISO Abbreviation:  Mil Med     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-06-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984771R     Medline TA:  Mil Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-87     Citation Subset:  IM    
Copyright Information:
Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.
Affiliation:
Division of Trauma Services, Surgery Education Department, Iowa Methodist Medical Center, 1415 Woodland Avenue, Suite 140, Des Moines, IA 50309.
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