title: A survey of upper and lower limb tourniquet use among Irish orthopaedic surgeons.
abstract: BACKGROUND
  Tourniquet use in orthopaedic surgery is common practice. However, the technique varies among Irish orthopaedic surgeons and there are no standard guidelines.
  
  
  OBJECTIVE
  To analyse trends in tourniquet use among Irish orthopaedic surgeons.
  
  
  METHODS
  Ninety-two Irish orthopaedic consultants were sent a 15-survey question about tourniquet use by post.
  
  
  RESULTS
  Sixty respondents returned a completed survey, of which 49 (81% of respondents) used both upper arm and thigh tourniquets. A variation in tourniquet pressure settings and techniques used was reported. Thirty-nine surgeons (65% of respondents) use a tourniquet pressure range of 201-250 mmHg for the upper arm and 30 surgeons (50% of respondents) use a range of 251-300 mmHg for the thigh. Thirty-six surgeons (60 % of respondents) experienced a complication secondary to tourniquet use, the most common complications being nerve and skin injury.
  
  
  CONCLUSIONS
  Based on published studies of limb occlusion pressures, this study suggests that some of the tourniquet cuff inflation pressures used may be higher than necessary. Guidelines for optimising cuff pressure and technique should be established to minimise the risk of complications. This study may help determine direction for future research on tourniquet use.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Royal College of Surgeons in Ireland, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. larrycunningham@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Cunningham
authors.forename: T
authors.initials: T
authors.lastname: McCarthy
authors.forename: J
authors.initials: J
authors.lastname: O'Byrne
mesh_terms: D001132:Arm / Q000502:physiology; D006801:Humans; D019637:Orthopedic Procedures / Q000295:instrumentation*; D009985:Orthopedics / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D011312:Pressure; D013848:Thigh / Q000502:physiology; D014111:Tourniquets / Q000706:statistics & numerical data*