Cuff deflation
You are the circulating nurse caring for an obese patient undergoing bilateral total knee replacement. Tourniquet cuffs are to be placed on both operative limbs. Outline the risks associated with each of the following and the steps you would take to minimise patient injury. Provide rationales for your actions.
What will be an ideal response?
Answer:
Risks
The patient may experience rapid physiological changes (e.g. decrease in core body temperature, embolic activity, metabolic shifts) when blood is shunted back to the extremity.
Embolic events may also occur during tourniquet deflation.
Note: the risk of injury is increased in bilateral total knee replacement.
Actions
Cuff deflation occurs most typically after cement hardening or wound closure.
Release of bilateral tourniquets should occur separately, thirty to forty-five minutes apart to reduce harmful side effects.
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