964 Intra-Operative Tourniquet Use in Lower Limb Orthopedic Surgery: A BOAST Audit

Aim Surgical tourniquets reduce operative time and blood loss and improve visualisation of the surgical field. However, risks include pain, neurovascular and local tissue damage. Operative tourniquet pressure should be baseline systolic pressure plus 70-130mmHg. Ischaemic tourniquet time should be less than 120 minutes. We aim to audit the use and documentation of surgical tourniquets of lower limbs surgery undertaken at a single DGH over a 6-month period against BOAST guidelines. Method Retrospective data collected on torniquet use, torniquet time, pressure and patient demographics recorded collected from operation notes and theatre logbooks. Results 66 patients were included, mean age 55 (7-92) years. 95.4% (62/66) of lower limb procedures had recorded use of tourniquet. 78.5% (51/66) had the total tourniquet time recorded. Mean tourniquet time was 82.4 (15-130) minutes. 58.7% (37/62) had inflation pressure recorded. Mean inflation pressure was 265.7mmHg (150-300). 5 patients (7.6%) exceeded the maximum recommended tourniquet time without deflation. Conclusions Our results indicated that level of documentation of tourniquet use fell below the standards set out in BOAST guidelines. A second cycle will determine whether implemented changes in the theatre documentation system has conferred change.