402 An Insight into the Use of Tourniquet During Orthopaedic Surgery at a District General Hospital

Introduction Tourniquet is a device used by orthopaedic surgeons to produce a bloodless field for limb operations. Historically applied to the most proximal part of the limb. The British Orthopaedic Association (BOA) created guidelines for the use of intraoperative tourniquet in October 2021. Method A retrospective study of the elective and emergency operation notes utilising tourniquet was performed over one month. The results were presented at the departmental educational meeting. A new operation note template was employed. A further month period was retrospectively reviewed. Results Over one month, 72 operations were carried out where a tourniquet was used, of them 45.8% (n=33) were on the upper limb (UL) compared to 54.2% (n=39) on the lower limb (LL). The inflation pressure was incorrectly used in 72.7% (n=24) of UL operations and 43.5% (n=17) of LL operations. The type and size of tourniquet was not recorded in 68.05% (n=49) and 41.7% respectively. A further one-month period was appraised post changed applied. Tourniquet was used in 34 operations with 54.2%(n=15) on the UL and 55.8% (n=19) on the LL. The inflation pressure was incorrectly applied in 30% of UL operations in comparison to 72.7% previously. The LL tourniquet pressure was incorrect in 22% of operations compared to 43.5% beforehand. The type and size of tourniquet used was recorded in 71% and 60% respectively. The skin condition prior to tourniquet was recorded in 40% of operations. Conclusions The implementation of an electronic operation note has improved our hospital’s compliance with national standards on safe tourniquet use.