830 Intra-Operative Tourniquet Use in Orthopaedic Surgery: How Tight Is Too Tight?

Abstract Aim Tourniquets are regularly used in Orthopaedic surgery as an effective means of ensuring a clear, 'bloodless' operating field. However, knowledge concerning the implementation of this commonly used appliance is infrequently tested. Our objective was to design a survey to assess the current level of knowledge surrounding the safe use of intra-operative tourniquets in Orthopaedic surgery. Method A survey was constructed using Google Forms, with standards comparable to BOAST Guidelines, and disseminated to Orthopaedic team members at one single centre, district general hospital. Anonymised results were collected. Results 22 responses were collected: 36.4%(8) from consultants, 22.7% (5) from Registrars, 22.7% (5) from scrub team members and 9.1% (2) responses from SHO's. 9.1% rated their level of confidence in safe tourniquet use as '1' ('Not confident') on the Likert scale, 36.4% rated a '4', whilst 22.7% rated themselves '5' ('Very Confident'). However, despite confidence levels, only just over half (54.5%) were aware of any guidelines available concerning tourniquet use. Half correctly answered that the tourniquet should encompass more than half of limb diameter. The majority of respondents (81.8%) correctly selected the ideal tourniquet pressure (above/in relation to systolic blood pressure) required for children. However, respondents were less confident in their selection of tourniquet pressures for adults. 63.6% selected the correct recommended upper limit for ischaemic tourniquet time whilst 22.7% recommended that audible reminders be given after this every 10 minute. Conclusions The mixed variety of survey responses demonstrates that there is still clear room for improvement in the safe management of tourniquets.