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Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
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Updated: Oct 3, 2025

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
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Forearm and Arm Tourniquet Tolerance.

Rachel Lefebvre1, Landon Cohen, Harrison Ford Kay

  • 1From the Department of Orthopaedic Surgery, Division of Hand Surgery, University of Southern California, Los Angeles, CA.

Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
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Summary

Forearm tourniquets are more comfortable than upper arm tourniquets for distal upper extremity surgeries. Despite longer inflation times, forearm placement offers greater subjective comfort and similar paresthesia resolution.

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Medical Devices

Background:

  • Tourniquet use in distal upper extremity surgery presents a choice between upper arm and forearm placement.
  • Patient comfort and tolerance are critical factors in surgical procedures.

Purpose of the Study:

  • To compare the discomfort and tolerance of upper arm versus forearm tourniquets in healthy volunteers.
  • To determine which tourniquet site offers superior patient comfort during distal upper extremity surgery.

Main Methods:

  • Forty healthy participants underwent sequential upper arm and forearm tourniquet application.
  • Tourniquets were inflated to 100 mm Hg above systolic blood pressure.
  • Visual analog scale (VAS) scores, time to request deflation, and paresthesia resolution time were recorded.

Main Results:

  • Forearm tourniquets were inflated significantly longer (16.1 min) than upper arm tourniquets (12.2 min).
  • No significant difference was found in VAS scores at removal or time to paresthesia resolution between the two sites.
  • Participants reported a subjective preference for the forearm tourniquet's comfort.

Conclusions:

  • Forearm tourniquet placement is subjectively more comfortable for patients undergoing distal upper extremity procedures.
  • Forearm tourniquets can be inflated for longer durations without compromising patient comfort or recovery time.