Inaccurate tourniquet pressure-gauge readings--a widespread problem

Complications due to inaccurate pneumatic tourniquet pressure-gauge readings have been well described. However, no standard protocol for regular testing of the tourniquet apparatus, especially at the pressures used in clinical practice, appears to have been developed. We therefore developed a protocol for testing the Kidde pneumatic tourniquet apparatus and used this protocol to test 13 apparatuses in regular use at several hospitals in the Western Cape. We found that 8 of the apparatuses checked were inaccurate by as much as 350 mmHg, 8 had defective valves and 1 was considered to be too dangerous for further clinical use. This random survey shows that the majority of pneumatic tourniquet apparatuses in clinical use may be inaccurate and that more frequent testing and appropriate maintenance are indicated.