Low-cost synthetic tourniquet training model. / Modelo sintético de baixo custo para treinamento do uso de torniquete.

OBJECTIVE: to present a low-cost model for bleeding control training with the use of a tourniquet and the results of the training evaluation. METHOD: low-cost and easy-to-purchase materials, such as upholstery foam, ethylene-vinyl acetate (EVA) sheet, plastic propulsion pump, saline container, water, school paint, serum equipment, rubber tubing for tourniquet, and a leg and an arm of a ghost mannequin, were used. In the model assembly, we created an active bleeding simulation system, which could only be controlled with the correct application of the tourniquet. The model was submitted to professional and academic evaluation. RESULTS: the model was similar to human anatomy, proved to be practical in the bleeding control training with the use of a tourniquet, and had low cost. CONCLUSION: the model for bleeding control training had excellent acceptability, was considered viable for educational purposes of tourniquet use, and had low cost.

OBJETIVO: apresentar um modelo de baixo custo para treinamento de controle de sangramento com o uso de torniquete e os resultados da avaliação do treinamento. MÉTODO: foram utilizados materiais de fácil aquisição e de baixo custo, como espuma de estofado, placa de etileno-acetato de vinila (EVA), bomba plástica de propulsão, recipiente de soro fisiológico, água, tinta escolar, equipos de soro, tubo de látex para garrote e manequins comerciais de perna e de braço. Na montagem, foi criado um sistema de simulação de sangramento ativo que só podia ser controlado com aplicação correta do torniquete. O modelo foi submetido à avaliação de profissionais e acadêmicos. RESULTADOS: o modelo teve semelhança com a anatomia humana, mostrou-se prático no treinamento da contenção de sangramento com uso de torniquete e teve baixo custo financeiro. CONCLUSÃO: o modelo para treinamento de controle de sangramento teve excelente aceitabilidade, foi considerado viável para fins educacionais do uso de torniquete e teve baixo custo.

Modelo sintético de baixo custo para treinamento do uso de torniquete / Low-cost synthetic tourniquet training model

RESUMO Objetivo: apresentar um modelo de baixo custo para treinamento de controle de sangramento com o uso de torniquete e os resultados da avaliação do treinamento. Método: foram utilizados materiais de fácil aquisição e de baixo custo, como espuma de estofado, placa de etileno-acetato de vinila (EVA), bomba plástica de propulsão, recipiente de soro fisiológico, água, tinta escolar, equipos de soro, tubo de látex para garrote e manequins comerciais de perna e de braço. Na montagem, foi criado um sistema de simulação de sangramento ativo que só podia ser controlado com aplicação correta do torniquete. O modelo foi submetido à avaliação de profissionais e acadêmicos. Resultados: o modelo teve semelhança com a anatomia humana, mostrou-se prático no treinamento da contenção de sangramento com uso de torniquete e teve baixo custo financeiro. Conclusão: o modelo para treinamento de controle de sangramento teve excelente aceitabilidade, foi considerado viável para fins educacionais do uso de torniquete e teve baixo custo.

ABSTRACT Objective: to present a low-cost model for bleeding control training with the use of a tourniquet and the results of the training evaluation. Method: low-cost and easy-to-purchase materials, such as upholstery foam, ethylene-vinyl acetate (EVA) sheet, plastic propulsion pump, saline container, water, school paint, serum equipment, rubber tubing for tourniquet, and a leg and an arm of a ghost mannequin, were used. In the model assembly, we created an active bleeding simulation system, which could only be controlled with the correct application of the tourniquet. The model was submitted to professional and academic evaluation. Results: the model was similar to human anatomy, proved to be practical in the bleeding control training with the use of a tourniquet, and had low cost. Conclusion: the model for bleeding control training had excellent acceptability, was considered viable for educational purposes of tourniquet use, and had low cost.

A prospective study of 100 cases of sterile T-RING™ digital tourniquet application.

The ideal finger tourniquet must be easy to use and provide a completely bloodless field with control of the pressure exerted at the compression site. The primary objective of this study was to evaluate the effectiveness of the T-RING™ digital tourniquet in emergency hand surgery; the secondary objective was to define the optimal indications and possible contraindications. This prospective study, undertaken between May 4 and July 30, 2015, comprised the application of 100 finger tourniquets in the following indications: all single or multiple digital wounds, distal from the base of the proximal phalanx, irrespective of their nature and the suspected structural damage. Data were collected with a questionnaire at the end of each surgical use of the finger tourniquet. An overall grade out of 30 was obtained by combining these scores. The facility of opening the packing was rated on average at 4/4, the facility of applying the finger tourniquet was rated at 3.8/4, the quality of the exsanguination at the beginning and at the end of the procedure were rated at 3.4/4 and 3.1/4, respectively, the difficulty related to positioning of the finger tourniquet was rated at 2.7/3, the facility of removing the finger tourniquet was rated at 3.6/4, the risk of forgetting the finger tourniquet at the end of the procedure was rated to 2.8/3, the comparison with an arm tourniquet was rated at 1.9/4. The overall grade was 25.1/30 on average. In current practice, use of the T-Ring™ tourniquet did not cause any difficulty. The tourniquet was never forgotten and the risk of forgetting it was considered low by the surgeons. The exsanguination appeared satisfactory, with a reduction in its effectiveness over time. We identified specific situations where its use could be indispensable: contraindication to trunk or plexus regional anesthesia, or as a relay to a pneumatic arm tourniquet after more than 2hours.

Is Velband still a safe and cost effective skin protection beneath the tourniquet in hand surgery?

Skin complications have been reported to be associated with tourniquet use. The UK Medical Devices Agency (MDA) recommends the use of a limb drape to act as underpadding to reduce these complications. Our hospital had traditionally used Velbands as an underpadding, but changed to limb drapes on the advice of the MDA. The purpose of this study is to establish whether Velbands are still a safe and cost-effective tourniquet underpadding. A prospective clinical study was performed on consecutive patients undergoing hand surgery over a four-month period. Patients were randomly allocated into one of two treatment groups. Group 1 using Velband as tourniquet underpadding and Group 2 using limb drapes as underpadding. All patients had identical tourniquets, tourniquet pressure and skin preparation agents. After surgery, the tourniquet was removed and the skin beneath the tourniquet was inspected for any skin reaction or damage. Each group included 50 patients. Skin was normal after tourniquet use in all cases and there was no difference between the two groups. Velband is still a safe and cost-effective tourniquet underpadding in hand surgery.