BP cuff as turniquet

[Lone Star]

If faced with making the choice of life or limb, (and all other methods of controlling the bleeding have failed), then I would not hesitate to use a tourniquet. Under the guidelines I was tought about tourniquets, wider is better. I would have no qualms about using a B/P cuff as a tourniquet. Im not sure of other states protocols, but in the event you DO get called in front of he local medical control board, you need to satisfy just one question: would someone of 'reasonable intelligence' and equal training have responded with the same treatments (obvously without volating the restrictions of your licensure level)?

[kevkei]

Not to be picky but in the interest of correct spelling it is called a Bier block. ...

Live long and prosper.

Spock

Well, you are being picky and that's okay. I guess I had an episode where I was stuttering while typing.

[Doczilla]

40-50cc's of 0.5% lidocaine are then injected and the IV removed.

If the surgeon finishes in 5 minutes you must leave the tourniquet inflated for at least 30 minutes to allow the lidocaine to degrade. Sudden loss of tourniquet can result in lidocaine toxicity and severe seizures.

This would work out to be 200-250mg of lidocaine, which shouldn't get you into trouble with toxicity unless you are doing it on a child. In recent years they have decreased the recommended dose of lidocaine for Bier blocks to 0.75-1.5mg/kg (from the previous 3mg/kg recommendation), which is the same dose you give for ventricular arrhythmias. Either way, one shot shouldn't cause seizures in an adult.

'zilla