Page 44 - JSOM Winter 2017

Figure 5 Differences between occlusion pressures and 120-second pressures, and between completion pressures and 120-second pressures.

(B)

(A)

(D)

(A) Occlusion pressures minus 120-second pressures in tourniquet
pairs. (B) Occlusion pressures minus 120-second pressures in single
tourniquet applications. (C) Completion pressures minus 120- second
pressures in paired tourniquets. (D) Completion pressures minus
(C) 120-second pressures in single tourniquet applications. Symbol expla-
nations are given in the Figure 2 legend.

in other words, increasing intertourniquet distance decreases statement are the occurrence of systolic pressure amplification
intratourniquet pressure interaction. distally in the arterial system and the path of the femoral artery
from relatively superficial very proximal to muscle protected and
An additional study finding is that, despite proximally increas- close to the femur distally. Because the pressure applied by non-
ing thigh circumference, there is a pressure advantage to very elastic tourniquets undergoes some dissipation with increasing
proximal thigh tourniquet placement. This is counter to the oft tissue depth, it is quite reasonable that a location with the ma-
12
made statement that higher tourniquet pressures are needed to jor artery located close to the skin could be occluded by a tourni-
reach occlusion on larger circumference limb locations. Factors quet at a lower pressure than needed at a smaller circumference
not accounted for in the simple pressure versus circumference location at which the artery was located farther from the skin.

42 | JSOM Volume 17, Edition 4/Winter 2017