The Tourniquet During Venepuncture

When you take blood or gain venous access, it’s important to maintain good hygiene standards. You gather your equipment: a sterile needle and collection tubes, a clean dressing and some gloves. You wash your hands, put on the clean gloves and pick up and apply the same contaminated tourniquet that you’ve used for the last 2 years, on thousands of patients. You then feel for a vein – touching the skin you’re about to puncture with gloved fingers that have just been handling the tourniquet!

Everything you touch risks being contaminated by the bacteria on the tourniquet.

We know from many studies that bacteria such as MRSA and Vancomycin-resistant Enterococcus can easily transfer from environmental sites onto patients, colonising them.⁹

“Transmission of MRSA from environmental surfaces to gloves or hands of HCWs has been documented by several investigators. In one study, 42% of 12 nurses who had no direct contact with patients contaminated their gloves by touching objects in the rooms of patients with MRSA in a wound or urine. In another study, 31% of volunteers who touched bed rails and overbed tables in patient rooms contaminated their hands with S. aureus (35% of which were MRSA). When volunteers touched bed rails and overbed tables in unoccupied rooms that had been terminally cleaned, 7% contaminated their hands with S. aureus.⁹”

Similar studies looking at VRE make it clear that transmission is equally frequent, with 70% of workers hands or gloves becoming contaminated on contact with a colonised patient¹⁰, and over 10% of sites touched after contact then becoming colonised themselves.¹¹

“2 highly efficient origins of transfer were the antecubital fossae and the blood pressure cuff, which are commonly considered “clean” areas remote from the rectal reservoir of VRE.¹¹”