Tourniquets: Home Sweet Home for Dangerous Organisms

From the WebMD Archives

Jan. 28, 2000 (Lake Worth, Fla.) -- E. coli bacteria, Candida, and staph infection are some of the disease-causing organisms that can be lurking in tourniquets -- the rubber tubing tied on the upper arm to limit blood flow during needle insertion. And, according to a study published in a recent issue of TheLancet, tourniquets are often not disposed of between patients.

British researcher Mark Golderand his team randomly selected 77 tourniquets from various medical wards in England and examined them for visible bloodstains. Although the study was conducted in the U.K., tourniquets are sometimes reused in the U.S., according to an expert from New York University.

The British researchers tested each of the 77 tourniquets, bloodstained or not, for various known disease-causing organisms called pathogens.

While they found no HIV or hepatitis B, they did find staphylococcus, E. coli, corynebacteria, Candida and non-Candida fungi, and Gram-negative bacilli, among others. Some of these pathogens can cause dangerous diseases, especially in patients with weak immune systems.

The study's authors say that reuse of tourniquets is a much overlooked vehicle of this sort of cross-infection transmission between hospitalized patients.

Disposable tourniquets are used in the U.S. but are often not thrown away between patients. According to Philip Tierno, PhD, the director of clinical microbiology and diagnostic immunology at NYU Medical Center, health care workers may not dispose of a tourniquet, even if it's marked reusable, because there is no visible blood on it.

"The biggest problem comes in with monitoring the supposedly 'disposable' tourniquets to make sure they're disposed of and to make sure they're not used on another patient," says Tierno.

Tierno says that even if hospitals reuse tourniquets to save money, there are steps that can be taken to ensure that the potential for cross-infection is diminished. "Many institutions assign a tourniquet to a bedside," he says. This keeps any infections indigenous to the patient. Also, if tourniquets are reused between patients, the one used should be sterilized and a new one used for the next patient, and so on, he explains.

Patients, Tierno says, should be aware of this and other issues concerning their care when they are hospitalized.

"Any individual ... should be aware that a hospital is a dangerous place, and you have every right to question every procedure that's done," Tierno says. "If you are aware of tourniquets that are being used on other patients, you have every right to ask for a new tourniquet."

It's important to remember that 80% of all infections are transmitted by touch, says Tierno.