Tourniquet Could Help Fight Hospital Infections

by Gopalan on Aug 12 2007 11:31 AM

What is the answer to increasing hospital infection? It could be a simple tourniquet – used to cause veins to expand when taking blood samples of inserting drips. Yes, a disposal tourniquet could effectively combat hospital infections, costing the National Health Service (NHS) in the UK as much as £1bn each year.

When Drs Ryan Kerstein and Christian Fellowes were studying at Imperial College they noticed that tourniquets were being used again and again.

Around 40 million procedures using a tourniquet are performed each year.

Convinced this must be a source of cross infection, they determined to carry out their own tests and come up with a financially viable disposable tourniquet.

And their product the 'Tournistrip' - a long strip of plasticized paper- is already generating interest and orders. They do not know exactly how much their product will cost, but say it will be pence, rather than pounds.

"We came up with the idea when on the wards, as medical students, we saw tourniquets being transferred from patient to patient, which we felt was unacceptable.

"The only available alternative was a rubber glove (often adapted by doctors for the same purpose), which seemed unprofessional and uncomfortable," said Dr Fellowes.

They said other disposable alternatives were little used because of their cost.

Dr Kerstein agreed: "Throughout our training there was always a lot of emphasis on infection control and good clinical technique.

"Watching some of our colleagues in the hospital environment it struck us that even though their technique was stringent they were limited by the re-usable equipment available."

So the students conducted their own small study.

Without giving any warning they bleeped colleagues and asked them for their tourniquets - taking 52 from doctors, phlebotomists and nurses.

Phlebotomists are those trained to draw blood, whether for laboratory tests or for blood donation.

Staff said their tourniquets had been in use for anything from two to 104 weeks and used an average of 11 times each day.

Quizzing their colleagues they found that all of them believed tourniquets could be a source of infection, but that just over a third had ever cleaned them.

And they found that only just over half had stopped themselves using them on patients they knew were infectious.

They grew cultures on these and found MRSA (methicillin-resistant or multiple antibiotic-resistant staphylococcus aureus) on three tourniquets and MSSA (methicillin sensitive staphylococcus aureus) on 30.

They also found bug cultures on hospital keyboards.

"I think people were surprised by how many nasty bugs we were able to get," said Dr Kerstein.

Their 'Tournistrip', which has similar dimensions to a watch strap, is fastened using a quick release seal and based on wrist bands used for security at events like concerts.

Dr Alison Holmes, director of infection control at Hammersmith Hospital and lecturer at Imperial, said the 'Tournistrips' would be a welcome addition in the fight against infection and that her hospital had already put in an order.

"Tourniquets are a vehicle for cross infection, going from person to person. And I am delighted by this.

"They have applied simple technology to solve this problem."

The students were finalists in the Imperial business plan competition.