By A. Marjorie Matthias, Margaret J. Penfold, Susan Fry

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The illustrations show a sphygmomanometer cuff used on an arm. Larger pneumatic cuffs must be used for legs. The dangers of tourniquets are: 1. Damage to nerve trunks and arteries caused by a narrow band of constriction, particularly over two bones. 2. Irreversible ischaemia caused by prolonged arterial occlusion. 3. Death of a limb caused by failure to remove the tourniquet at the end of the operation. These dangers can be avoided by observing a strict routine. 1. Distribute the pressure evenly with a wide cuff over mid-thigh or upper arm.

The area of contact of the active electrode is very small causing high density current; coagulation will therefore take place. The area of contact of the indifferent electrode should be as large as possible to produce low density current and prevent burns. Good contact between plate and patient is obtained by the following: 1. Covering the plate with thick material which is soaked in concentrated saline solution. The higher the concentration of salt, the better the contact. 2. Moulding the plate round calf or thigh and bandaging it in place so that its whole surface makes contact.

49 fiaper envelopes Paper is cheap, disposable, permeable to steam under pressure and is a good antibacterial barrier when stored in a dry, dust-proof cupboard. The envelopes are folded so that they can be unfolded by an unscrubbed nurse without the open edge becoming contaminated. The sealing tab must bear proof of sterilization. SEALING Fold corners. Fold point. Start with a sterile towel. 50 UNSEALING (I) Pull tab to raise first fold. (2) Put thumbs under folded corners. (3) Separate thumbs to raise corners.

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