A 19-year-old male received an intravenous peripheral nerve block (PNB/Bier block)for an open reduction internal fixation (ORIF)of an ankle fracture.The anesthesia provider injected a distal dorsal vein of his right foot with 2% lidocaine,after placing a single cuffed pneumatic tourniquet circumferentially around his upper right thigh.The surgeon looked through the OR window to check on anesthesia progress as he scrubbed at the sink outside of the OR.The circulating nurse had his leg elevated and was prepping his ankle.The surgeon noticed that the cuff seemed to be deflating and that the anesthesia provider was turned away from the patient.The circulating nurse also noticed the movement under the protective towel placed over the cuff,and saw the tourniquet tubing fall to the floor.The nurse's first response should be to:
A) alert the anesthesia provider, run for the code cart, and tell the scrub person to wrap the Esmarch bandage around the deflated cuff.
B) alert the anesthesia provider, reconnect the tubing to cuff and reinflate, and send for the code cart.
C) send the scrub person for the code cart, alert the anesthesia provider to reconnect the tubing and reinflate the cuff, and continue the skin prep.
D) alert the anesthesia provider, reconnect the tubing and reinflate the cuff, and send the surgeon for a replacement cuff.

Question

Quizplus · Accepted Answer

Although problems can occur from an overdose or toxic reaction to lidocaine,these are rare if the tourniquet has been inflated more than 20 minutes.In this case,however,loss of pneumatic pressure in the tourniquet can cause a toxic reaction and loss of anesthesia.

A 19-Year-Old Male Received an Intravenous Peripheral Nerve Block (PNB/Bier