Sensation and Skin Pressures Under Blood-Draw Tourniquets

NCT ID: NCT03187041

Last Updated: 2020-02-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2018-10-31

Brief Summary

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Purpose: This research study seeks to determine whether surface pressures generated by elastic tourniquets used by phlebotomists during blood-draws can penetrate to deeper tissues where major arteries and nerves lie. Additionally, investigators will also determine the effects of prolonged tourniquet application on hand sensation using a controlled, reproducible force stimulus. In conjunction, the investigators will also track changes in skin surface pressures and pain levels over this prolonged tourniquet application. Hypothesis: The investigators hypothesize the use of common elastic tourniquets used for blood draws does not significantly impact sensation and will not elicit nerve or tissue damage. Technologies used: Monofilaments and Pressure Sensor

Detailed Description

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The objective of this study is to investigate the reproducibility and consequently the safety of common elastic tourniquet methods for blood draws. Specifically, the study will investigate whether the surface pressures produced by blood draw tourniquets when applied by experienced phlebotomists are significant enough to penetrate to deeper tissue near bone where major arteries and nerves lie. By relating factors including tourniquet width and patient arm circumference to our surface pressure measurements and comparing our results to previous literature, the investigators hope to determine the safety of current blood draw tourniquet procedures.

In addition, the investigators will track changes in skin surface pressures over time to determine if prolonged exposure to these tourniquet pressures has the potential to permanently affect nerve function and muscle in tissues near bone.

Hand sensation will be investigated during a prolonged tourniquet application trial of the study to test the effects of the generated pressures on median, ulnar, and radial nerve viability over time.

Conditions

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Skin Pressures Under Blood Draw-tourniquets

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

In order to acquire our data, a Microlab PicoPress device will be employed. It has been shown to provide accurate, linear, and reproducible measures of surface pressure between the skin and device. For tourniquets, the investigators will be using a MedSource perforated tourniquet, which is the type of elastic tourniquet the phlebotomists are accustomed to using in their daily practice. For each experiment throughout both phases of the study, the PicoPress pressure sensor will be folded in half and taped over the lateral aspect of the right arm, approximately 2 inches distal to the deltoid muscle along the brachialis muscle. Arm circumferences will be taken prior to experimentation at this same location. For each trial, the phlebotomists will tie the 2.5cm elastic tourniquet around the arm and pressure sensor while ensuring that the tourniquet is not knotted directly on top of the sensor. The study will be divided into two phases of experimentation conducted sequentially.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Skin surface pressures under tourniquets and sensation

Phase 1: Each phlebotomist will apply the tourniquet 10 separate times to the right arm of each subject. The tourniquet will remain on the arm for approximately ten seconds, to be able to allot enough time to collect an accurate pressure measurement. All 10 tourniquet skin pressure measurements will take place on the same day for a subject.

Phase 2: 20 subjects will be subjected to a prolonged blood-draw tourniquet application for a duration of 1 hour. The purpose of phase 2 is to determine whether there is an effect on sensation from prolonged blood tourniquet use.

Group Type EXPERIMENTAL

Sensation and Skin Surface Pressures Under Blood-Draw Tourniquets

Intervention Type OTHER

Phase 1: Skin surface pressures will be recorded by an investigator during each of the 10 applications of the tourniquet. All 10 tourniquet skin pressure measurements will take place in the Blood Draw clinic at the UCSD Medical Center in Hillcrest on the same day for a subject.

Phase 2: The same 20 subjects will be subjected to a prolonged blood-draw tourniquet application for a duration of 70 minutes. The purpose of phase 2 is to determine whether there is an effect on sensation from prolonged blood tourniquet use. External skin pressures will not exceed 60mmHg. During this prolonged tourniquet application the investigators will monitor changes in hand sensation at 10-minute intervals using Semmes-Weinstein monofilaments on three peripheral nerves of the hand (median, radian, and ulnar).

Interventions

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Sensation and Skin Surface Pressures Under Blood-Draw Tourniquets

Phase 1: Skin surface pressures will be recorded by an investigator during each of the 10 applications of the tourniquet. All 10 tourniquet skin pressure measurements will take place in the Blood Draw clinic at the UCSD Medical Center in Hillcrest on the same day for a subject.

Phase 2: The same 20 subjects will be subjected to a prolonged blood-draw tourniquet application for a duration of 70 minutes. The purpose of phase 2 is to determine whether there is an effect on sensation from prolonged blood tourniquet use. External skin pressures will not exceed 60mmHg. During this prolonged tourniquet application the investigators will monitor changes in hand sensation at 10-minute intervals using Semmes-Weinstein monofilaments on three peripheral nerves of the hand (median, radian, and ulnar).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years or older

Exclusion Criteria

* no history of abnormal heart conditions
* no history of coagulation disorders
* will not be on prescription medications that affect cardiovascular system (ex: medications that affect blood pressure or cardiac contractility etc.)\*\*
* does not have diabetes
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Alan R Hargens, PhD

Role: PRINCIPAL_INVESTIGATOR

UCSD

Locations

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UC San Diego Medical Center

San Diego, California, United States

Site Status

Countries

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United States

References

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Crenshaw AG, Hargens AR, Gershuni DH, Rydevik B. Wide tourniquet cuffs more effective at lower inflation pressures. Acta Orthop Scand. 1988 Aug;59(4):447-51. doi: 10.3109/17453678809149401.

Reference Type BACKGROUND
PMID: 3421083 (View on PubMed)

Partsch H, Mosti G. Comparison of three portable instruments to measure compression pressure. Int Angiol. 2010 Oct;29(5):426-30.

Reference Type BACKGROUND
PMID: 20924346 (View on PubMed)

Other Identifiers

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161885

Identifier Type: -

Identifier Source: org_study_id

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