After applying a tourniquet, which assessment should you perform to evaluate distal circulation?

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Distal circulation after a tourniquet is best assessed using multiple signs rather than relying on a single measure. The most reliable approach is to check distal pulses, skin color, temperature, and capillary refill, and to monitor these over time for improvement or deterioration. A tourniquet can affect pulse palpation, so pulses alone may be misleading; color and temperature reveal how well perfusion is actually returning to the area, and capillary refill offers a quick sense of microcirculation. If the limb remains pink and warm with brisk cap refill, perfusion is adequate; if it becomes cool, pale, or cap refill is delayed, perfusion may be compromised and you’d reassess the situation. Measuring blood pressure in the affected arm isn’t a practical or reliable way to judge distal circulation when a tourniquet is in place, and evaluating capillary refill alone misses other important cues.