An integral step in drug injection is identifying a vein for entry. A tourniquet or ‘tie’ is a long strip of elastic that is tied around the arm to help raise blood veins to the surface of the skin and even protrude, or ‘bulge’, outward. This helps make veins more evident.1
Why should a tourniquet be used?
Although not all people who inject drugs need to use a tourniquet to help protrude veins, those who do may be using alternate supplies such as belts, shoelaces, ropes, and wires to act as makeshift tourniquets. These makeshift tourniquets may be more difficult to release which can lead to: problems injecting, trauma to skin and veins, burst veins, disrupt blood flow (and potential loss of limb), as well as an increase risk of overdose, among other harms.1,2 Using a tourniquet that is provided by BC Harm Reduction Strategies and Services can minimize likelihood of these injuries.
What type of tourniquets does BC Harm Reduction Strategies and Services provide?
The BC Harm Reduction Strategies and Services provide non-latex 18 inch tourniquet. In cases where a person is unable to obtain one of these tourniquets, an acceptable alternative would be to use a non-lubricant condom (or tie two condoms together). The condoms should be used in the same fashion as the non-latex 18 inch tourniquet provided by BC Harm Reduction Strategies and Services.
How to use a tourniquet
The BC Harm Reduction Strategies and Services provide an illustrated guide on how to safely use a tourniquet (see the image below). A tourniquet should be tied in a quick release fashion so that it can easily be removed if it becomes uncomfortable.
It is important to note that tourniquets should never be shared. When an individual uses a tourniquet, he/she may expose their blood and/or bacterial infections (such as Methicillin-resistant Staphylococcus aureus (MRSA)) on the tourniquet.3 Therefore, we advise individuals do not share their tourniquets in order to avoid possibly transmitting disease or infection to another person.
Why does BC Harm Reduction Strategies and Services provide tourniquets?
The BC Harm Reduction Strategies and Services is concerned about the health risks associated with using substitute products such as belts and shoelaces as makeshift tourniquets. Providing tourniquets to enable safer drug use not only reduces the chance of injury to the user, but creates a way to engage hard-to-reach and under-serviced populations. No studies have found that providing safe supplies make people more likely to engage in harmful drug use.
How can tourniquets be ordered?
Tourniquets can be ordered by harm reduction distribution sites which are approved by the appropriate regional health authority. The harm reduction supply requisition form available online on the BCCDC website should be used and the tourniquets ordered at the same time as other harm reduction supplies. The completed form is faxed to BCCDC.
More information on the Canadian best practice recommendations for tourniquet distribution can be found here.
2. Scott, J. “Safety, Risks and Outcomes for the Use of Injecting Paraphernalia”. Scottish Government Social Research 2008 page 64.
3. Ontario Needle Exchange Program: Best Practice Recommendation. March 2006 [cited 23 Nov 20110. Pg 132 – 133.