Tourniquets
Product Description
Tourniquets or ties are used to "tie off" and restrict blood flow causing a vein to bulge out and become accessible.
OHRDP distributes latex-free, smooth, blue tourniquets.
These single person, single use tourniquets are kinder to the skin than leather belts or similar ties.
They are pliable and easy to release.
Practice/Usage
Tourniquets should be single person, single use only and used only if they are really needed. Many injectors, at least early in their injecting lives, should be able to access veins without using a tourniquet.
Various techniques can be used to help superficial veins become more accessible, including:
- Clenching and re-clenching the fist
- Applying a hot compress to the vein
- 'Windmilling' the arm
- Any vigorous exercise (like push ups)
- Letting the limb hang down
- Slapping the vein
- Bathing the arm in warm water (If the client is injecting depressants (opiates) it is important to point out the dangers of injecting in a bath as a period of unconsciousness could result in drowning.)
Tying Off
- Tourniquets help to secure rolling veins like the ones found in the forearm.
- It is best to tie a slip-knot, so that the tourniquet can be removed quickly.
- If a person needs to re-cook their shot or transfer it to another syringe, remind them to take their tourniquet off and to re-tie it just before they are ready to inject.
Illustration from http://www.harmreduction.org/idu/chapter1.html , pg 18
Discussion/Associated Risks
- Service providers should encourage single person, single use tourniquets distributed through OHRDP and discourage the use of ropes, belts, bandanas and wire, which can lead to severe trauma to the skin, veins and increase the risk of overdose
- Tourniquets, like other injecting equipment, can facilitate the transmission of blood-borne pathogens such as HIV and HCV. Participant observation studies of injection drug users in Australia (Croft N et al, 1999) and Scotland (Taylor A et al, 2004) have shown that tourniquets may be another potential source of exposure to blood-borne viruses when shared.
- Remind clients to remove the tourniquets as soon as possible because leaving it on will prevent their circulation from flowing and can cause a limb to turn blue and lose sensation and eventually can cause gangrene.
- If a tourniquet is not loosened prior to injection, excess pressure has to be used to get the solution into the vein which can lead to leakage of the drug into the tissue or can cause the vein to rupture. If a client is complaining of "missing hits", check that they are releasing the tourniquet before injecting.
- Crofts N, Aitken CK & Kaldor JM. "The Force of numbers: why hepatitis C is spreading among Australian injecting drug users while HIV is not". Med J Aus 1999; 170:220-1.
- Taylor A, Fleming A, Rutherford J & Goldberg D., Examining the injecting practices of injecting drug users in Scotland. Edinburgh: Effective Interventions Unit, Scottish Executive Drug Misuse Research Programme, University of Paisley, 2004.
- Strike C, Leonard L, Millson M, Anstice S, Berkeley N, Medd E. Ontario Needle Exchange Programs: Best Practices Recommendations. Toronto: Ontario Needle Exchange Coordinating Committee 2006
- Lavingne P. Memo: Provision of tourniquets to injection drug users through the Site Program. Ottawa Public Health, December 23, 2004.
- www.exchangesupplies.org/publications/safer_injecting_briefing/section3.html
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