Vein Pattern Locating Technology for Cannulation: A Review of the Low-Cost Vein Finder Prototypes Utilizing near Infrared (NIR) Light to Improve Peripheral Subcutaneous Vein Selection for Phlebotomy <s> Studies Regarding the Assessment on Vein Visualization by Conventional or Standard Method (Visualization or Palpation) and with the Use of Infrared Vein Finder Device <s> A randomized trial of the Vein Viewer versus standard technique for placement of peripherally inserted central catheters (PICCs) in neonates <s> BIB001 </s> Vein Pattern Locating Technology for Cannulation: A Review of the Low-Cost Vein Finder Prototypes Utilizing near Infrared (NIR) Light to Improve Peripheral Subcutaneous Vein Selection for Phlebotomy <s> Studies Regarding the Assessment on Vein Visualization by Conventional or Standard Method (Visualization or Palpation) and with the Use of Infrared Vein Finder Device <s> BACKGROUND ::: Peripheral venous (PV) cannulation, one of the most common technical procedures in Emergency Medicine, may prove challenging, even to experienced Emergency Department (ED) staff. Morbid obesity (body mass index [BMI] ≥ 40) has been reported as a risk factor for PV access failure in the operating room. ::: ::: ::: OBJECTIVES ::: We investigated PV access difficulty in the ED, across BMI categories, focusing on patient-related predicting factors. ::: ::: ::: METHODS ::: Prospective, observational study including adult patients requiring PV lines. Operators were skilled nurses and physicians. PV accessibility was clinically evaluated before all cannulation attempts, using vein visibility and palpability. Patient and PV placement characteristics were recorded. Primary outcome was failure at first attempt. Outcome frequency and comparisons between groups were examined. Predictors of difficult cannulation were explored using logistic regression. A p-value <0.05 was considered significant. ::: ::: ::: RESULTS ::: PV lines were placed in 563 consecutive patients (53 ± 23 years, BMI: 26 ± 7 kg/m(2)), with a success rate of 98.6%, and a mean attempt of 1.3 ± 0.7 (range 1-7). Failure at the first attempt was recorded in 21% of patients (95% confidence interval [CI] 17.6-24.4). Independent risk factors were: a BMI ≥ 30 (odds ratio [OR] 1.98, 95% CI 1.09-3.60), a BMI < 18.5 (OR 2.24; 95% CI 1.07-4.66), an unfavorable (OR 1.66, 95% CI 1.02-2.69), and very unfavorable clinical assessment of PV accessibility (OR 2.38, 95% CI 1.15-4.93). ::: ::: ::: CONCLUSION ::: Obesity, underweight, an unfavorable, and a very unfavorable clinical evaluation of PV accessibility are independent risk factors for difficult PV access. Early recognition of patients at risk could help in planning alternative approaches for achieving rapid PV access. <s> BIB002 </s> Vein Pattern Locating Technology for Cannulation: A Review of the Low-Cost Vein Finder Prototypes Utilizing near Infrared (NIR) Light to Improve Peripheral Subcutaneous Vein Selection for Phlebotomy <s> Studies Regarding the Assessment on Vein Visualization by Conventional or Standard Method (Visualization or Palpation) and with the Use of Infrared Vein Finder Device <s> OBJECTIVES ::: To evaluate the effectiveness of a vein visualization display system using near-infrared light ("Vein Display") for the safe and proper selection of venipuncture sites for indwelling needle placement in the forearm. ::: ::: ::: METHODS ::: Ten second year nursing students were recruited to apply an indwelling needle line with and without Vein Display. Another ten participants were recruited from various faculty to serve as patients. The quality of the venipuncture procedure at various selected sites was evaluated according to a scale developed by the authors. Time, scores and patterns of puncture-site selection were compared with respect to three different methods: [1] attempt 1 (tourniquet only), [2] attempt 2 (Vein Display only) and [3] attempt 3 (both). To validate the effectiveness of Vein Display, 52 trials were conducted in total. ::: ::: ::: RESULTS ::: We found that venipuncture site selection time was significantly improved with the Vein Display, particularly in the case of difficult to administer venipuncture sites. Overall, we found no significant difference with respect to venipuncture quality, as determined by our scale. ::: ::: ::: CONCLUSION ::: These results suggest that equipment such as the Vein Display can contribute immensely to the improvement of practical skills, such as venipuncture, especially in the context of elderly patients. <s> BIB003 </s> Vein Pattern Locating Technology for Cannulation: A Review of the Low-Cost Vein Finder Prototypes Utilizing near Infrared (NIR) Light to Improve Peripheral Subcutaneous Vein Selection for Phlebotomy <s> Studies Regarding the Assessment on Vein Visualization by Conventional or Standard Method (Visualization or Palpation) and with the Use of Infrared Vein Finder Device <s> Abstract Background Children with special health care needs (CSHCN) are predicted to be at particular risk for difficult peripheral venous access (PVA). Near infrared (NIR) technology is a noninvasive method that reveals vessels that are otherwise not visible to the eye. Our primary objective was to determine whether PVA success improved with NIR when compared with traditional visualization/palpation, specifically in CSHCN. Methods A retrospective analysis of all patients requiring PVA insertions by the vascular access team at a 350-bed tertiary children's hospital from July 2013 until June 2014 were included. Independent variables included age, gender, ethnicity, CSHCN status and modality used (NIR, ultrasound guidance, transillumination, or none). The primary outcome was subjective difficulty, PVA success, and number of attempts required. The effect of NIR and CSHCN was analyzed using χ 2 test. Results Data were gathered on 7896 PVA placements in children. Out of these, 6071 children were deemed to have special health care needs. CSHCN had subjectively difficult access 88% of the time compared with non-CSHCN at 74.7% ( P P P P Conclusions NIR decreases the number of attempts and improve overall success rates in acquiring PVA in CSHCN. Further studies on maximizing PVA success in this patient population are warranted. <s> BIB004
A limited number of publications regarding the assessment for personnel performing venipuncture was observed and variations in the methodology, number of patients, type of patients according to their demographics and materials used in developing a vein finder prototype were noted. The success in the cannulation process does not merely rely on the vein finder but more so to the skills of the medical practitioner. The Chiao et al., 2013 [25] study showed that the possible cannulation site with the use of a vein finder device has better results with 9.1 (95% CI 8.6-9.5) compared with the conventional method 5.8 (95% CI 5.4-6.2). In addition, the result shows that African-American or Asian ethnicity, and obesity were associated with decreased vein visibility, and these were also been observed in the Sebbane et al., 2012 BIB002 study with consideration on obesity as an independent risk factor for difficult peripheral venous access. While in 2012 Phipps et al., BIB001 a study based on successful first attempt for peripherally inserted central catheter shows 59.00% (33/56) for standard technique (visualization or palpation) and 64.00% (38/59) with a vein finder. Recently, a 2016 study by Barreras and Chang BIB004 revealed that the use of a near infrared (NIR) device significantly increased intravenous access success rates compared with visualization or palpation 26% vs. 19.6%, respectively in children with special health care needs. Moreover, the Fukuroku et al., 2016 BIB003 study on validating the effectiveness of vein infrared visualization performed by second-year nursing students, confirmed that the vein viewer contribute immensely to the improvement of their practical skills in venipuncture, specifically, in the site selection time with the context for the elderly patients. 