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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> Introduction. This study aims to evaluate for the first time the value of visualizing veins by a prototype of a near-infrared (NIR) vascular imaging system for venipuncture in children. Methods. An observational feasibility study of venipunctures in children (0-6 years) attending the clinical laboratory of a pediatric university hospital during a period of 2 months without (n = 80) and subsequently during a period of 1 month with a prototype of an NIR vascular imaging system (n = 45) was conducted. Failure rate (ie, more than 1 puncture) and time of needle manipulation were determined. Results. With the NIR vascular imaging system, failure rate decreased from 10/80 to 1/45 (P = .05) and time decreased from 2 seconds (1-10) to 1 second (1-4, P = .07). Conclusion . This study showed promising results on the value of an NIR vascular imaging system in facilitating venipunctures. <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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> This paper presents an infrared finger vein image acquisition terminal design method. The design contains the optical, mechanical and electrical models, which is convenient for the users to capture their infrared finger vein images. The optical model is consisted of the infrared light source, infrared sensor, lens and filter. The mechanical model is the acquisition device model. And the electrical model is composed of the driver of light source, the sensor control and the communication interface. The proposed acquisition terminal can be connected to a PC for capturing a finger vein image on line. <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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> The use of infrared radiation for medical diagnosis is a very new concept in the field of medical technology that promises to deliver high-end results. While a very few devices based on infrared technique have been implemented, there still exists a strong need to develop such medical devices. Therefore, our aim is to develop a low-cost subcutaneous vein detection system, which uses infrared technique to capture vein images, processes (enhances contrast) these images, and displays them on screen. These images can also be projected on the limb. This type of system will provide an easy access to the doctor for efficient drug delivery. A vein imaging system has been implemented successfully using the ARM 9 single board computer as the development platform. A customized webcam is used for capturing vein images. Thereafter, contrast enhancement algorithms based on histogram equalization method have been tested, implemented and the experimental results are presented in this paper. <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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> Venipuncture is now a common medical means. Several devices have been developed to aid the paramedics or physicians in locating the vein. There are two problems existing in vein display devices: (1) The vein cannot be shown directly on the skin; (2) The method of displaying the vein on the skin is complex. An approach based on the camera-projector system is proposed to help the paramedics or physicians quickly find the vein for diagnosis and treatment. The proposed approach can solve the two problems and it is easy to be accomplished. A simple system including IR light, an IR camera and a DLP projector is constructed to test and verify this approach. In the experiment, the vein is projected directly on the surface of the skin and the whole process takes only a short period of time. The result of the projection of the vein can meet the requirement of the venipuncture. <s> BIB004 </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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> The process of venous access for drawing blood or intravenous drug delivery is a crucial one, upon which the number of successful attempts and quality of specimens depend. In this paper, we present a simple and cost effective design for a vein imaging system with wireless communication capability assisting in vein finding procedure performed on patients. The vein imaging is based on the differential pattern of Infrared (IR) light absorption by blood. A serial JPEG camera module interfaced with an Xbee pair wirelessly transmits the images to a central image processing unit which suitably highlights the superficially located veins thereby reducing the error involved in puncturing the right vein by the phlebotomist. Our results indicate that this could be transferred to the clinic for real world applications. <s> BIB005 </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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> BACKGROUND ::: Recently, various near-infrared vascular imaging devices aimed at facilitating peripheral intravenous cannulation (PIC) were introduced, all claiming to increase success rate of PIC. We evaluated the clinical utility of a near-infrared vascular imaging device (VascuLuminator(®)) in pediatric patients who were referred to the anesthesiologist because of difficult cannulation. ::: ::: ::: METHODS ::: There were 226 consecutive children referred to pediatric anesthesiologists by the treating pediatrician of the in- and outpatient clinic, because of difficulties with intravenous cannulation, were included in this cluster randomized clinical trial. The presence and use of the near-infrared vascular imaging device for PIC was randomized in clusters of 1 week. Success at first attempt (Fisher exact test) and time to successful cannulation (Log-rank test) were assessed to evaluate differences between groups. ::: ::: ::: RESULTS ::: Success at first attempt in the group with the VascuLuminator(®) (59%) was not significantly different from the control group (54%, P = 0.41), neither was the median time to successful cannulation: 246 s and 300 s, respectively (P = 0.54). ::: ::: ::: CONCLUSIONS ::: Visualization of blood vessels with near-infrared light and with near-infrared vascular imaging device did not improve success of PIC in pediatric patients who are known difficult to cannulate. <s> BIB006 </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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> A common problem that medical practitioners experience is the inability to successfully locate a vein for intravenous access procedures. Currently, there are several methods that can allow for increased venous visibility. However, these are expensive processes that involve infrared detectors and high-end processing capabilities. The system proposed can successfully make a clear image of a vein using low-cost, nearinfrared LEDs and photographs taken with a smartphone. The near-infrared lights, when under the correct specifications, will highlight the location of a vein described by the principles of vein transillumination. By applying edge-finding algorithms and contrast differentiation, a clear image and relative location of a vein can be produced to aid practitioners. As a result, low cost materials can capture and process an image of a vein and return the vein location. These results can be applied to current research to create medical devices that aid practitioners in locating a vein and completing intravenous procedures. <s> BIB007 </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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> Poor quality of the images captured by a conventional vein viewer or finder renders it to be un-useful as a diagnostic tool. This is a result of an insufficient amount of venous blood in the superficial veins and the low resolution of the near-infrared (NIR) cameras used in the traditional vein viewers. In this paper, we propose using a high resolution NIR camera, vein warmer and image contrast enhancer (CLAHE) to improve the view of the superficial veins. This approach effectively produces a diagnostic medical superficial vein images. <s> BIB008 </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> Basic Composition, Its Principle and Designs of a Vein Finder Prototype <s> The near-infrared light source is a crucial part of a hand-vein scanner. Depending on its position there are two main illumination types: reflected light and transillumination. Commercial scanners and all publicly available data sets use reflected light. We established two dual illumination dorsal hand-vein data sets (one of them is made publicly available) including both, reflected light and transillumination images acquired using the same subjects, hand position and environmental conditions. This enables a direct comparison of both illumination scenarios as well as cross-illumination matching. Several experiments utilising common hand-vein recognition algorithms were carried out to quantify the recognition performance in each of the illumination scenarios and in the cross-illumination matching one. <s> BIB009
A basic prototype vein finder is composed of a high power NIR-LED as the light source, a compact infrared-sensitive camera, sensor that will capture and format the image and a filter to remove unwanted impurities BIB001 BIB002 BIB005 BIB003 BIB008 BIB009 (see Figure 2 ). Other prototypes were incorporated with additional parts by the researchers for enhancement purposes, like the use of a Digital Light Processing (DLP) projector that allows vein image on the surface of the skin BIB004 . Sensors 2018, 18, x FOR PEER REVIEW 5 of 18 A basic prototype vein finder is composed of a high power NIR-LED as the light source, a compact infrared-sensitive camera, sensor that will capture and format the image and a filter to remove unwanted impurities BIB001 BIB002 BIB005 BIB003 BIB008 BIB009 (see Figure 2 ). Other prototypes were incorporated with additional parts by the researchers for enhancement purposes, like the use of a Digital Light Processing (DLP) projector that allows vein image on the surface of the skin BIB004 . The principle of a vein finder device is based on two illumination types: Reflected light and transillumination. For reflected light, the light from the source was reflected at the site, showing an example of the hand surface and then captured by the camera; this principle was usually applied by a commercial hand-vein scanner. While for transillumination, the light penetrates the skin and tissue of the site and then the image will be captured by the camera BIB009 . The image in transillumination is due to the presence of deoxyhemoglobin in venous blood which absorbs the red light and illuminates the veins as dark lines on the skin surface, allowing the phlebotomist/medical practitioners to locate the vein BIB007  . This is composed of two stages, firstly; the infrared (IR) light penetrates the human tissue and secondly, deoxyhemoglobin in the venous blood absorbs more of the incident IR light than the surrounding tissue BIB005 . The reflected light type of a vein finder shown in Figure 2a became more popular in commercial devices due to its characteristics, such as: It requires lower light intensity; less power consumption suitable for battery operated devices, and enables a compact design vein finder. While transillumination devices is the opposite, which require a higher light intensity that uses more power and non-compact with the arm or hand being scanned were placed in between the light source and the camera shown in Figure 2b [34] (see Figure 3) . The sample projected a vein image of the dorsal hand using the NIR vein finder prototype. Recently, the use of the near infrared region (NIR) of the electromagnetic spectrum became more popular in developing a low cost but efficient type of vein finder. This is to primarily address the estimated cost of available commercial vein finder using NIR technology for about 4500 USD (portable) to 27,000 USD (non-portable)  . Moreover, the most significant reason is the challenges that the physician, nurse, emergency medical technician and other medical practitioners encountered during venipuncture  , intravenous (IV) drug delivery BIB003 and cannulation. This is usually due to the following reasons; veins are either very small, and/or deep, the patient's age (elderly or pediatrics), skin color  , and obesity level BIB003 BIB004 . It often results in multiple attempts in needle insertion leading to pain, discomfort, dissatisfaction, delayed treatment  , hematoma, swell in the skin, cuts on the bone [39] , bleeding, and even infection. Especially in young children, despite the dedicated and highly skilled physicians, multiple attempts are often unavoidable, which can be traumatic BIB006 , even requiring blind puncture and may sometimes needs general anesthesia BIB001 . In The principle of a vein finder device is based on two illumination types: Reflected light and transillumination. For reflected light, the light from the source was reflected at the site, showing an example of the hand surface and then captured by the camera; this principle was usually applied by a commercial hand-vein scanner. While for transillumination, the light penetrates the skin and tissue of the site and then the image will be captured by the camera BIB009 . The image in transillumination is due to the presence of deoxyhemoglobin in venous blood which absorbs the red light and illuminates the veins as dark lines on the skin surface, allowing the phlebotomist/medical practitioners to locate the vein BIB007  . This is composed of two stages, firstly; the infrared (IR) light penetrates the human tissue and secondly, deoxyhemoglobin in the venous blood absorbs more of the incident IR light than the surrounding tissue BIB005 . The reflected light type of a vein finder shown in Figure 2a became more popular in commercial devices due to its characteristics, such as: It requires lower light intensity; less power consumption suitable for battery operated devices, and enables a compact design vein finder. While transillumination devices is the opposite, which require a higher light intensity that uses more power and non-compact with the arm or hand being scanned were placed in between the light source and the camera shown in Figure 2b [34] (see Figure 3) . The sample projected a vein image of the dorsal hand using the NIR vein finder prototype. Recently, the use of the near infrared region (NIR) of the electromagnetic spectrum became more popular in developing a low cost but efficient type of vein finder. This is to primarily address the estimated cost of available commercial vein finder using NIR technology for about 4500 USD (portable) to 27,000 USD (non-portable)  . Moreover, the most significant reason is the challenges that the physician, nurse, emergency medical technician and other medical practitioners encountered during venipuncture  , intravenous (IV) drug delivery BIB003 and cannulation. This is usually due to the following reasons; veins are either very small, and/or deep, the patient's age (elderly or pediatrics), skin color  , and obesity level BIB003 BIB004 . It often results in multiple attempts in needle insertion leading to pain, discomfort, dissatisfaction, delayed treatment  , hematoma, swell in the skin, cuts on the bone [39] , bleeding, and even infection. Especially in young children, despite the dedicated and highly skilled physicians, multiple attempts are often unavoidable, which can be traumatic BIB006 , even requiring blind puncture and may sometimes needs general anesthesia BIB001 . In fact, studies reported that in consideration of the factors stated above, it leads to a significantly low first-attempt successful rate in venipuncture  . fact, studies reported that in consideration of the factors stated above, it leads to a significantly low first-attempt successful rate in venipuncture  . Sample projected vein image of the dorsal hand using NIR vein finder prototype. Table 2 shows the different prototypes with their basic characteristics, including the parameters considered by the researchers for the purpose of their evaluation. Table 2 shows the different prototypes with their basic characteristics, including the parameters considered by the researchers for the purpose of their evaluation. 