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> I Very light complexion II <s> Venipuncture is pivotal to a wide range of clinical interventions and is consequently the leading cause of medical injury in the U.S. Complications associated with venipuncture are exacerbated in difficult settings, where the rate of success depends heavily on the patient's physiology and the practitioner's experience. In this paper, we describe a device that improves the accuracy and safety of the procedure by autonomously establishing a peripheral line for blood draws and IV's. The device combines a near-infrared imaging system, computer vision software, and a robotically driven needle within a portable shell. The device operates by imaging and mapping in real-time the 3D spatial coordinates of subcutaneous veins in order to direct the needle into a designated vein. We demonstrate proof of concept by assessing imaging performance in humans and cannulation accuracy on an advanced phlebotomy training model. <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> I Very light complexion II <s> Multispectral imaging has shown promise in subcutaneous vein detection and localization in human subjects. While many limitations of single-wavelength methods are addressed in multispectral vein detection methods, their performance is still limited by artifacts arising from background skin reflectance and optimality of postprocessing algorithms. We propose a background removal technique that enhances the contrast and performance of multispectral vein detection. We use images acquired at visible wavelengths as reference for removing skin reflectance background from subcutaneous structures in near-infrared images. Results are validated by experiments on human subjects. <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> I Very light complexion II <s> Abstract Background and objective: To evaluate a novel skin tone meter (STM) to categorize skin tones into one of the six categories of the Fitzpatrick skin type (FST) classification system, thus optimizing safety in light-based dermatological procedures. This numerical classification method measures several components; principally the reaction of human skin to ultraviolet (UV) light exposure, which is used to help predict skin response in laser and intense pulsed light (IPL) treatments. Materials and methods: Two-hundred twenty volunteers of varying ethnic origin, age and gender were enrolled in a preliminary study. The subjects’ Fitzpatrick skin type was ascertained by a standardized questionnaire that determined their reaction to significant sunlight exposure. A calibrated prototype STM device (consisting of an optical head at 460 nm, detector, microprocessor, and a liquid crystal display) was used to measure the subjects’ inner arm skin; which typically has little UV exposure and minimal hair, and compared the obtained value with measurements taken from a skin color chart and digital photographs. To evaluate device performance (within subject) across different skin states, a section of skin from the inner arm of a sub-group of eight volunteers was marked into test areas using a template. The skin in each area was then prepared (i) with a control area, (ii) by degreasing with acetone for 1 min to represent dry skin, (iii) with a fine layer of coupling gel to represent hydrated skin, (iv) with a thin layer of petrolatum (Vaseline) to represent oily skin, and (v) with saline solution applied then dried to represent dried perspiration. Results: There was a consistent trend between the STM prototype and the assessed skin tone derived from a proprietary skin color chart against the measurement on skin across a range of skin conditions. Conclusion: The presented preliminary study demonstrated the subjective nature of the FST classification system and the weakness of skin tone self-assessment by an individual, as judged by expert assessors. The FST classification requires an objective measurement to replace the textual description for each skin tone. It may significantly decrease the risk of potential side effects through overtreatment, and extend treatment to a wider patient population with light-based dermatological procedures. <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> I Very light complexion II <s> BackgroundSubcutaneous veins localization is usually performed manually by medical staff to find suitable vein to insert catheter for medication delivery or blood sample function. The rule of thumb is to find large and straight enough vein for the medication to flow inside of the selected blood vessel without any obstruction. The problem of peripheral difficult venous access arises when patient’s veins are not visible due to any reason like dark skin tone, presence of hair, high body fat or dehydrated condition, etc.MethodsTo enhance the visibility of veins, near infrared imaging systems is used to assist medical staff in veins localization process. Optimum illumination is crucial to obtain a better image contrast and quality, taking into consideration the limited power and space on portable imaging systems. In this work a hyperspectral image quality assessment is done to get the optimum range of illumination for venous imaging system. A database of hyperspectral images from 80 subjects has been created and subjects were divided in to four different classes on the basis of their skin tone. In this paper the results of hyper spectral image analyses are presented in function of the skin tone of patients. For each patient, four mean images were constructed by taking mean with a spectral span of 50 nm within near infrared range, i.e. 750–950 nm. Statistical quality measures were used to analyse these images.ConclusionIt is concluded that the wavelength range of 800 to 850 nm serve as the optimum illumination range to get best near infrared venous image quality for each type of skin tone. <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> I Very light complexion II <s> OBJECTIVE ::: To compare the performance on the detection of the invisible veins between our modified prototype device and an existing device in elderly hospitalized patients. ::: ::: ::: METHODS ::: A prospective, cross-sectional, and observational study was performed in the invisible veins in elderly patients. The major variables, skin color near the invisible veins, and diameter and depth of the invisible veins were measured. The vein visualization rate was calculated as the ratio of the visualized veins to the invisible veins by the visualization device. ::: ::: ::: RESULTS ::: We analyzed 53 invisible veins in the cubital fossa and 56 invisible veins in the forearm in a total of 72 patients (median age, 73 years). The visualization rate for our prototype device was higher than that for an existing device in the cubital fossa and the forearm sites. The visualized veins of the prototype device had a higher intensity ratio than that of an existing device. No significant differences were observed in the body mass index, vein depth, and vein diameter of the visualized veins at the cubital fossa and forearm sites. ::: ::: ::: CONCLUSION ::: The prototype surpassed the existing device in visualizing the invisible veins. However, the prototype was unable to visualize all the invisible veins. We need to look for ways to reduce noise and to visualize the invisible veins, and the visualization rate of devices needs to be investigated in further association with the percentage of success with actual intravenous access and locating time to vein. <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> I Very light complexion II <s> This work presents a portable, affordable and reliable vein locating device to overcome the complications in vein localization irrespective of age and tissue thickness during medical procedures like Phlebotomy and intravenous infusion. A prototype has been developed using infrared (IR) detector and multispectral near infrared (NIR) (740,765,770,780 nm) source. The differential absorption of the NIR by veins due to the presence of deoxyhemoglobin, helps in enhancing the localization of the vein. The detector is integrated with the single board computer (SBC) and connected with LCD through serial programming interface (SPI) for real time display of veins. The initial observations have found to be successful. It is expected that this affordable device will help in reducing time and improving accessibility to locate antecubital and cephalic vein without multiple incision and minimal pain. <s> BIB006
Light complexion III Medium complexion IV Darker complexion V Dark complexion VI Black complexion BIB003 Various studies showed that darker skin color causes difficulty in viewing the vein BIB004 BIB005 BIB006 BIB001 BIB003 . Moreover, a study showed that a commercial NIR vascular imaging device was reported with limited value in improving success at first attempt of intravenous (IV) cannulation in children with dark skin color  . Aside from the skin color, hairy skin was also noted to cause strong reflectance glare that severely impair the vein contrast. It blocks the skin underneath and the subcutaneous veins has a very low contrast ratio resulting to almost visually unnoticeable in the NIR image BIB002 .