Evaluation of venous distension device: Phase II: Cannulation of nonemergent patients

Amsterdam, James T.; Hedges, Jerris R.; Weinshenker, Eugene; Schwytzer, Deborah

doi:10.1016/0735-6757(88)90004-6

Cited by 10 publications

(3 citation statements)

References 4 publications

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“…Use of the vacuum device for 30 s resulted in significant increase in venous turgor, but at 60 s use, mild to moderate discomfort and petechiae formation were noted (26). Another study of this vacuum device, in patients who either had no prominent veins or were obese, demonstrated statistically significant success at intravenous cannulation (27). The vacuum device is of simple design and has shown promise in clinical trials, but does not seem to have gained widespread acceptance (2).…”

Section: Venous Distention Devicementioning

confidence: 94%

Venodilatation techniques to enhance venepuncture and intravenous cannulation

Roberge

2004

The Journal of Emergency Medicine

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Section: Venous Distention Devicementioning

confidence: 94%

Venodilatation techniques to enhance venepuncture and intravenous cannulation

Roberge

2004

The Journal of Emergency Medicine

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“…The venous distension device, which creates a vacuum around the arm to augment venous filling, was deemed promising for DIVA in the 1980s [59] but failed to gain traction in popularity following the emergence of ultrasonography as a more definitive adjunct. Another device, Veinplicity, uses electrical stimulation to aid dilation of forearm veins.…”

Section: Venodilation Devicesmentioning

confidence: 99%

Management of difficult intravenous access: a qualitative review

Ng¹,

Mark²,

Lateef³

2022

World Journal of Emergency Medicine

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Establishing peripheral intravenous access (PIV) is one of the most ubiquitous and crucial steps in managing critically ill patients. Yet only 74% of first attempts during emergency resuscitation in adults [1] are successful and this falls to an even-more-dismal 33% in difficult intravenous access (DIVA) patients. [2] A perennial challenge faced by clinicians, DIVA impacts patient outcomes adversely by causing downstream delays in both diagnoses (difficulty in obtaining blood specimens and administering intravenous contrast for advanced imaging) and therapy (provision of parenteral fluids, blood products or drug administration to facilitate procedures such as sedation or rapid-sequence intubation). [3] Failed cannulation attempts often cause patient and clinician alike considerable frustration and distress and may lead to complications like thrombophlebitis, infection and haematoma. [4] Moreover, time-to-cannulation averages 2.5-13.0 min for most patients but can take up to 30 min to hours in DIVA cases. [5] As DIVA patients tend to distract disproportionately more time and attention of the attending emergency physicians, this inevitably compromises the care of other patients.Although there is no consensus or universallyaccepted definition, DIVA is commonly defined as either two or more failed attempts by an experienced operator using traditional landmark-based methods BAcKGRound: A perennial challenge faced by clinicians and made even more relevant with the global obesity epidemic, difficult intravenous access (DIVA) adversely impacts patient outcomes by causing significant downstream delays with many aspects of diagnoses and therapy. As most published DIVA strategies are limited to various point-of-care ultrasound techniques while other "tricks-of-the-trade" and pearls for overcoming DIVA are mostly relegated to informal nonpublished material, this article seeks to provide a narrative qualitative review of the iterature on DIVA and consolidate these strategies into a practical algorithm. MEtHodS:We conducted a literature search on PubMed using the keywords "difficult intravenous access", "peripheral vascular access" and "peripheral venous access" and searched emergency medicine and anaesthesiology resources for relevant material. These strategies were then categorized and incorporated into a DIVA algorithm. RESuLtS:We propose a Vortex approach to DIVA that is modelled after the Difficult Airway Vortex concept: starting off with standard peripheral intravenous cannulation (PIVC) techniques, progressing sequentially on to ultrasound-guided cannulation and central venous cannulation and finally escalating to the most invasive intraosseous access should the patient be in extremis or should best efforts with the other lifelines fail. concLuSIon: DIVA is a perennial problem that healthcare providers across various disciplines will be increasingly challenged with. It is crucial to have a systematic stepwise approach such as the DIVA Vortex when managing such patients and have at hand a wide repertoire of techniques t...

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“…The various techniques of improving venous prominence and / or locating peripheral veins are (1) proximal application of ordinary rubber venous tourniquet or manual circumferential limb compression (less efficient and uncomfortable), (2) application of sphygmomanometer cuff inflated to just below the diastolic pressure (time-consuming), (3) local warming, [1] (4) Topical nitroglycerine [2] (risk of local skin reaction and headache), (5) ultrasonic guidance [3] (not available in most centers and need skilled personnel) (6) venous distension device. [4] Here, I would like to suggest a different approach to venous cannulation in difficult situations, which has been used successfully in our center with a 100% success rate. The technique involves the placement of a torchlight (flashlight) or a cold light source (for example, the endoscopic light which uses a xenon light source delivered to the tip by fibreoptic bundles and commonly available in operating room settings) under the limb / palm to visualize the veins on the dorsum of hand.…”

Section: Letters To Editormentioning

confidence: 99%

Intravenous access: A different approach

Samantaray

2007

J Indian Assoc Pediatr Surg

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Evaluation of venous distension device: Phase II: Cannulation of nonemergent patients

Cited by 10 publications

References 4 publications

Venodilatation techniques to enhance venepuncture and intravenous cannulation

Venodilatation techniques to enhance venepuncture and intravenous cannulation

Management of difficult intravenous access: a qualitative review

Intravenous access: A different approach

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