Veinlite Transillumination in the Pediatric Emergency Department

Abstract

After adjusting for multiple significant covariates and controlling for random effect of provider, our results indicated a benefit in the use of Veinlite transillumination for IV insertion in first attempt and within 2 attempts. This technique seemed to facilitate nonemergent IV placement in pediatric patients compared with standard practice.

Peripheral Difficult Venous Access in Children

“…Special interventions are defined as the use of any technique or hospital resource with the potential to improve peripheral IV insertion success rates. These include traditional methods of enhancing the visibility and palpability of peripheral veins (eg, warming the catheter site to induce vasodilation) [10][11][12] ; advanced visualization technologies such as ultrasound, transillumination, and nearinfrared lighting 2,[13][14][15] ; and enlisting designated IV specialists and/or hospital staff with extensive experience in starting pediatric IVs. 16 Some children may need more invasive interventions such as intraosseous (IO) infusion, a peripherally inserted central catheter, or a central venous catheter (CVC) to achieve parenteral access.…”

“…Clinical studies show that only 53% to 76% of children are successfully cannulated on the first attempt. [1][2][3][4] Multiple failed attempts are painful and upsetting for the child and distressing for family members and caregivers, [5][6][7][8][9] yet there are no guidelines or consensus statements on the recognition and management of this problem.…”

“…Studies of IV insertion success rates indicate that 5% to 33% of children require more than 2 needle sticks to achieve IV access. [1][2][3][4] Even when interventions such as transillumination and ultrasound are used, up to 15% of children still require more than 2 attempts to establish venous access.…”

“…Studies of IV insertion success rates indicate that 5% to 33% of children require more than 2 needle sticks to achieve IV access. [1][2][3][4] Even when interventions such as transillumination and ultrasound are used, up to 15% of children still require more than 2 attempts to establish venous access. 2 A recent prospective analysis of 593 insertion attempts in centers with pediatric hospitalist services showed that successful placement E stablishing peripheral intravenous (IV) access in pediatric patients can be challenging.…”

Ultrasound or near-infrared vascular imaging to guide peripheral intravenous catheterization in children: a pragmatic randomized controlled trial

“…1 Success rates of first attempt at intravenous catheter placement in chil dren vary greatly, from 40%-76%, with up to 15 attempts reported in one case. [2][3][4][5][6][7][8][9] Failed procedures ensure further painful skin punctures, significant delays in urgent treatment, decreased efficiency and increased costs to the health care system. 10,11 The standard procedure for peripheral intra venous catheterization involves placement of the needle in a location considered most likely to con tain a vein, with the choice based on visualization and palpation of the vessel, knowledge of anatomy and experience of the practitioner, most often a nurse.…”