Product Review
by
Tom Trimble, RN CEN
of
Veinlite
by TransLite
LLC
Finding Veins in Patients with Difficult Access!
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In an Emergency Department, venous access is seldom an elective procedure . . . usually, it is an essential and non-deferrable part of the diagnostic and treatment process. We take all comers and many patients do not have big strong healthy young veins. At my academic tertiary non-trauma medical center, we have many special populations of complex patients who often have difficult IV access with poor to no veins. Our nurses are highly skilled at difficult access, but still face challenges in patients who do not have vascular access devices (which we also use). We often use small veins, less conventional sites, external jugular veins, call in adept colleagues, or ICN/PICU nurses, and some nurses are qualified to use ultrasound to access deep or difficult veins. Still, one always hopes for an extra edge.
A sample of Veinlite EMS was submitted to ENW! for testing. The manufacturer --TransLite, LLC, describes it as "Advanced Side-Transillumination Technology for Vein Imaging of Varicose Veins and Vein Access in Pediatrics, Neonatal, Emergency Medicine, Critical Care and Oncology." How it works is described as " The side-transillumination method is where a bright ring of light is placed on the skin and focused under the skin to form a virtual light source below the skin. This virtual light source is like having a bright light bulb under the skin that moves with the Veinlite. Therefore, uniform transillumination of the skin is made possible almost anywhere on the skin. An opening in the Veinlite devices provides access to the vein while imaging it for faster and accurate vein access. The unique design of the Veinlite devices blocks the vein and stretches the skin for easier access."
The model tested is Veinlite EMS, without the accessory shield for overhead lighting or the pediatric sized smaller ring. Patients upon whom it was used were all difficult IV starts, having failed two attempts, or known by history or assessment as difficult IV starts. No "drop testing" or destructive testing was done. The device is small (pocket sized, less than an inch thick), light weigh, battery powered, simple and easy to use.
What is our impression?
—Upon whom was it tested? A convenience sample of patients in a medical center emergency department who needed IV access and had been found to be difficult. No patient was in crisis.
—Does it perform as claimed? Yes.
—What does it not do? It can't make veins exist where they don't, nor less fragile, nor guarantee success. If only a 24-gauge vein is available, it won't help you get a 20-gauge for the CT Scanner if no 20-gauge vein can be found. If a central line is the only possibility, then it will remain so.
—What does it do? It helps one assess and and analyze veins; the skillful user can make better choices. Those "little blue-line specials" can be looked at for straightness, fullness, degree of tortuosity or possible internal hazard that may threaten successful cannulation. One can visualize somewhat deeper vessels, but it is no substitute for ultrasound in truly difficult cases or to visualize needle path and vein entry. Skin pigmentation is less of a problem; one can scan likely areas more quickly with Veinlite EMS than palpate vessels that are not visible through the skin. It gives greater confidence that the selection made is the best one possible.
—What are the advantages? It's handy, slick, and cute. It's easier to pull out of your pocket or IV kit than to fetch and wheel into the room an ultrasound machine from a distant location. It quickly and easily helps you choose a vein. The patient (who usually has been dreading the IV process due to past experiences) is intrigued and impressed that above-average efforts are being made to ease their experience. The LEDs are cool. Literally. There's no problem with heat transfer from ordinary use, as there might be from using an otoscope or other bright light incandescent source to transilluminate an infant's hand, for example. The only control is a push-on, push-off switch.
—What are the disadvantages? It's handy, slick, and cute. I worried that I would drop it, lose it, or have it stolen. Fortunately, the case is black so that it is less likely to be lost among white bed linen. The case is plastic, not immersible, and the device weighs 1.5 ounces without the two AA batteries. A plastic bar is provided for attaching a lanyard, but it wasn't possible to thread ordinary twill tape (umbilical tape from the ED) through it. It doesn't have the robust heft or armored construction typical of equipment suitable for hard field use (as if it were "Mil-Spec", i.e., military specification). Being small and slick, it feels easy to drop without a rubberized coating or skateboard tape on it (admittedly however, it must be disinfectable and avoid injury to tissues). If put in a trouser pocket, the push button on-off switch can go on accidentally.
—What do the photographs not show? It must be used with little plastic covers, like a pair of shorts with a cuff, that protect both skin and device from contamination, but should be wiped with alcohol if using it in a sterile area (fifty covers come with it and more can be ordered).
—Does it work on kids? Old People? Yes. It works well on small vessels or well-used vessels. It lets you choose which vessel you feel most game for. It does not frighten or burn.
—Will I go on using it? Absolutely.
—What role do I see for it in an ED? I'd like to see two or three available as a more rapid intermediate step before ultrasound-guided or central line techniques are used or if not immediately feasible. It helps skilled users be more skillful.
—What do I recommend to the manufacturer? Enlarge and reinforce the lanyard attachment. "Rugged-ize" the device and its case; we had no problem and did not test durability, but circumstances may not always be controlled. In a busy code, or mobile environment, one might want a holding case (and a pocket for the covers) with industrial Velcro or powerful magnet mounting to which to return it.
| Date of Review: June 2006 | Tom Trimble, RN CEN, is an experienced Emergency Nurse, Instructor, and the Editor & Publisher of this website. The opinions expressed are his own. |
| Statement of Interest: The product was supplied without cost by the manufacturer. The testing, findings, and opinions were without conditions or editorial influence. No other funding or fee was provided or used. |
| Disclosure: ENW! receives sample books or products for impartial review under its GUIDELINES. ENW! has no financial arrangements with publishers, authors, or manufacturers. Where present, an Internet link or purchase link is provided by ENW! as a convenience to its readers. The non-obligatory use of these links sometimes provides a small fee to ENW! (if from amazon.com) which provides no significant portion of operating costs for the website. ENW! is non-profit and dedicated solely to the interests of the Emergency Nursing specialty for which it is operated in trust. This page, as all others of the website, and the opinions of reviewers are subject to our DISCLAIMER. |
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