Vein Illumination Devices in Long-Term and Acute Care Settings: A Review of Clinical Effectiveness, Cost-Effectiveness and Guidelines [Internet]

Excerpt

Vascular access, for blood withdrawal or administration of intravenous medications, in acute and long-term care settings is an essential component of many treatment procedures. In addition to treatment delays, patients can experience additional pain and trauma associated with repeated vascular access attempts when prolonged or repeated attempts are required. Repeated attempts at vascular access may also increase the incidence of complications including blockage of arteries, bleeding outside blood vessels (hematoma), blood clots, and damage to blood vessels and nerves.

Among the most important predictors of a difficult venipuncture are advanced age, dehydration, previous hospitalizations, previous failed attempts, and a history of hypertension or diabetes mellitus.^, Adult populations of advanced age often have age-related changes to subcutaneous tissue that can make vein puncture difficult.

The standard procedure for vascular access is initiated by localization of a suitable vein by visual inspection and palpation. Vascular illumination devices aim to aid in vein localization, facilitating accurate needle placement by the device operator and thereby decreasing the time and attempts required to obtain vascular access.^, These devices use near infrared light capable of penetrating several centimeters of tissue to produce a 2D image of blood-filled structures superimposed upon the surface of the skin. Vein illumination devices can be made portable, lightweight, and cordless. The clinical benefit of these devices for some populations remains unclear.^,

The purpose of this report is to retrieve and review the existing evidence on the clinical effectiveness and cost-effectiveness of the use of vascular illumination devices for adult patients, including elderly patients, in acute or long-term care settings. Additionally, this report aims to retrieve and review the evidence-based guidelines on the use of vascular illumination devices for this population.