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Facilitation of peripheral intravenous access: an evaluation of two methods to augment venous filling
P A Nee1, A J Picton, D R Ralston
1Department of Emergency Medicine, University Hospital of South Manchester, England.
Study Objective:
To evaluate two methods of augmenting venous filling as potential aids to i.v. cannulation.
Design:
Comparative study of cross-sectional areas of preselected antecubital fossa veins.
Setting:
Vascular laboratory of a British university teaching hospital.
Participants:
Thirty healthy, normotensive, adult volunteers.
Interventions:
Vessel cross-sectional areas measured noninvasively using a color flow duplex ultrasound scanner. Measurements were taken at rest, after application of a venous tourniquet, with tourniquet and Esmarch bandage, and with tourniquet and Rhys-Davies exsanguinator.
Results:
Mean (+/- SD) cross-sectional area at rest was 0.18 +/- 0.094 cm2 and after tourniquet was 0.28 +/- 0.14 cm2. Application of an Esmarch bandage produced an increase to 0.33 +/- 0.14 cm2, and Rhys-Davies exsanguinator produced an increase to 0.32 +/- 0.15 cm2 (P < .0001 for all comparisons except Rhys-Davies exsanguinator versus Esmarch bandage).
Conclusion:
Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused significant filling of antecubital fossa veins in excess of that produced by a venous tourniquet alone in normovolemic, normotensive volunteers.