Venous Access: From the practitioner's point of view
Cannulation procedure
Access to the vein can be a stressful experience for the patient involved in the procedure, but what about the medical practitioners who carry out the process? As identified by Arash Bakhtyari, radiologist and the CEO of Olberon,
“As a clinical professional I often experience difficulty with i.v. cannulation and regularly see my colleagues also having difficulties. I found that currently there is no product available that helps a clinician in this common but frequently difficult procedure, which however at times is life saving.’ Medical practitioners often have a difficulty with the introduction of a needle into a body cavity.”
What is cannulation & phlebotomy?
First and foremostly, cannulation is the procedure of inserting a cannula into a peripheral vein, located in the arms, hands, feet or leg specifically for vascular access. It is one of the most common invasive medical procedures performed worldwide with 859 million cannulations per annum. Alternatively, phlebotomy is the process of taking blood exclusively, such as drawing blood (In other words, venipuncture), and there are similar problems that arise with both procedures.
As well as issues for the patient (Which has been covered in articles here and here), medical practitioners also have difficulties with the cannulation procedure. A practitioner could lose confidence within themselves after a first failed attempt, resulting in a nerve, tendon or artery being inadvertedly punctured and causing unintentional pain. A haematoma may also form as consequence of accidental piercing of the wall of a vein so the practitioner can no longer gain access to that particular area. In this case, it could result in a counterproductive procedure without a positive or beneficial outcome.
Correspondingly, the intervention of a senior medical practitioner is time consuming, yet necessary for the well-being of the patient. But with over 70% of patients admitted to hospitals requiring a cannula, this alternative is not a feasible solution to the problem.
Furthermore, during regular procedures involving patients who are easier to cannulate and experienced practitioners, there is a 10-16% failure rate for first time attempts, highlighting the point that the cannulation procedure is simply not a straightforward process.
Vulnerable groups - Children
A lower threshold for pain paves the way for more emotional stress and a lack of understanding of the circumstances for the procedure, meaning it is generally more difficult to cannulate a child. During an observational trial (Carried out by Dr. Kadiyali M. Srivatsa, MD), it is a known problem with first time failure rates of senior doctors is 59.1%, and 87.5% failure rate for junior practitioners during an observational trial at a children’s ward.
What are we doing?
The Vacuderm on a patient's arm
The Vacuderm and Paediatric Vacuderm have both been design to make venous access easier, ultimately reducing the number of failed cannulation attempts:
• Increasing patient comfort and experience.
• Improving the process of cannulation.
• Assisting practitioners to improve their success rate in first attempt venous access.
For practitioners in particular, it would be useful for use in hospitals, clinics and home-care nurses. In the busy and fast paced nature of the Accident & Emergency department, the Vacuderm could heavily reduce the time taken for cannulation proving to be time-saving, and more importantly, life-saving. Dr. Ellis, an experienced theatre technician states the Vacuderm,
“Would be a great adjunct for trauma cases and the like, where the patient is under shock, has suffered major blood loss, is dehydrated, grossly obese, etc. but would need rapid cannulation for resuscitation purposes.”
