The antecubital fossa with the veins for venipuncture. Drawing from these sites can cause blood clotting and hemostasis. Fukuroku K., Narita Y., Taneda Y., Kobayashi S., Gayle A. Step 1: Identify The Vein. While most patients veins are compatible with a standard needle gauge, others require a. . Common Venipuncture Sites | Healthfully GoldEye P-032 SWIR camera (AlliedVision, Stradtroda, Germany), a Swiss Ranger SR-400011 TOF 3D camera (MesaImaging, Zrich, Switzerland), NIR CCD camera (Grasshopper3 GS3-U3-41C6NIR-C, Point Grey Inc., Richmond, BC, Canada) and a high-resolution lens (GMTHR48014MCN, Goyo Optical Inc., Asaka, Japan) 850 nm band-pass filter (BP850-S44.5, Midwest Optical System Inc., Palatine, IL, USA), Compact IR-sensitive charged-coupled device (CIS) CCD, Multispectral imaging IR 740, 765, 770, 780, Web camera with CMOS sensors, IR pass filtersKodak wratten 87 IR filter infrared (IR) photographic film, 25 dark skinned people, 25 obese subjects, 25 paediatrics, and 2 elderly, Vuzix STAR 1200XL eyewear system IR CCD camera, CMOS camera, captured image is compressed in Joint Photographic Experts Group (JPEG) format, IR filter, Standard (Universal Serial Bus) USB camera Pass-through filter (exposed and developed empty 35 mm camera film, Skin tone: Fair, light brown, dark brown, and dark, Two monochrome FireWire cameras with high sensitivity CCD sensors in the near-infrared range (Point Grey Firefly MV) 8501060 nm band pass filters (Edmund Optics), Age, gender, BMI and skin color (Fitzpatrick skin type), Monochrome NIR CMOS camera (EO-0413BL Edmund) with DLP projector (DL3000 Texas Instruments), Real-time camera IR long-pass filter 695 nm, Vein model (plastic tube and dogs blood), Multispectral imaging IR 850, 615, 570, 546, 475, Spectrocam Multispectral Imaging Camera (Ocean Thin Films, Golden, Colorado) NIR enhanced CCD camera (a Sony ICX285 sensor) through a Carl Zeiss Distagon 2.8/25 mm ZF-IR lens With multi filters, Asian male, Caucasian male, skin tone, hairy forearm, Camera with CMOS high-transmittance imaging lens. Copyright 2019 A.D.A.M., Inc., as modified by University of California San Francisco. This makes the vein swell with blood. Juric S., Flis V., Debevc M., Holzinger A., Zalik B. This variation indicates that the standardization for the optimum wavelength for the purpose of vein viewing is not been set to date yet. Other materials used such as a common filter were the following: Kodak wratten 87 IR filter [47], pass-through filter (exposed and developed empty 35 mm camera film) [58], butter paper [52], polarizing filters and blank sheet made of polycarbonate noted with a very high absorption rate at a given wavelength [53]. Veins in the foot and ankle should be utilized only as a last resort. Moreover, the Fukuroku et al., 2016 [28] study on validating the effectiveness of vein infrared visualization performed by second-year nursing students, confirmed that the vein viewer contribute immensely to the improvement of their practical skills in venipuncture, specifically, in the site selection time with the context for the elderly patients. Shedding Light on the Veins Reflected Light or Transillumination in Hand-Vein Recognition; Proceedings of the 2018 International Conference on Biometrics; Gold Coast, QLD, Australia. anchored and will roll, making it difficult to phlebotomist more control over a rolling vein. 2830 May 2012. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. Bedside laboratory and microbiologic procedures. Dr. Jasleen Kukreja and the Life-Saving Gift of Breath, Care, Convenience and Support at New Cancer Facility, 10 Ways to Get the Most Out of Your Doctors Visit, UCSF Health Ranked Among Nation's Top 10 Hospitals. In the elderly, vein access was challenging due to the changes in the vein structure as thin and fragile people lose elasticity while pediatrics have smaller peripheral veins with higher content of subcutaneous fat and are usually prone to vasoconstriction. Light tapping of the vein may be useful but can be painful and may result in the formation of haematoma in patients with fragile veins (Dougherty, 1999). Knowing the anatomy of the arm will help you in locating and Giavarina D., Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. The reflected light type of a vein finder shown in Figure 2a became more popular in commercial devices due to its characteristics, such as: It requires lower light intensity; less power consumption suitable for battery operated devices, and enables a compact design vein finder. In: Rifai N, ed. also be avoided. Median vein - first choice. The principle is based on the diffuse reflectance images at three isosbestic wavelengths to measure both the depth and thickness of subcutaneous veins. The CLSI H03-A6 document which suggested modifications in some of the steps in venipuncture, such as to cleanse the site and to allow drying before applying tourniquet to view and select the vein and finally to release the tourniquet immediately when the filling of the first tube started. The BMI is an estimate of body fat based on height and weight for calculation that applies to both adult men and women. From choosing baby's name to helping a teenager choose a This site complies with the HONcode standard for trustworthy health information: verify here. 2527 November 2015. Any duplication or distribution of the information contained herein is strictly prohibited. Among the three are the veins in the median aspect (center of the arm) must be the first choice followed by the veins in the lateral aspect (outer thumb side), i.e., the cephalic vein, and last are the veins in the medial aspect (inner little finger side), i.e., the basilic vein [68]. van der Woude O., Cuper N., Getrouw C., Kalkman C., de Graaff J. Recently, a technological development provided trans-illuminating devices, which uses the near infrared light-emitting diodes (NIR-LED) to visualize superficial veins with the hemoglobin absorbing of the light emitted, forming an image on the skin surface [5]. Agnalt S., Canfield D., Perreault K., Legris J., McPheron B. As a countermeasure, phlebotomists. Methods of Vein Selection. This study stated that there is a linear correlation between depth and diameter of veins. A 2010 study by Kam J and Taylor D [62] showed that patient management difficulty did not increase until the BMI was in the obese or morbidly obese range, especially in cannulation and venipuncture. What is the first step in a successful venipuncture? As a library, NLM provides access to scientific literature. It must be with advancement in order to achieve a greater degree in quality healthcare, especially from activities starting with ordering, obtaining and handling of biological specimens [1]. Lalongo C., Sergio Bernardini S. Phlebotomy, a bridge between laboratory and patient. The Chiao et al., 2013 [25] study showed that the possible cannulation site with the use of a vein finder device has better results with 9.1 (95% CI 8.69.5) compared with the conventional method 5.8 (95% CI 5.46.2). While, the result from color skin/subjects were 8/13 (61.53%) and 6/13 (46.15%) with and without the use of the device, respectively. Shishido S., Oguro Y., Noda T., Sasagawa K., Tokuda T., Ohta J. CMOS image sensor for recording of intrinsicoptical-signal of the brain; Proceedings of the 2009 International SoC Design Conference (ISOCC); Busan, South Korea. What happens if you hit an artery during venipuncture? The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. Meng G., Shahzad A., Saad N., Malik A., Meriaudeau F. Prototype Design for Wearable Veins Localization System Using Near Infrared Imaging Technique; Proceedings of the IEEE Xplore 11th International Colloquium on Signal Processing its Applications (CSPA2015); Kuala Lumpur, Malaysia. In the electromagnetic spectrums range of 740 nm to 940 nm, the light can penetrate to about 5 mm deep of the skin tissue reaching the deoxygenated hemoglobin. Venipuncture What is the most common needle gauge for venipuncture? Legend: NANon applicable, BMIBody Mass Index, SWIR TOFshort-wave-infrared camera, Time-of-flight camera, CCDCharge-coupled device, CMOSComplementary metal oxide semiconductor, *Requires direct skin contact. Our students gain a vast amount of experience with phlebotomy vein sites through our hands-on and engaging curriculum and externship program. Ghozali H., Setiawardhana, Sigit R. Vein Detection System using Infrared Camera; Proceedings of the 2016 International Electronics Symposium (IES); Denpasar, Indonesia. Patients who are dehydrated, obese, terminally ill, or hard sticks often get their blood drawn in other locations rather than the antecubital fossa. veins A Review of Medical Errors in Laboratory Diagnostics and Where We Are Today. This area contains the three vessels primarily used by the phlebotomist to obtain venous blood specimens: the median cubital, the cephalic and the basilic veins. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. The results of their study were all validated using comparative ultrasound measurements. A basic prototype vein finder is composed of a high power NIR-LED as the light source, a compact infrared-sensitive camera, sensor that will capture and format the image and a filter to remove unwanted impurities [29,30,31,32,33,34] (see Figure 2). Philadelphia, PA: Elsevier; 2019:chap 67. and M.D.F. Which vein is the first choice for venipuncture? - Studybuff.com Segmented vein imaging is utilized to specify the location of veins and extract the OD ratio values. Linking to and Using Content from MedlinePlus, U.S. Department of Health and Human Services. Venipuncture Flashcards | Quizlet Specimen collection and processing. In the study of Ganesh, S., the ultrasound images were obtained using techniques, such as dot and tick-mark methods, and were analyzed with the software Corel Draw Graphics Suite 12. Veins are blood vessels that aim to return the blood to the heart. In pursuit of harmony, on behalf of European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working group for Preanalytical Phase (WG-PRE). The BMI measurement is very significant. The said determinations of the veins depth and its diameter can be considered as a useful parameter for future studies. What are 3 complications that can occur with a venipuncture procedure? Table 1 shows that pre-analytical phase in clinical laboratory testing in various studies has the highest percentage error as compared to the analytical and post analytical phases from 46.00% up to 77.10% with the average of 61.55%. This can result in a lack of blood flow, eventually causing the tissue to die. Light tapping of the vein may be useful but can be painful and may result in the formation of haematoma in patients with fragile veins (Dougherty, 1999). It is most often done for laboratory testing. Finally, it was noted that publications regarding the assessment of the performance of phlebotomists using vein finders were limited. Characteristics of the different prototypes. Methods: Electronic databases were searched online, these included PubMed (PMC), MEDLINE, Science Direct, ResearchGate, and Institute of Electrical and Electronics Engineers (IEEE) Xplore digital library. Medical laboratory diagnostics is an important part of patient care by personalized (precision) medicine. In: Roberts JR, Custalow CB, Thomsen TW, eds. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Children (0-6 years) male and female Dark skin, fat padding, Children tested: 80 without NIR light, 45 with the NIR prototype, Ordinary camera phones with even VGA quality pictures Optical filter using butter paper and filter made from exposed and developed film strips, Camera with CCD Polarizing filters and blank sheet made of polycarbonate. Vein visualization: Patient characteristic factors and efficacy of a new infrared vein finder technology. var iframe = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas").getElementsByTagName("iframe")[0]; Moreover, vein detection does not always equal successful venipuncture, which undermines any formal conclusions in respect of NIR cost-effectiveness. Hammerling J. A blown vein occurs when a needle punctures through the vein and causes it to rupture. Why is median basilic vein the last choice for venipuncture? While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. 810 April 2011. Pre-analytical quality improvement: From dream to reality. , Step 2: Gather Supplies. After the needle selection, phlebotomists begin to look and feel for a viable vein. These challenges necessitate for the improvement of steps in performing cannulation.
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