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LETTER TO THE EDITOR
Year : 2020  |  Volume : 13  |  Issue : 4  |  Page : 420-421  

Using mobile phone to assist in difficult vein cannulation


1 Department of Anaesthesia, PGIMER, Chandigarh, India
2 Department of Anesthesia, GMC, Jammu, Jammu and Kashmir, India

Date of Submission05-Sep-2019
Date of Decision02-Nov-2019
Date of Acceptance06-Jan-2020
Date of Web Publication20-Jul-2020

Correspondence Address:
Pallavi Bloria
Department of Anesthesia, GMC, Jammu, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_250_19

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How to cite this article:
Bloria SD, Luthra A, Chauhan R, Bloria P, Kataria K. Using mobile phone to assist in difficult vein cannulation. Med J DY Patil Vidyapeeth 2020;13:420-1

How to cite this URL:
Bloria SD, Luthra A, Chauhan R, Bloria P, Kataria K. Using mobile phone to assist in difficult vein cannulation. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Dec 1];13:420-1. Available from: https://www.mjdrdypv.org/text.asp?2020/13/4/420/290172



Dear Sir,

Venous cannulation is needed for the management of nearly all patients, as such the need to have a good venous access cannot be overemphasized. However, sometimes, peripheral venous cannulations can prove to be very difficult and even nearly impossible. Multiple failed attempts to venous cannulation can cause delays in patient care, and many attempts have been made to reduce failed venous cannulation.

Various methods have been suggested, and many devices have been used to assist for venous cannulation.[1],[2],[3],[4] These include gentle slapping of the skin overlying the vein, using venous tourniquet, using warm compresses, transillumination, ultrasound, etc. We present a novel application of mobile phones in helping us in cannulation of patients with difficult veins.

After dimming the lights for better visualization, the flashlight of mobile phone is turned on and kept in close contact with the arm to be cannulated. It is then scanned across arm's width for the presence of veins. Veins appear as dark cords while rest of the soft tissue appears as reddish regions [Figure 1]. After scanning the course of veins, an appropriate site for venous cannulation can be decided and cannulation done [Video 1].
Figure 1: Using mobile phone to assist vein cannulation

Click here to view


This method helps due to transillumination of veins. There are commercial instruments that work on the same principle of illumination, but they are costly and not widely available. The purpose of writing this letter is to sensitize others of a novel application of a device which today all of us have.

Cai et al. using a similar method had used torch pens to facilitate venous cannulation in their patients (also based on transillumination) and found the method to be effective.[5] We advise cleaning mobile phones with spirit before and after coming in contact with the patient. Further, it helps if the flashlight of the mobile is situated toward the periphery of mobile as it then provides better illumination.

Regarding other methods of securing venous cannulation, the use of a proximal venous tourniquet is a very commonly used modality. However, prolonged application of a venous tourniquet is said to increase venous tortuosity and fragility. Wiping the skin with alcohol is also said to improve visualization of veins.[6]

Stolz et al. reviewed the use of ultrasound in aiding venous cannulation and concluded that ultrasound improved success rates when compared to traditional methods of intravenous cannulation in patients with difficult peripheral venous access.[7] However, there was no effect on time to successful cannulaton or number of punctures required for successful cannulaton. Further, ultrasound is not available in many patient-care settings and not everyone is skilled in using it.

We do admit that this method does not provide us information about the depth of the vein from the skin surface and there is a learning curve associated with learning of this method. In addition, the ability of transillumination to visualize deeper veins has also been criticized. However, in many patients, it can save many pricks to the patients and anxiety to the treating physician in case of difficult cannulations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mbamalu D, Banerjee A. Methods of obtaining peripheral venous access in difficult situations. Postgrad Med J 1999;75:459-62.  Back to cited text no. 1
    
2.
Jaques PF, Mauro MA, Keefe B. Ultrasound guidance for vascular access. J Vasc Interv Radiol 1992;3:427-30.  Back to cited text no. 2
    
3.
Hess HA. A biomedical device to improve pediatric vascular access success. Pediatr Nurs 2010;36:259-63.  Back to cited text no. 3
    
4.
Katsogridakis YL, Seshadri R, Sullivan C, Waltzman ML. Veinlite transillumination in the pediatric emergency department: A therapeutic interventional trial. Pediatr Emerg Care 2008;24:83-8.  Back to cited text no. 4
    
5.
Cai EZ, Sankaran K, Tan M, Chan YH, Lim TC. Pen torch transillumination: Difficult venepuncture made easy. World J Surg 2017;41:2401-8.  Back to cited text no. 5
    
6.
Liu PL. Atlas of Basic Anaesthesia Procedures. In: Barnet J, editors. Principles and Procedures in Anaesthesiology, Part VI. Philadelphia: Lippincott: 1992. p. 381.  Back to cited text no. 6
    
7.
Stolz LA, Stolz U, Howe C, Farrell IJ, Adhikari S. Ultrasound-guided peripheral venous access: A meta-analysis and systematic review. J Vasc Access 2015;16:321-6.  Back to cited text no. 7
    


    Figures

  [Figure 1]



 

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