How Projection Vein Finders Support Difficult Venipuncture in Elderly Patients

Editorial note: This article uses published literature on vein visualization and near-infrared visualization as technical background. Clinical outcome data are attributed specifically to the 2017 study by Kou et al. and the device evaluated in that study. The references are not intended to imply that all Projection Vein Finder systems have identical clinical performance.

Introduction

Peripheral venipuncture can be challenging in elderly patients, particularly when veins are difficult to identify through conventional visual inspection and palpation.[1]

Near-infrared and other visualization approaches have been discussed in the literature as techniques that can provide additional information during peripheral venipuncture and vein localization.[3,5,7]

A published clinical study conducted at Xuanwu Hospital of Capital Medical University evaluated near-infrared visualization-assisted venipuncture in 160 elderly patients with difficult peripheral venous access. The study used a specific projection infrared vein imaging device and reported differences in first-attempt puncture success, puncture time, and puncture site between the visualization-assisted and conventional groups.[1]

Why Is Venipuncture Difficult in Elderly Patients?

Age-related vascular and skin changes may make peripheral venous access more challenging. The published study described characteristics including thicker and harder vein walls, narrower vessel lumens, reduced vascular elasticity, increased vascular fragility, and looser skin tissue.[1]

The study defined difficult peripheral vascular access as a condition in which the course of the peripheral vessel could not be determined through visual inspection or palpation.[1]

Earlier literature has also reviewed factors affecting peripheral venipuncture and the development of visualization-assisted approaches, providing background for the use of additional vein-location technologies.[2,7]

How Does a Projection Vein Finder Support Vein Visualization?

Near-infrared vein visualization can provide additional information to support vein assessment before venipuncture.[1,3,5,7]

Previous literature has specifically discussed projection-based infrared vascular imaging for venipuncture and the clinical application of visualization technologies.[3,7]

Related research has also described the design and application of portable vein visualization equipment, illustrating the broader development of auxiliary technologies for superficial vein assessment.[4,5]

In the 2017 clinical study discussed in this article, the visualization-assisted group used a projection infrared vein imaging device to assess vessel course and depth and to identify vascular branches before peripheral venipuncture.[1]

The researchers also used the device's depth mode to assist with estimating vessel depth and adjusting the needle insertion angle.[1]

Vein visualization should be considered an adjunct to professional clinical assessment rather than a replacement for venipuncture skills or clinical judgment.

Clinical Study of Near-Infrared Visualization in Elderly Patients

The study was published in the Chinese Journal of Modern Nursing in 2017.[1]

Researchers selected 160 hospitalized patients over 60 years of age with difficult peripheral venous access at Xuanwu Hospital of Capital Medical University. The patients were randomly assigned to an observation group and a control group, with 80 patients in each group.[1]

The control group underwent conventional vein assessment using visual inspection and palpation, while the observation group received vein assessment and peripheral venipuncture assisted by a projection infrared vein imaging device.[1]

Both groups used B-D 24G safety peripheral intravenous catheters, and the procedures were performed by trained vascular-access nurses.[1]

First-Attempt Success Rate

In the study, the first-attempt venipuncture success rate was 91.25% (73/80) in the visualization-assisted group, compared with 43.75% (35/80) in the conventional group. The difference was statistically significant (χ² = 43.495, P < 0.01).[1]

These findings suggest that, under the conditions evaluated in this study, near-infrared visualization assistance was associated with a higher first-attempt venipuncture success rate in elderly patients with difficult peripheral venous access.[1]

This result should not be interpreted as a guaranteed success rate for all patients, healthcare facilities, operators, or Projection Vein Finder systems.

Puncture Time

The study also reported a difference in mean puncture time. The visualization-assisted group had a mean puncture time of 3.7 ± 1.8 minutes, compared with 5.6 ± 3.2 minutes in the conventional group (t = 4.629, P < 0.01).[1]

The findings suggest that near-infrared visualization assistance may help reduce puncture time in the specific elderly patient population evaluated in this study.[1]

Actual procedure time may vary depending on patient characteristics, vascular conditions, operator experience, clinical workflow, and other factors.

Supporting Forearm Vein Selection

The study also evaluated the puncture site. 72.5% of patients (58/80) in the visualization-assisted group received puncture in a forearm vein, compared with 27.5% (22/80) in the conventional group.[1]

The researchers suggested that near-infrared visualization could help nurses identify forearm veins that may be difficult to assess using conventional methods.[1]

The selection of a puncture site should remain based on professional assessment, patient condition, treatment requirements, vascular characteristics, and applicable clinical protocols.

What Does the Existing Literature Discuss?

Published literature has examined several aspects of visualization-assisted venipuncture, including the development of auxiliary devices, projection infrared vascular imaging, and clinical applications of visualization technologies.[3,4,5,7]

A 2014 review discussed progress in auxiliary devices for visualized superficial vein puncture.[5] A 2015 review summarized clinical applications of visualization techniques for venipuncture, including vascular imaging and other visualization approaches.[7]

A 2016 study specifically examined venipuncture using a projection infrared vascular imaging device.[3] Another 2017 publication reported on the design and application of a new portable vein visualization device.[4]

These publications provide technical and clinical background for understanding the development of vein visualization technologies. However, their findings should not be combined into a single performance claim for every Infrared Projection Vein Finder Device.

Evidence-Based Considerations

When evaluating clinical evidence for Projection Vein Finder technology, it is important to distinguish between evidence for the broader technology category and results obtained with a specific device.

The strongest numerical evidence presented in this article comes from the 2017 study by Kou et al., which evaluated a specific projection infrared vein imaging device in 160 elderly patients with difficult peripheral venous access.[1]

The other cited publications are used primarily to provide background on visualization-assisted venipuncture, auxiliary devices, projection infrared vascular imaging, and related clinical applications.[3,4,5,7]

The numerical results from the Kou et al. study should therefore be attributed to that study rather than presented as universal performance data for every Projection Vein Finder.[1]

Further research involving different patient populations, clinical settings, operators, and vein visualization systems may provide additional evidence regarding the broader clinical application of Projection Vein Finder technology.

Frequently Asked Questions

Q: What is a Projection Vein Finder?
A: A Projection Vein Finder is a vein visualization device designed to provide additional visual information about superficial veins, helping healthcare professionals assess potential venipuncture sites.

Q: Can a Projection Vein Finder help with difficult venipuncture?
A: Published literature has investigated visualization-assisted venipuncture, including near-infrared and projection infrared approaches.[3,5,7] In one study of 160 elderly patients with difficult peripheral venous access, the visualization-assisted group had a higher first-attempt success rate than the conventional group.[1]

Q: What was the first-attempt success rate reported in the study?
A: The study reported a first-attempt success rate of 91.25% in the visualization-assisted group and 43.75% in the conventional group.[1] These figures apply specifically to the study population, clinical protocol, operators, and device evaluated in that research.

Q: Does a Projection Vein Finder replace clinical judgment?
A: No. A vein visualization device provides additional information to support vein assessment, but healthcare professionals should continue to use clinical judgment, vascular assessment, patient-specific considerations, and applicable clinical protocols.

Q: Is the reported clinical evidence applicable to every Projection Vein Finder?
A: Not necessarily. The principal clinical study cited here evaluated a specific projection infrared vein imaging device. Its findings provide evidence for the clinical application studied but should not automatically be interpreted as performance data for every Projection Vein Finder.

References

[1] Kou JL, Yang Y, Cao F, Han B. Effects of near-infrared visualization puncture technology in senile patients with difficulties in venipuncture. Chinese Journal of Modern Nursing. 2017;23(32):4159–4161. DOI: 10.3760/cma.j.issn.1674-2907.2017.32.025.

[2] Tan HL. Research progress on improving the success rate of intravenous infusion puncture. Journal of Minimally Invasive Medicine. 2012;7(3):288–290. DOI: 10.3969/j.issn.1673-6575.2012.03.032.

[3] Dai JL. Evaluation of venipuncture using a projection infrared vascular imaging device. Today Nurse. 2016;7:141. [Chinese].

[4] He FJ, Chen J, Wang XY, et al. Design and application of a new portable vein visualizer. Chinese Journal of Modern Nursing. 2017;23(10):1391–1394. DOI: 10.3760/cma.j.issn.1674-2907.2017.10.014.

[5] Zhang B, Gui L, Liu JJ, et al. Progress in auxiliary devices for visualized superficial vein puncture. Chinese Medical Equipment Journal. 2014;35(3):114–116. DOI: 10.7687/J.ISSN1003-8868.2014.03.114.

[6] Han T, Wang YL, Xu M. Application of ultrasound guidance in peripheral venous access: A meta-analysis. Chinese Journal of Modern Nursing. 2017;23(8):1105–1108. DOI: 10.3760/cma.j.issn.1674-2907.2017.08.017.

[7] Cai YL. Progress of clinical application of visualization technique in venipuncture. Journal of Minimally Invasive Medicine. 2015;10(6):785–788. DOI: 10.11864/j.issn.1673.2015.06.22.

[8] Yao SL, Wang J. Visualization technology—revolutionary changes in clinical anesthesia. Modern Practical Medicine. 2014;26(2):121–122. DOI: 10.3969/j.issn.1671-0800.2014.02.001.

Reference-use note: References [2], [3], [4], [5], [7], and [8] are included as background literature from the source paper's reference list. They should only be used to support the general background statements for which they are cited. The quantitative clinical outcomes in this article are sourced specifically from [1]. Reference [6] concerns ultrasound-guided peripheral venous access and is not used to support near-infrared or Projection Vein Finder performance claims in this article.