Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography

Mukai, Kanae; Nakajima, Yukari; Nakano, Taito; Okuhira, Manami; Kasashima, Aya; Hayashi, Rina; Yamashita, Misaki; Urai, Tamae; Nakatani, Toshio

doi:10.1097/pts.0000000000000441

Cited by 21 publications

(12 citation statements)

References 14 publications

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“…The medial cubital vein was paramount to our results, because it's the most prominent and easy to puncture, usually doesn't roll under the skin, and is also a good choice to prevent nerve injury and an hemolyzed sample. 1,[17][18][19] Currently there is no study with which we can compare our results, but as stated by Lima-Oliveira et al, about 78% of phlebotomies in outpatients are performed in the medial cubital vein when using a tourniquet, 20 and we have achieved similar results without its use.…”

Section: Discussionmentioning

confidence: 52%

Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use

Freitas

Alves

2020

Preprint

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Background: Guidelines for venous blood sampling procedure (phlebotomy) discourage tourniquet use whenever possible. Here, we aim to assess Biomedical Scientists capability of not using the tourniquet in phlebotomy, which we hypothesised to be equal to 50% of the patients attended, and identifying the most frequent venipuncture site. Materials and Methods: We selected and assigned two (BMS) with the same age (41 years) and experience (20 years) to record ten phlebotomy days, the first with prioritized and the latter with non-prioritized patients. In a simple record form, each acquired daily data for the number of attended patients, age and gender, the frequency of non-tourniquet usage and the punctured vein. To test our work hypothesis we used the two-tailed single sample t-test (p < 0.05). Differences between age-group means and non-tourniquet use means by each BMS were tested by two-tailed t-test for independent means (p < 0.05). Results: In 10 phlebotomy days 683 patients were attended, with males representing 43,2% of the population. We found no statistically difference between age-group means. The combined capability of non-tourniquet use was 50,5%, which did not differ from our null hypothesis, but the individual group-means were statistically different, being 33% and 66.9% in the prioritized vs non-prioritized group. The medial cubital vein was the most prone to be punctured (77,7%). Conclusions: We have shown that performing phlebotomies without tourniquet use is possible and desirable in at least half of the attended patients, though being more limited in specific group populations. Our results provide room for quality improvement in the laboratory pre-analytical phase.

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Section: Discussionmentioning

confidence: 52%

Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use

Freitas

Alves

2020

Preprint

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“…Estes dados corroboram com o estudo de Yamagami & Inoue (2019) em que as veias mais escolhidas para punção venosa com o uso da tecnologia foram as cefálicas, medianas e basílicas. Isso ocorre em virtude de elas serem mais calibrosas, portanto mais fáceis para a punção (Mukai et al, 2020). Também é importante frisar que em pacientes adultos, veias muito superficiais (<0,3 cm) e muito profundas (>1,5 cm) são difíceis de puncionar (Nakayama et al, 2020).…”

Section: Discussionunclassified

Experiência de estudantes de enfermagem na técnica de punção venosa periférica com e sem o uso de transiluminador cutâneo portátil

Lima

Lenhani

Batista

et al. 2021

RSD

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Objetivo: Descrever a experiência de acadêmicos de enfermagem na técnica de punção venosa periférica com e sem o uso de transiluminador cutâneo portátil. Método: Estudo observacional, descritivo, transversal e quantitativo realizado em uma faculdade privada no município de Curitiba-Paraná. Participaram 18 acadêmicos divididos aleatoriamente em dois grupos: Grupo I (técnica tradicional, sem o uso transiluminador cutâneo portátil - venoscópio) e Grupo II (técnica com o uso do venoscópio). Os dados foram coletados com a utilização de dois instrumentos elaborados pelos pesquisadores contendo variáveis demográficas e questões relacionadas ao uso do venoscópio. Utilizou-se de estatística descritiva e inferencial para a análise dos dados. Resultados: Houve correlação significativa entre o conhecimento teórico de punção venosa e a identificação do vaso a ser puncionado (p=0,000), e do conhecimento teórico com o nível de dificuldade para puncionar (p=0,005). Quanto ao número de tentativas de punção, 33,3% dos acadêmicos puncionaram com êxito na primeira tentativa com o venoscópio, para 44,4% dos acadêmicos sem o uso do aparelho. Ao abordar a experiência com o uso do venoscópio, 66,7% citaram ser vantajosa, e 55,6% relataram que o seu uso favoreceu a visualização de veias. Conclusão: A punção venosa com o uso do venoscópio foi válida ao aprendizado e considerada uma experiência vantajosa para os acadêmicos.

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“…So in our hospital, upper limb is superior to lower limb for IVA, this was why upper limb was researched in our study. Meanwhile, there are several safe and suitable sites on arm for appropriate venipuncture and cannulation, such as cephalic vein, median cubital vein and basilic vein [9]. The exclusive criteria were as follow: history of upper limb thrombosis, history of upper limb surgery, upper extremity malformation and/or fracture, upper limb infection or venipuncture within three months, any acute medical illness, pregnancy, prior intravenous drug abuse.…”

Section: Methodsmentioning

confidence: 99%

Which, Tourniquet or Inflation of Blood Pressure Cuff, can Dilate Peripheral Vein Adequately for Intravenous Access?

Xiong¹,

Zhan²,

Ding³

et al. 2019

BJSTR

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Objectives: Peripheral intravenous access is a common clinical procedure. It is wellknown that venodilation improves success rate of peripheral intravenous cannulation. Elastic tourniquet and blood pressure cuff are frequently applied to dilate peripheral veins. The objective of this study is to evaluate which maneuvers designed to dilate antecubital veins are more effective. Methods:This was a prospective non-random trail enrolling fifty healthy volunteers. Ultrasound was used to select an antecubital vein as a target vein. Its' diameter and cross-section area were measured sonograghically at the same position with different maneuvers, that was baseline, elastic tourniquet and blood pressure cuff with different inflation pressure. The blood pressure cuff was inflated with pressure from 30mmHg to 120mmHg, in 30mmHg increments. Time-intervals between each maneuver were longer enough and basic measurements were repeated to ensure the target vein recover to initial state. At the same time, volunteers' subjective feeling and degrees of tight under different maneuvers were recorded and evaluated by Visual Analogue Scale. Comparisons among different maneuvers were performed by Repeated Measurement test and Bonferroni test. Non-parametric test Kruskal-Wallis One-Way ANOVA was used to pairwise compare differences of volunteers' scores of Visual Analogue Scale. The differences of diameter and cross-section area between right and left arm were evaluated by Paired-Sample test.Results: All maneuvers dilated diameters and cross-section areas of target antecubital veins significantly from baseline (P=0.000). Target veins were dilated most significantly by blood pressure cuff with 60mmHg inflation pressure (P=0.000). Blood pressure cuff with 90mmHg inflation pressure resulted in the second largest increase in target vein size (P=0.000). Although there were no significant differences between blood pressure cuff with inflation of 30mmHg and 120mmHg pressure (P=1.000), elastic tourniquet significantly increases diameters and cross-section areas of target vein size when compared to them (P=0.000). Scores of Visual Analogue Scale of elastic tourniquet and blood pressure cuff with 120mmHg inflation pressure were not significantly different (P=0.581), but these were significantly higher than other maneuvers (P=0.000).Blood pressure cuff with 30mmHg inflation pressure significantly decreased the score of Visual Analogue Scale, when compared with maneuvers of 60mmHg and 90mmHg inflation pressure. Nevertheless, there was no significant difference between the scores of 60mmHg and 90mmHg inflation pressure (P=0.369). The differences of baseline of

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Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography

Cited by 21 publications

References 14 publications

Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use

Improving the quality of venous blood sampling procedure (phlebotomy): avoiding tourniquet use

Experiência de estudantes de enfermagem na técnica de punção venosa periférica com e sem o uso de transiluminador cutâneo portátil

Which, Tourniquet or Inflation of Blood Pressure Cuff, can Dilate Peripheral Vein Adequately for Intravenous Access?

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