Clinical Experience

I. Arterial Access (Radial Artery)
A study of 58 patients in the Emergency Department at Allegheny General Hospital found that using the VascularViewer for arterial sticks for ABGs resulted in:

✓40% reduction in the number of attempts to obtain a sample
✓30% reduction in the number of blood gas kits used
✓45% reduction in time to perform procedure
✓60% reduction in pain rating

The authors’ conclusion was: “Infrared trans-illumination is a very effective aid for peripheral ABG access, providing significant performance improvement over the traditional unaided method.” — Michael R. Dunn, M.D. and Shawn Conrad, M.D.


II. NICU Study (Veins)
The graph below shows the number of veins visible with and without the VascularViewer in a study of 12 neonates in the NICU at Nationwide Children’s Hospital. The data show that the VascularViewer was able to visualize 86% more veins than could be seen with eyesight and using palpation.

VascularViewer study in the NICU

• Patients 1-10: Upper extremity (arm) surveyed
• Patients 11 – 12: Lower extremity (hand) surveyed
• Weight range: 1217 – 5400 gms (2.7 lbs – 11.9 lbs)


III. Adult Study (Veins)
The graph below shows the number of veins visible with and without the VascularViewer in the hand, wrist and lower forearm of 24 adults in the Heart & Lung Institute at the Ohio State University Medical Center. As with the NICU study at Nationwide Children’s Hospital, theVascularViewer visualized almost twice as many veins as were visible with eyesight and using palpation.

VascularViewer Study in Adults

• Veins surveyed were in the hand wrist and lower forearm
• Patient Weight Range: 115 lbs – 250 lbs


IV. PIV Access (Veins) — Pediatrics
The only trans-illumination study INRIS has ever seen that was not done by INIRS was published by the University of Utrecht (NL) Medical Center. The table below shows impressive results in a venous access study.

                                            Failure Rate	             Time > 15 seconds
Without Device                              12.5% (1 in 8)	             21.30% (1 in 5)
With Device	                            .20% (1 in 45)	             6.70% (1 in 15)

• Children under 6 years old; n = 125 (80 without, 45 with system)
• Failure = more than 1 puncture needed to access vein


V. Case Histories
The following examples across all patient groups illustrate the capabilities and clinical value of the VascularViewer and show the highly positive response from clinicians:

• Children’s Hospital — NICU – In addition to being used for numerous peripheral IVs, Nurse Practitioners have used the VascularViewer in the placement of PICC-lines and arterial sticks for ABGs. Veins have been imaged in multiple locations including the wrist, foot, shoulder, forearm and ACF (elbow), while arteries have been imaged in the wrist, ACF and the back of the knee. Pulsing of the arteries can be seen in the on-screen image.

• Children’s Hospital — PICU – The vascular access “Go To” nurse for the hospital used the VascularViewer to find a vein suitable for a vincristine infusion in a 16 month old leukemia patient. The child is well known in the hospital as ‘an extremely difficult stick’. Using theVascularViewer the nurse located and accessed five veins that could not be seen or palpated; two in each foot and one in the hand. The first four veins had insufficient blood flow for a vincristine infusion, which forced her to continue to seek an acceptable vein for the infusion. The process took 1.5 hours with the VascularViewer in use the entire time. Five PIV kits were used in the process. If the nurse had been unable to find a vessel for the infusion the child would have been sent to the operating room for a “cut down” to find a vein suitable for the infusion.

• Major Medical Clinic — Anesthesiology — The VascularViewer has been used to place over 100 arterial lines in children and adults in addition to its use for PIVs.

• Major Medical Center — NICU – The VascularViewer was used to image the vasculature of a neonate in the NICU. Veins, including the basilic vein above and below the ACF, as well as arteries at the wrist and the brachial artery at the ACF, were all successfully imaged. The participating respiratory therapists were particularly impressed with being able to see pulsing of the arteries.

• Children’s Hospital – The “Go To” nurse on the IV Team suggested that the Emergency Department should have a VascularViewer. She said the VascularViewer would dramatically cut down on the number of patients requiring an hour or more for an IV placement so that other things could be done with the time saved.

• Regional Hospital – The VascularViewer was used to visualize veins in the hands, and arteries in the wrist, of several adults. The hospital “Go To” nurse, who had just spent over an hour gaining access on a patient, commented that the VascularViewer could save significant amounts of time in difficult access patients.

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