FACILITATION OF PERIPHERAL INTRAVENOUS ACCESS - AN EVALUATION OF 2 METHODS TO AUGMENT VENOUS FILLING

Study objective: To evaluate two methods of augmenting venous filling as potential aids to IV cannulation. Design: Comparative study of cros s-sectional areas of preselected antecubital fossa veins. Setting: Vas cular laboratory of a British university teaching hospital. Participan ts: Thirty healthy, normotensive, adult volunteers. Interventions: Ves sel cross-sectional areas measured noninvasively using a color flow du plex ultrasound scanner. Measurements were taken at rest, after applic ation of a venous tourniquet, with tourniquet and Esmarch bandage, and with tourniquet and Rhys-Davies exsanguinator. Results: Mean (+/-SD) cross-sectional area at rest was 0.18+/-0.094 cm2 and after tourniquet was 0.28+/-0.14 cm2. Application of an Esmarch bandage produced an in crease to 0.33+/-0.14 cm2, and Rhys-Davies exsanguinator produced an i ncrease to 0.32+/-0.15 cm2 (P<.0001 for all comparisons except Rhys-Da vies exsanguinator versus Esmarch bandage). Conclusion: Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused si gnificant filling of antecubital fossa veins in excess of that produce d by a venous tourniquet alone in normovolemic, normotensive volunteer s.