Is anyone using the VienViewer? If so, are you seeing success with it? Do you notice that you can see veins up to 1cm deep? Also, what do you think of them stating that once you put a catheter through a valve, that valve is forever damaged and will remain open? Our facility has purchased some of these and we are not seeing the success that was advertised and I am unsure how valid the valve info is. Any input would be great!
Thanks,
Molly
Molly,
Our facility also purchased VeinViewers recently... We have some in the ED, and they actually go unused due to their non-helpfulness. I have had access to them in other facilities as well, and never have found them to be helpful.
It is my opinion that the veins they are intended to visualize are either identifiable by landmarks, or by touch. I would NEVER stick a vein that I could not feel unless I was visualizing with it ultrasound. The reps who visited our hospital stated that it would decrease the number of sticks drastically, but I have not seen this in practice. I felt like they were trying to sell us a pretty green light. The veins that they visualized on themselves were large surface veins, and not representative of our more difficult population. Personally, I would have liked to have access to more portable ultrasound visualization devices, at least for ED.
If I have a difficult access situation in the ED, I always head straight for the SonoSite. Perhaps others have had different experiences, but the VeinViewer is not a helpful piece of equipment in my vascular access practice.
R. Erin Fortune, BSN, RN, CCRN, VA-BC
Our facility purchased several vein viewer machines some years ago and they did not perform very well. Quite a bit of money was spent and now these machines sit unused in supply rooms.
We have a Vein Viewer and I have found it a useful tool. I don't use it as often as the rep. thought I would however I feel that I have achieved a fairly good success rate with it. Assessing depth is the learning curve that I found most challenging. I think this device is much more useful than the hand held devices. They are mostly not helpful at all.
Thank you for your feedback. Our facility has purchased several of the vein viewers. We have had mixed reviews. It seems to help build the confidence of new nurses who are not as experienced. We have also found that it does not actually show you a vein to the 10mm depth. We have assessed the patient with vein viewer and didn't see much but then evaluated with ultrasound and found beautiful veins. It seems we could get our money back if it doesn't perform up to their claims.
Molly
Molly M. Black, RN, BSN, CRNI, VA-BC
Specialty Practice Nurse
Vascular Access Team/Clinical Education and Practice
Indiana University Health Bloomington
812.353.9021 l 812.353.5062 (fax)
[email protected]
Molly Judge, RN, BSN, CRNI, VA-BC
Specialty Practice RN
IU Health Bloomington Hospital
I would be curious to know what specific types of vein viewers you are discussing? The near infra-red?
VeinViewer is the tradename for the infrared light device manufactured by Christie Medical. There are several other brands of infrared light such as Accuvein. There are several other brands of devices that use visible light and have a variety of tradenames includig VeinLite. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
If you need one of these, the patient probably needs a picc. I've always thought that if getting an PIV is too difficult, even if you get one in, its probably not going to last. I've only played with these, I'm sure practice makes perfect.
Sorry Natalie, but I do strongly disagree with your point of view on this. There are numerous times when a PICC is placed unnecessarily simply because a peripheral catheter can not be inserted. No veins can be easily seen or palpated. Successful insertion of a PIV increases when some type of vein visualization device is used. How long the catheter dwells depends upon many other factors such as choice of a site away from a joint and appropirate use of an engineered stabilization device. If a site in a joint (hand or wrist) is the only site that can be found, you must use a handbvoard to ensure it lasts for as long as it is needed. These unnecessary PICCs are placed when the therapy does not require a CVAD and/or when the IV catheter is only needed for a few hours or a couple of days. I have seen so many times when a PICC is inserted, then removed within 24 hours - such a waste of time, money, and other resources. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
I totally agree with Lynn. I persoanlly purchaed a small hand held light for use in the home and I love it! I wonder if your hospital nurses are really using your vein finder? I have learned all of the ones our organization purchased are using down stairs by the equipement room which tells me they are not using them :( Valorie
Valorie Dunn,BSN, RN, CRNI, PLNC
Our medical/surgical floor had a similar device for several years. It was barely ever used. A bright flash light worked on the same level. We are transitioning more to using ultrasound guided peripheral starts. As Lynn said, having to put a PICC line in just because of inability to start a peripheral is just not feasible in most cases. Our PICC team starts most of the hard IV's with one of our ultrasound machines. Our anesthesia department has a portable ultrasound and our ER purchased one of the small PreVue ultrasound for IV starts. I talked to one of the ER nurses regarding this because we are looking at getting the small ultrasounds on the adult specialty floors. He said "sometimes I feel like I am cheating when I use it" (he is a phenomenal IV starter from years as lead paramedic in flights) He said there was a few nurses who just grasped right onto the concept and continue to assist other nurses who are not so comfortable with it. Since I do hundreds of US guided peripheral IV starts with great success I would suggest you look into that. With the small ultrasound you can see diameter of vein, depth of vein, if the vein drops down, shrinks up or does whatever. There is a little learning curve as with anything but the patient satisfaction is priceless. Veinviewer brags to make IV starts 50% more successful. I would guess I am >95% with ultrasound.
Paula C RNBC,CRNI
Intravenous Resource Nurse
Paula Campbell RNBC, CRNI
Intravenous Resource Nurse
I would agree with the USG-PIV. We place them when the patient's needs are for short term IV access when a midline or PICC is not needed. (Right line, right time PIV,midline,picc, cvc) It is a procedure that has to be done frequently to maintain/gain proficiency. I have heard it said that a clinician should place a minimum of 50 PICC a year to maintain/gain proficiency. I believe that to be true and possibly more since the veins are often times smaller than the PICC'ed veins. I and my assistant place approx 2-4 per day and have a 99% efficacy with getting the IV and with approx. 94% of those on the first attempt. (She holds the skin tight if needed or turns the probe long axis if the vein is of sufficient size) Keep in mind than these are the patients that the most experienced nurses have already tried. We have also lowered our PICC placements and with that risk of CLABSI IMO. I have also noticed that the USG-PIV usually lasts longer than the PIV on the most difficult patients. FYI. We secure the longer 1.88 inch catheters with statlock or they seem to kink off at the insertion site quickly.