Facilitation of peripheral intravenous access: an evaluation of two methods to augment venous filling.

ABSTRACT

STUDY OBJECTIVE: To evaluate two methods of augmenting venous filling as potential aids to i.v. cannulation. DESIGN: Comparative study of cross-sectional areas of preselected antecubital fossa veins. SETTING: Vascular laboratory of a British university teaching hospital. PARTICIPANTS: Thirty healthy, normotensive, adult volunteers. INTERVENTIONS: Vessel cross-sectional areas measured noninvasively using a color flow duplex ultrasound scanner. Measurements were taken at rest, after application 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 increase to 0.33 +/- 0.14 cm2, and Rhys-Davies exsanguinator produced an increase to 0.32 +/- 0.15 cm2 (P < .0001 for all comparisons except Rhys-Davies exsanguinator versus Esmarch bandage). CONCLUSION: Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused significant filling of antecubital fossa veins in excess of that produced by a venous tourniquet alone in normovolemic, normotensive volunteers.