This is the method used by the IV-eye. By transmitting NIR light from both sides of the target area, the device transmits light deeper into the patient’s tissue than the reflective method, therefore displaying deeper veins more clearly.
The Royal College of Nursing recommend that “site selection should involve assessment for previous venepuncture and subsequent damage to the vein. Aids to assist in cannulation including ultrasound and infrared imaging should be considered.” RCN Standards for Infusion Therapy, 2016
The Infusion Nurses Society Infusion Therapy Standards of Practice 2016, recommend that vascular visualisation technology is used in patients with difficult venous access and/or after failed venepuncture attempts.
The Association of Anaesthetists of Great Britain and Ireland (AAGBI) suggest that transillumination, ultrasound and infrared devices may be useful for peripheral cannulation. Safe Vascular Access 2016 AAGBI Guidelines
© Infection Prevention Society (IPS), National Infusion and Vascular Access Society (NIVAS), Royal College of Nursing (RCN), 2015
A study conducted by Patti Wilcox (2015) into the implementation of near infrared technology to decrease PICC placements, made the following conclusions:
The Implementation of NIR technology has contributed to:
1. improvement in the health care delivery process.
2. increased success in obtaining peripheral vascular access on patients, which has decreased PICC placements
3. increased patient satisfaction, cost savings, and vein preservation.
A study by Guillion et al. (2015) found that
“A NIR vein visualizer showed significant promise for facilitating vein location and mitigating patient pain in those [difficult vein access] patients.”
|Directly applied NIR light |
|Reflective/projected NIR light|
|Requires a stand?||No||Yes|
|Needs time and attention to focus?||No||Yes|
|Must be held a specific distance from the skin to focus?||No||Yes|
|Must be held at a specific angle to focus?||No||Yes|
|Works in bright light?||Yes||No|
|Requires extensive training?||No||Yes|
Measurement of contrast of phantom and in vivo subsurface blood vessels using two near-infrared imaging systems
Author(s): Jeremy C. Hebdena; Aysha Alkhajaa; Laure Maheb; S. Powella; N. L. Everdela.
aDepartment of Medical Physics & Bioengineering, University College London (UCL), London, UK.
bPolytech Lyon, University of Lyon, France.
A quantitative comparison has been performed between two commercial near-infrared (NIR) vein-viewing systems which are designed to supplement the clinician’s traditional skills in locating veins by means of visualization and palpation. The AccuVein AV300 and Novarix IV-eye real-time imaging systems employ very different imaging geometries; the former generates an image from reflected NIR light produced by a beam scanned across the surface, while the latter illuminates the viewed region at four points on the periphery and records the resulting distribution of diffusely transmitted light. The comparison involved measuring the contrast produced by absorbing rods (simulated blood vessels) in a cylindrical phantom with tissue-like optical properties, and the contrast of superficial blood vessels in the arms of healthy volunteers. The locations and sizes of the blood vessels were independently verified using a clinical ultrasound imaging system. The phantom measurements suggested that the AV300 displays the most superficial vessels with greater contrast, but the IV-eye is able to detect vessels when they are at a depth up to 2 mm greater than the limit observed for the AV300. The results for thirty healthy volunteers also indicated that the AV300 typically displays vessels with higher overall contrast, but the effectiveness of the IV-eye at visualizing deeper vessels was even more pronounced, with a maximum depth several millimeters greater than that achieved by the AV300, and more than ten times as many vessels observed at depths below 4 mm.