Author(s): Patric A Nee, Andrew J Pictou, David R Ralston
Study objective: To evaluate two methods of augmenting venous filling as potential aids to IV 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 tournique alone in normovolemic, normotensive volunteers.