Venoscope II, Veinlight EMS/LED, transilluminators

dscrn · Apr 9, 2010

NICU's use transilluminators on babies all the time. The one that I've seen in use wasn't portable, but I'm sure that there is such a thing...good luck to you...getting stuck all the tie is no fun at all...

Emergency RN · Apr 9, 2010

The venoscope2 and other transcutaneous illumination adjuncts are really nothing more than just fancy flashlights. Any good needle sticker can use a plain ole Minimag or Streamlight Junior and do exactly the same thing, that is, find a vein with it. However, if there is no vein to begin with, then the fanciest flashlight would remain essentially worthless as there is nothing to be found in the first place.

Based on what you wrote, you might consider looking beyond peripheral veins and going central instead. That is, if your uncle (an anesthesiologist, who are generally experts at finding veins) is already having a hard time doing peripheral access on you, then your veins are likely no longer useful for clinical purposes. Since you have something chronic, ask your doctor about the risks (mostly from infections) versus advantages of installing an infusaport (aka mediport, portacath) device. These are surgically implanted devices normally reserved for people who need IV therapy fairly constantly as a matter of routine, for a variety of reasons (chemo for cancer patients, IV access for sickle cell anemia with poor access, or for frequent blood sampling, etc). An alternative to an infusaport would be a PICC (peripherally inserted Central Catheter) line. Talk with your doctor about the advantages and disadvantages of both.

Depending on your currently clinical status, they may or may not be right for you. Again, speak with your doctor and Good luck. :up:

Difficult_To_Stick · Apr 9, 2010

I'll ask about that surgical implant. It sounds like it's around the same lines as a PICC line (edit: I just noticed that I missed you mentioning a PICC line)? I have a feeling that my doctors are going to advise me against it due to the risk of infection. I actually have more than one condition as far as chronic illness, one of them was just diagnosed recently (it's a genetic mutation) and it turns out that it exacerbates the elements of another condition leaving me immuno-compromised, and the infusion therapy makes it worse too. There's no harm in asking.

As far as a central line - how painful is that? I've seen them done, but I don't think I've ever had one.

The issue with my veins isn't really that they're unusable. The veins on top of my hands I would say are unusable as they almost always blow within a few hours. My veins otherwse are more a problem in the sense that they're difficult to see and/or feel. They tend to be somewhat deep, and I'm told that they "move" (which I didn't know they could do). It usually works out that once they get an IV started, it stays usable for days.

There have been nurses and doctors who almost 100% of the time get an IV started with me on the first stick. Unfortunately, when I moved across the country for law school, I gave up being able to use them to start my IVs.

I really feel that if I could just help the nurses and/or doctors find them that my problem would be gone. So, that's where I'm coming from with this request for info on whatever devices exist that would make the job easier. My veins are awful, but not in the sense that they're unusable, it's more the placement of them and their willingness to cooperate (that is if they "move" as I've been told).

Thanks. :)

annmariern · Apr 9, 2010

Hi, have no advice as to the gadget aspect of your question, I guess I would say the mediport differs from the PICC in that it can be deaccesssed between uses and a monthly flush keeps it patent, reducing the risk of infection. With chronic conditions, such a sickle cell pts, it seems to work well, frequent sticks on anyone is tough all round and veins scar like any other tissue and get harder to access. Mediports can be accessed when you need frequent sticks,for labs, IV access. Not sure if this is right for you, agree with the advice to talk to your doc. On a personal note, you sound like a lovely person and I wish you well.

twentytenRN · Apr 9, 2010

I am sorry to hear of your health problems and your troubles. As a nurse I have to say that you can use all the fancy gadgets in the world you want when starting an IV but none of them hold a candle to someone who is truly good at starting IV's. And as a patient, you don't know whether or not the person starting your IV is "good at it" until they take a stab at you. Pun intended.

I would think something a long the lines of the mediport or portacath would be a good option for you to discuss with your physician for someone receiving such frequent IV treatment. The risk of infection with multiple and repeated peripheral sticks is usually more than having a central access.

Good luck and I wish you the best with your health and your education!

nursemike, ASN, RN · Apr 9, 2010

I use a Venoscope regularly. It's kinda pricey for what it is, but not so bad for what it does. It works. Can't make veins where there are none, and can't make the needle go in, but a lot of times it does help to visualize potential sites and get an idea how deep the vein is. If you see the vein as a sharply defined line, it's near the surface, if it's fuzzier, it's deep. I bought mine when I was still new and having trouble. It was worth it just for the improved confidence. It also helps judge where not to stick--a vein that feels good, but takes a sharp turn, for example.

These days, I rarely use it for easy sticks, but put it in my pocket before I try one out of superstition, in much the way God hates nurses who only bring one Angiocath. But I've also gotten some very tough sticks that our resident experts couldn't. It won't help the OP, but as the one doing the stick, I also like that it helps distract the patient a bit.

I agree that an infusaport might be worth considering. A PICC is okay for a month or so, but not really for long term. Sticking yourself isn't entirely impossible--I've seen a Youtube of ER nurses (the skaterboys of nursing) sticking themselves to see who was fastest, but it isn't recommended.

I'm a little bit of a tough stick, myself. So I might just consider putting it in my pocket when I go in to have labs drawn.

P-medic2RN · Apr 9, 2010

Bedside ultrasound works also.

simboka · Apr 9, 2010

I'm a fan of veinlights, but they aren't miracle workers. Often deep veins don't show up really well either with them, and they're a pain in the butt to use effectively (gotta turn off all the lights to see really well). Honestly, the portacath/port/mediport/whatever they're called in your area will probably be your best bet long term. To reiterate what annmariern said: PICCs(peripherally inserted central catheter) will be basicall a big IV that just stays with you, but it'll need to be cared for even when not being used. The port will just be a little implant under the skin usually on your chest. It is just accessed whenever it's needed and doesn't do much otherwise. They both will usually give blood pretty well. Infections for both are the number 1 risk. And it seems to me that I see more clots formed around PICCs then I see associated with ports (anybody concur?). As for pain, most of the people I access the ports of, barely flinch when I stick them.

Difficult_To_Stick · Apr 9, 2010

Hi, have no advice as to the gadget aspect of your question, I guess I would say the mediport differs from the PICC in that it can be deaccesssed between uses and a monthly flush keeps it patent, reducing the risk of infection. With chronic conditions, such a sickle cell pts, it seems to work well, frequent sticks on anyone is tough all round and veins scar like any other tissue and get harder to access. Mediports can be accessed when you need frequent sticks,for labs, IV access. Not sure if this is right for you, agree with the advice to talk to your doc. On a personal note, you sound like a lovely person and I wish you well.

I will definitely ask about the Mediport. I have a strong feeling that I'm going to be told that my susceptibility towards developing an infection is too high to consider this type of approach. I will ask though. For the moment, we'll pretend like the doctor has told me I can't do it. I will call and leave a message with both my Infectious Disease doc, Gastroenterologist, my primary doc, and also my uncle who is an anesthesiologist. I'll also ask my father who coincidentally specializes in the disease I have that requires immuno-suppressant drugs. One of them should have an idea of whether it would be safe with me.

Thank you for the compliments. :)

I am sorry to hear of your health problems and your troubles. As a nurse I have to say that you can use all the fancy gadgets in the world you want when starting an IV but none of them hold a candle to someone who is truly good at starting IV's. And as a patient, you don't know whether or not the person starting your IV is "good at it" until they take a stab at you. Pun intended.
I would think something a long the lines of the mediport or portacath would be a good option for you to discuss with your physician for someone receiving such frequent IV treatment. The risk of infection with multiple and repeated peripheral sticks is usually more than having a central access.
Good luck and I wish you the best with your health and your education!

Well, you are correct that somebody who really knows what they're doing is better than a gizmo. I have no argument. For my infusions, before I moved, I knew a nurse who really knew what she was doing and got me every time. She was so good that I was thinking of somehow putting her on retainer to start an IV whenever I need a procedure not at that hospital. lol. So far, I haven't found anybody like that up here unfortunately. Maybe I will eventually, but until then, I'm going to seek whatever help I can get, and if that comes in the form of a glorified flashlight -so be it - if it works.

As I said above, I'm happy to discuss the port idea. I just don't think they're going to spring for it. To illustrate why, the last time I had minor surgery, just a small infection or cyst, the site got reinfected 3 times in 6 months and had to keep getting opened up over and over again. There's no knowing if I'm done yet. I have a microdiscectomy scheduled in 2 and 1/2 weeks and the doctors is quite scared about the risk of infection. So, I just feel that they're going to shy away from installing something like that. Nevertheless - I really will ask.

Thanks. As for my education, it's temporarily on hold until this fall. My upcoming surgery along with some other factors put my education on hold. It's ok though. Now I'll just have 2 groups of friends from law school. My old section who will give me their outlines and tips as to what to expect on the exams, and my new section this Fall.

I use a Venoscope regularly. It's kinda pricey for what it is, but not so bad for what it does. It works. Can't make veins where there are none, and can't make the needle go in, but a lot of times it does help to visualize potential sites and get an idea how deep the vein is. If you see the vein as a sharply defined line, it's near the surface, if it's fuzzier, it's deep. I bought mine when I was still new and having trouble. It was worth it just for the improved confidence. It also helps judge where not to stick--a vein that feels good, but takes a sharp turn, for example.
These days, I rarely use it for easy sticks, but put it in my pocket before I try one out of superstition, in much the way God hates nurses who only bring one Angiocath. But I've also gotten some very tough sticks that our resident experts couldn't. It won't help the OP, but as the one doing the stick, I also like that it helps distract the patient a bit.
I agree that an infusaport might be worth considering. A PICC is okay for a month or so, but not really for long term. Sticking yourself isn't entirely impossible--I've seen a Youtube of ER nurses (the skaterboys of nursing) sticking themselves to see who was fastest, but it isn't recommended.
I'm a little bit of a tough stick, myself. So I might just consider putting it in my pocket when I go in to have labs drawn.

So you feel the Venoscope does do what it's advertised to do? Monetarily, it seems ok. $199.99 directly from the company with a money-back guarantee. $180 through other vendors.

Bedside ultrasound works also.

Well, the problem with that is that phlebotomists don't have that kind of technology, nor does the infusion center in Minneapolis. If there is a portable version though- I'd be interested in looking into it.

I'm a fan of veinlights, but they aren't miracle workers. Often deep veins don't show up really well either with them, and they're a pain in the butt to use effectively (gotta turn off all the lights to see really well). Honestly, the portacath/port/mediport/whatever they're called in your area will probably be your best bet long term. To reiterate what annmariern said: PICCs(peripherally inserted central catheter) will be basicall a big IV that just stays with you, but it'll need to be cared for even when not being used. The port will just be a little implant under the skin usually on your chest. It is just accessed whenever it's needed and doesn't do much otherwise. They both will usually give blood pretty well. Infections for both are the number 1 risk. And it seems to me that I see more clots formed around PICCs then I see associated with ports (anybody concur?). As for pain, most of the people I access the ports of, barely flinch when I stick them.

WHen you say "veinlights" are you talking about the Venoscope, or the Veinlight, either EMS or LED. It's a separate brand owned by a company called Translite.

So wait.... the port is in my chest? What does it connect to? I was thinking that this went into the arm. I need o google "mediport" and get a better understanding of it. Or ask my uncle about it. One or the other.

Thanks soo far guys. For the moment, I'd love to focus on the core question above of the Veoscope v. the Veinlight and whether there are any other competitors out there. The "Weelite" doesn't seem like a competitor because it's been a while since I was considered an infant, despite my love for Spongebob Squarepants at age 27. :rolleyes:

Emergency RN · Apr 9, 2010

One of the problems that hasn't been discussed here is the fact that by purchasing such a transillumination device, the OP obviously has certain expectations that the person he gives it to will know how to use it. This isn't necessarily so; that is, it isn't as simple as pushing a button. A user who has never performed venipuncture with transillumination will likely not be able to do it even if handed the device. How do I know this? I used to work on an IV team, and taught IV insertions for several years to all new nursing hires in a medium sized hospital.

What I discovered about venipuncture is this; the problem with using lights is that some nurses can't learn to manipulate both the light and the needle at the same time. It isn't that they're stupid, but rather a hand eye coordination thing. Some can do it really well and adapt quickly while others just can't. I myself generally use one of two small LED flashlights (the INOVA T2 or the Olight T20 3watt; both are real flashlights, nice and bright) whenever I need transcutaneous illumination. But basically any light source that is enclosed by an opaque rim that can be held to a patient's arm will do the trick. Using real flashlights is easier because they're not limited to finding veins (like a venoscope); I can use them to look at throats, transilluminate swollen scrotums, as well as finding my car keys at night in a dark parking lot, LOL...

Back to the issue; while seeing the vein clearly can help with insertion, it doesn't mitigate the fact that all veins are not created equal, even in the same individual. They can vary not just in size and depth, but lumenal caliber, degree of elasticity, and how tolerant each are of IV therapy. Sometimes, it takes one who is tremendously knowledgeable about veins and their differences in character to be able to easily get access. The OP alluded to this with his comment that there was one individual who always seemed to get him with one shot. This just goes to show how important experience is when it comes to difficult access. Like another respondent hinted at, it isn't the adjunct used, but rather, who is wielding the needle that is the critical determinant of success.

So while a certain device or technique can help, one should not expect it to be any sort of holy grail, especially if the person doing the procedure has never encountered or used techniques such as transillumination assisted venipuncture before. That person would likely have to do several hundred "sticks" with it before being comfortable enough to use it as a matter of routine.

shiccy · Apr 9, 2010

No no these ports are something completely different than a PICC or CVC or TLC. These access ports are also called IMPLANTED ports. This is a site that describes them further for you. http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Linesports/Implantableport.aspx

As you can see ppl with chemo use them, so immunocompromised patients have acceptable benefits from them.

As always talk to your doc about them. He probably has no idea this is happening with your poor access. Ask him if he thinks something along these lines is a good thing and go from there. Good luck!