Venoscope II, Veinlight EMS/LED, transilluminators

[Difficult_To_Stick]

Hi there nurses, doctors, and whomever else is on this website.

I will start by saying that I am not a doctor, nurse, or in the medical field at all. Instead, I'm a law student. I do come from a family with several doctors and others in the medical field. My father and uncle are M.D.s, another uncle is a pharmacist, an aunt is a nurse, and there are others. So, between talking with all of them, I've picked up little bits and pieces and have a basic understanding of some aspects of medicine.

I come here hoping you all can help me out. I am an individual with chronic illness, who gets IV infusion theraphy every 6 weeks, constant bloodwork, and ends up in the hospital somewhat frequently. I'm not complaining about that. I've gotten used to it.

My problem is that I unfortunately have awful veins. Often, it can takes more than 5 sticks before an IV is started. The record for me is at 8 (not something I'm proud of). My uncle who is an anesthesiologist had to stick me 3 times today before getting an IV started for my infusion.

I simply wish to make my life a little easier by resolving the IV issue. The problem is two-fold. First, obviously it's painful to get stuck multiple times. More importantly though, I end up with black and blue marks at the IV sites and I have to imagine that my law school classmates must wonder if I'm using intravenous drugs or something. It's a little embarassing.

For a few years I was thinking that maybe I could take a class somewhere and learn how to start an IV on myself. I've since come to the conclusion that this isn't going to happen. First of all, I hate needles. It's hard enough to give myself my B12 shots in my leg. I doubt I have the mental will-power to stick one in a vein. The second problem is that it would seem to be physically impossible.

So, I've arrived at option 2, and the one that makes more sense. I've recently learned of these devices called transilluminators that help highlight veins using the refraction of light. I've played around with the concept using just an LED flashlight, and conceptually it seems like a good idea. Today I briefly saw a Venoscope II used, but I never got a chance to hold it myself and run it up and down my arm. I've also read about the Veinlight, a competing product.

I found a thread or two on this site mentioning them and it seems they got mixed reviews. I was hoping to just bring this issue to the forefront once more. My questions are:

1) Are there other competitors to the Venoscope II and Veinlight? If so, what are they? (note: it would have to be portable as the plan would be that I'd bring it with me when I go for infusions or bloodwork)

2) Which device have you found to be best? I realize that some people feel that the devices are no substitute for a trained professional feeling around, however that approach hasn't worked out terribly well over the years.

3) Are there any other gadgets (maybe not transilluminators) that do the same thing?

Cost isn't the big factor. The Veinlight LED is $500 and I'd gladly pay that if it meant I could put this trouble behind me. I just don't want to get stuck with a device that does nothing. I also realize, as my father has brought up, that some hospitals or other centers might not want to use whatever device I bring in. I'm ok with that, but the way I see it - if I just can find a vein myself using one of these devices and then say to them, "Look, here's a good one. Stick me here." - I tend to think that they would be ok with it. Am I wrong?

Any help you can offer would be helpful. I wouldn't mind getting the IVs and bloodwork as much if I could just make sure that they get a vein on the first stick. I've been doing some reading here and elsewhere, I'd love to know what you all think of these devices and your experience with them. My only requirement of the device is that it be portable enough to bring with me to either the hospital, lab, or infusion center - and of course be somewhat helpful or effective.

Thank you very much in advance. :)

[Difficult_To_Stick]

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.

Nooooo. Quite the contrary. I have no expectation that the nurse or doctor that tries to start my IV will be familiar with how to use a transilluminator. I especially have no expectation that they will know how to manipulate one while simultaneously manipulating a needle/catheter.

The way I envision it would work like this:

First I get to know the device well and spend considerable time running it along my arms, hands, etc. looking for noteworthy veins.

Then, when I bring it into the hospital, lab, or infusion center, I could simply use it to show the nurse or doctor exactly where a good vein is. This would at least eliminate the whole "stick and pray" game that goes on. Sometimes when they miss, they miss by a long ways. So, at least we could eliminate that problem and make sure the needle is at least going into the same zip code as where the vein lies.

An additional option would be to buy the sterile disposable covers for it and hold it myself while the nurse gets the IV started. That way, they don't need to know how to manipulate it and the needle. This would probably be easier with a Veinlite than the Venoscope based on the larger area illuminated.

All of the points raised are legitimate. I'm still ok with trying a transilluminator. In the worst case scenario, I waste some money and have a weird looking flashlight.

I just need to know which is better at illuminating the area. I will be happy to explore the idea of having a port installed, but in the meantime, I'm happy to entertain the idea of getting a transilluminator. It's easier to entertain though when I know which product works best.

[nursemike, ASN, RN]

I've never had access to a Veinlight, so I can't compare. My view of the Venoscope is that it's overpriced. I paid $180 for mine. It's basically a plastic flashlight. After a few drops, I have to tape the battery compartment closed. But I haven't had much luck finding veins with a well-made, durable, and relatively inexpensive Mini Mag-light.

One of my coworkers, also male, likes it a lot, and we've done a couple of sticks in the dark with me holding it in place while he sticks. Most of my coworkers aren't impressed. But I've been doing significantly more sticking for other people than having people stick for me, and I think my first-try percentage is better than it used to be.

Back to the implanted ports: almost all I've seen were for people on chemo, but I think I've seen one in a patient with MS. I've seen a few infected PICCs and central lines, but never an infected Infusaport. I'm sure there are cons--there are always cons--but I don't know what they are.

[simboka]

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.

By veinlights, I mean any of those products, 6 of one, half dozen of another, IMHO. I'm a big fan of them, and won't hesitate to break them out, but they're not easy to use, and they also don't give any estimate of the quality of the vein either.

Venoscope:

My floor currently has a venoscope that we'll break out if we've looked everywhere and can see anything good. Usually though if it's bad enough 2-3 people can't find anything, there's not going to be anything especially to get an IV. The product itself is ok, it's got a nice big open area that it shines in. But it only has like 4-6 lights.

Veinlite LED or EMS: (there's 8 more little lights on the veinlite LED)

I played with one a few years ago, but never got to use to stick. It has a lot more lights, but seemed like your "workable area" was smaller since the lights were more pointed in towards the center of that circle.

Another option:

A nurse I've worked with uses a 2AAA mini mag with this or this LED update and he swears by it (I don't remember which). A whole heck of a lot cheaper than either of the others. I had mine for about a week before it disappeared in a room where I was searching feet for anything.

...despite my love for Spongebob Squarepants at age 27.

I lol'd. Here's a heart for your circulatory system :redbeathe. Here's a picture series of a guy having his port accessed. The reason for less infection for ports is that when not in use it just sits there under the (hopefully) intact skin. However, I've seen a number of infected ports, and I've only been in practice on my gen med/tele/onc floor for ~2yrs. And while the majority of ports I've seen have been for chemo infusion, I have had a couple of patients who had ports simply because of poor access.

[Difficult_To_Stick]

Hi all, I just wanted to hit this once more. Veinlite v Venoscope, which do you use and if you've used both, which one works best?

That's all I'm asking. :)

[Difficult_To_Stick]

Ok. I appreciate all of the input. I realize that this is a tough issue as many nurses (and doctors) still prefer to get an IV started manually.

I was told something yesterday that made me think. I had to get my pre-op bloodwork done again as the 30 day point had expired. I told the phlebotomist "you're best bet is going to be to stick me right here." and I poked around until I felt a spot I was familiar with. I've always noticed that my veins seem fairly sensitive and I can feel when something or somebody is pushing on one. It's a feeling that's kind of like the feeling you get when you accidentally trap your ulnar nerve between your bone and skin and it gets smacked (aka hitting your funny bone), but with more pain. I can't feel the vein with my finger, but my vein feels my finger (if that makes any sense). She didn't see or feel a vein there, but I assured her that there was a vein there. She stuck me, but there was nothing. I told her to move it slightly because I could feel that she's in the right spot. Then I felt vacuum pressure and told her "You're there, I just felt vacuum pressure". I looked over, and just after I said that, blood started flowing through the tubing. She seemed astonished and said she had never come across somebody who had tactile sensation in their vein. Until yesterday, I thought this was normal. I don't know if she was just playing around with me or if this is really abnormal.

I decided last night to order the Venoscope II. I went with it over the Vein-Lite for a few reasons.

1. I spoke to Translite (who makes the VeinLite and was told that the EMS and LED unit use standard LEDs, not high-intensity LEDs). I know from seeing the Venoscope that it uses high-intensity LEDs similar to some of the ones in high end LED flashlights I own (not quite as bright though as my flashlights get hot enough to cook on because they're so bright). That meant that in order to get more light, I'd have to get the LED unit rather than the EMS unit. The LED unit has 2 drawbacks for me. The first is that it's very pricey at almost $450 for just the unit itself. The second is that it is rechargeable. I hate rechargeable batteries. There is no need for rechargeable batteries in that unit as I'm sure if nothing else, they could have gotten it to work with 2 AA batteries and a step-up voltage converter for the extra 0.7 volts. Even easier would have been a CR123A battery which already has a nominal voltage of 3.6v with the Li-ion CR123As which can be purchased in bulk at very reasonable prices online (a small fraction of what you'd pay at a local retailer). I'm sure they opted for the rechargeable battery due to its being flat and compact. Nonetheless, I didn't like the idea of a rechargeable battery which will one day die and need replacement. I've seen what happens. My father (a physician) has 2 Welch-Allyn diagnostic sets that are in "retirement". They're both the standard Otoscope/Ophthalmoscope interchangeable base combo. The batteries are rechargeable, but dead. I just recently found a source to buy new batteries as I feel that it's a complete waste to just have these two perfectly good sets sitting in a drawer because of bad batteries, and they aren't cheap. I'll buy them because I know my father would like to use those sets again and doesn't have the time to deal with battery shopping, but lesson-learned: avoid rechargeable batteries. So, between the price and the battery - I was losing interest.

2. The Venoscope has more listed clients, in more hospitals I frequent, and the Veinlite does not publish a client list like the Venoscope folks do. To me, this is an indicator that the Veinlite hasn't caught on yet. I could be wrong, but I found all of the hospitals I use listed amongst Venoscope's clients. To me, that said that the Venoscope is both reputable, AND more importantly, staff would be familiar with how to use it. So, no more "Oh, well, we have one, but it's in the OR." or other reasons why not to use it. I'll bring it, they can use it.

Those are the main reasons I went with the Venoscope II. I could be wrong about the Veinlite. It could be the best thing since sliced bread as far as I know. I'm forced to make a lot of assumptions in choosing. Going this route however affords me Venoscope's 30 day money-back guarantee. I will have the Venoscope by the time i have surgery next week. That will be it's first trial. I'll go over my arms and hands with a fine-toothed comb (or rather with the Venoscope) and familiarize myself with spots that look good ahead of time.

I'll give it a try. If the Venoscope doesn't work, maybe I'll try the Veinlite EMS. I'm really turned off by the Veinlite LED's price and battery though. 8 LEDs do not cost $200. I think the price is really in the battery. Some people might like rechargeable. That's fine. I just am not amongst them.

If you folks would like, I'd be happy to keep you posted on how the Venoscope works out. I feel that if next week, it can be used to get an IV going (and they do btw use the Venoscope at the hospital I'm having surgery at, so they should be familiar with it), it's a keeper. I'm hopeful that gone are the days that I walk around with arms that look like I have a heroine addiction. If it doesn't work out next week, I'll try it with my next infusion as I know for sure that the head nurse where I get my infusions is familiar with the Venoscope (and likes it too).

Thanks again.

[Vein-Eye Brad]

You most certainly have a great deal of knowledge about this subject. I'm in Arizona and we get a lot of older people with dark tan (brown to very dark skin) and its very hard to find a viable vein the first time.

I agree the more experience the better!

We are fortunate to have been asked to test a prototype vein visualization camera for about 1 month now and we are very excited about it because its hands free and you can see the vein's runway and the needle penetration. Near Infrared Imaging developed it and they say they will begin marketing in a month or so.

Although not excited about the cost, if the production camera works as good as the prototype then my clinic said the would buy 2-3 when available.

[OCNRN63, RN]

I second the mediport. I worked in outpatient oncology, and we had many patients with them. I have one myself. They are a blessing when you have veins that are difficult to access or when you need frequent sticks.

The port is implanted in the chest and has a tube that threads through a large vein. It's accessed with a special needle. It doesn't hurt, and there's even a numbing cream you can get if you're afraid of needles/being stuck.

I would get that over a PICC, but that's just me.

[sistrmoon, BSN, RN]

I've worked Oncology for 7 years and the Port is often used as access for them. I've had patients with 0 white blood cells, essentially as immunocompromised as you can get, with them. Of course infection is a risk but if it's considered a viable option for these patients, I don't see why it wouldn't be for you? Best wishes! I hope you find a solution.