- 作者：Amy Kule ; MD ; Bophal Hang ; MD ; Amit Bahl ; MD
- 关键词：ultrasound ; venous access ; peripheral vein ; tourniquet ; blood pressure cuff ; compressibility
- 刊名：Journal of Emergency Medicine
- 出版年：May 2014
- 年：2014
- 卷：46
- 期：5
- 页码：659-666
- 全文大小：795 K
Objective
This study utilizes ultrasound to assess vein compressibility with different tourniquet techniques commonly available in the emergency department.
Methods
After approval by the Institutional Review Board, a prospective single-center study was conducted assessing the compressibility of basilic veins with ultrasound. Compressibility was assessed at baseline, use of one proximal tourniquet, two tourniquets (one distal and one proximal), and a proximal blood pressure cuff inflated to 150 mm Hg. Vein compressibility was rated as complete, moderate, or mild after light pressure was applied with the ultrasound probe.
Results
One hundred healthy patients were recruited into the study. Ninety-eight subjects had completely compressible basilic veins at baseline. When one tourniquet and two tourniquets were applied, 62 and 31 participants, respectively, demonstrated completely compressible veins. Fisher's exact test comparing one vs. two tourniquets revealed no difference between these two techniques (p = 0.4614). Only two participants continued to have a completely compressible vein after application of the blood pressure cuff with statistical significance by Fisher's exact test compared to both tourniquet groups (p < 0.0001).
Conclusions
Both tourniquets and blood pressure cuffs can decrease the compressibility of peripheral veins. Although no difference was identified between one and two tourniquets, utilization of blood pressure cuffs significantly decreased compressibility. The findings of this study can be utilized in the emergency department when attempting to obtain peripheral venous access, specifically supporting the use of blood pressure cuffs to decrease compressibility.