Field of the Invention
The present invention relates to a device for assisting a user in gaining vascular access of a patient.
Description of the Background
Venous access is among the critical first steps in caring for patients in the pre-hospital, emergency department/trauma center, and in-hospital environments. Fluid therapy and medication delivery rely on adequate intravenous (IV) access and, accordingly, 60-90% of hospitalized patients require a peripheral IV during their hospital stay. Over 300 million peripheral IV's are sold yearly in the US and over 1 billion units are sold worldwide. However, in 12-26% of adult patients and 24-54% of pediatric patients, the first attempt at catheter insertion fails, requiring additional, painful attempts. Moreover, blood vessel trauma resulting from failed insertion attempts increases the risk of subsequent catheter failure, with failure defined as catheter removal before the end of its intended dwell time or before the CDC recommended 72-96 hour dwell time limit. Peripheral IV's fail at a rate of 35-50% due to painful processes such as inflammation (phlebitis); fluid or medication leakage into surrounding tissue (infiltration); dislodgment; mechanical failure (e.g., occlusion); and site or bloodstream infection. Unsuccessful IV insertion attempts and IV failures are expensive in terms of direct equipment costs; provider time; necessitating more invasive venous access procedures; management of complications; additional hospital days; and, of course, the patient's pain and dissatisfaction.
Providers with high levels of training and experience have a significantly higher first pass success rate and lower incidence of ultimate IV failure, both of which directly reduce the pain experienced by the patient. Of course, training and experience are, by their very nature, time-intensive and otherwise expensive to acquire. An innovative device that enables novices to mimic the fluid expert approach could be of great value, provided that it is rigorously designed to meet patient, disease process, user, environmental, size, weight, and cost requirements.
The past several years has seen innovation relevant to IV placement. Examples include ultrasound and near-infrared technologies to aid vessel identification; antibiotic-impregnated and other cleansing approaches to tubing, connectors and dressings; and novel approaches to catheter stabilization. However, little has been done to simplify the often difficult task of actual IV insertion. In fact, novel technologies often assume a baseline level of competency with IV placement—an assumption that is not supported by the literature cited above, nor recent reports of >20% nursing turnover and high nursing vacancy rates in emergency settings. Emergency Medical Services (EMS) providers also turn over frequently. Functionally, high turnover rates in emergency settings equate to less experienced providers attempting IV placement on patients who are often the most difficult to access (e.g., due to dehydration) and in the most immediate need. Again, a device that simplifies the most difficult aspects of IV insertion could be of value.
Several of the steps followed for IV insertion require precision and a steady hand to prevent the needle from going all the way through the vein. Senior nurses, and the literature, counsel new nurses to pay special attention to these steps, especially in patients who have difficult-to-access veins due to dehydration, excess or thin skin, scarring, obesity, and edema, among other conditions. As described in primers on IV placement written by nurse educators, the most common errors after appropriate target vessel identification and tourniquet placement are related to vein stabilization, angle of approach, and IV assembly advancement after a flash of blood is visualized, offering an opportunity for innovation.
It is, therefore, an object of the present invention to provide an easy-to-use IV placement assist device that is designed to pull the skin taut and stabilize the vein, enhance catheter advancement, add needle/catheter stability, and decrease reliance on freehand approximation of the approach angle.
It is another object to provide an IV placement assist device that facilitates small movements of the needle/catheter assembly or either part individually, such as with advancement of the cannula over the needle; and prevent unwanted needle movement—all without interrupting the flow of the IV start procedure or reducing tactile feedback.
It is an overarching object to provide an IV placement assist device with the foregoing qualities that facilitates a higher first attempt IV placement success rate and decreased vessel trauma and, as a result, decreased IV failures, increased patient comfort and satisfaction, and decreased cost.
In accordance with the foregoing objects, the invention disclosed herein is a low-cost and simple-to-use IV placement assist device with a base, finger interface extending from the base, and mechanical means to engage a needle hub. A catheter advancer is slidably integrated with the base to guide advancement of a catheter linearly along the insertion plane defined by the orientation of the base. In addition, a stabilizer component comprising a traction pad and means of constraining movement of the needle and catheter, which is placed on the patient's skin surface, may be used along with the base and catheter advancer to assist the user in placing an intravenous catheter.
The foregoing components combine to form an integrated assistive device of the present invention. The result is an easy-to-use, handheld device that can stabilize and guide the critical needle insertion and catheter advancement steps of a complication-prone and very common procedure. The base serves as a stabilizing component that emanates from the user's hand, designed to function as an extension of his/her fingers. This component provides the user with means of gripping and controlling the typically small needle hub, as well as providing clear view of the flash chamber contained within the needle hub. Engagement with the needle hub is tight and secure in a manner that readily transmits forces acting on the needle, thereby maintaining tactile feedback to the user. The base also may have guide tracks along which the catheter advancer component slides, thereby providing linear and non-twisting insertion guidance of the catheter about the needle. The catheter advancer component slidably integrates with the base component and may come completely and freely apart from the base during proper use of the device during the catheter advancement step of the IV insertion procedure. Engagement between the catheter advancer and the catheter is specifically not tight and secure, so the component can be freely removed from the inserted catheter without any possibility of dislodging the catheter. The stabilizer component provides means of facilitating skin traction and preventing unintended motions of the needle or catheter tip during alignment, approach, and insertion steps of the procedure. In this device, the angle of approach is not specifically controlled, though use of all device components encourages the user to approach and insert at the preferred low angle. For example, the tip and traction pad of the stabilizer may be positioned apart from each other by a distance that, when holding the base over the user's fingers that are in contact with the traction pad, creates a desired approach and initial needle insertion angle (approx. 15-30 deg).
Key benefits of the intravenous access assist device are as follows:
Other objects, features, and advantages of the present invention will become more apparent from the following detailed description of the preferred embodiment and certain modifications thereof when taken together with the accompanying drawings in which:
The present invention is an IV placement assist device for assisting in the manual placement of an IV catheter without interrupting the flow of the IV start procedure.
With reference to
In reference to
As seen in
To interface with catheter advancer 20, base 10 preferably has at least one sliding track 15 that constrains the advancement motion of the catheter advancer 20 along only the longitudinal axis of needle 40. In the preferred embodiment, there are two parallel tracks 15, with one on each lateral side of base 10 and their configuration also prevents twisting of catheter 50 about needle 40. To achieve a compact design, tracks 15 may be positioned between lateral securement features 14 and finger interfaces 12 on each side. This position also ensures a wider finger grip for clear visualization of the flash chamber, possibly (and often) within the needle hub 41, through at least one viewing window 16 through the spanner 110.
In reference to
Advancement of catheter 50 using catheter advancer 20 is facilitated through finger interface 22, which is shaped and configured as a right-angle tab to be pushed by the user's index finger. Finger interface 22 is preferably at least as wide and as tall as the tip of a small user's finger. Finger interface 22 is intended to be easy and comfortable to use by users with large, gloved fingers, so it is appropriately sized to accomplish this function. Finger interface 22 preferably extends vertically from rail guides 23, and perpendicular to the longitudinal axis of the needle 40 and catheter 50. The finger interface 22 may have some concavity to prevent slipping of the user's finger. Other textures and features may be added within the same invention. One embodiment of the invention may also incorporate a smaller finger interface 24 (see
Catheter advancer 20 has at least one and preferably two rail guides 23 that slidably integrate with track(s) 15 of base 10. Rail guide 23, through slidable integration with track 15, is constrained to provide linear, non-twisting advancement of catheter hub 51 about needle shaft 43 when distal, longitudinal force is applied at finger interface 22. Preferably there are two rail guides 23, laterally spaced to fit outside the width of needle hub 41. Catheter advancer 20 may contain features to facilitate maintaining engagement with the catheter hub 51, while also enabling free disengagement thereof. These features may include at least one release member 25 and preferably two lateral members 25 as shown in
In reference to
Extending distally from traction pad 31 are legs 35, which are preferably spaced apart sufficiently wide to create window 36, through which the user can clearly visualize the target vessel in which catheter 50 will be inserted. Legs 35 come together at the distal end to form a tip 37, which provides a constraint on needle and catheter motion in one direction when the needle and catheter are rested on it. Tip 37 may also incorporate other features, such as upwardly protruding yoke 38, which provide additional stop limit constraints on needle 40 and catheter 50 motion at their respective tips. In the pictured preferred embodiment, needle tip 42 is constrained vertically and laterally when placed on stabilizer tip 37 between protrusions 38, such that the effect of any micro-manipulations at the user's hand are minimized or removed prior to and during insertion. By incorporating such a component that combines skin traction and needle tip stabilization, errors due to patient movement, especially in ambulatory environments, are minimized since the needle tip and patient skin are coupled and will move together.
In operation, the intravenous access assist device 2 is assembled and a needle 40 carrying a deployable catheter 50 is loaded therein such that the catheter advancer 20 lightly engages catheter 50 at its hub 51. The needle 40/catheter 50 combination is advanced by pushing the catheter advancer 20 for linear translation there along until base 10 securely engages needle 40 at its hub 41, at which point continued translation pushes the catheter 50 off needle 40.
It should now be apparent that the foregoing provides an easy-to-use IV placement assist device that is designed to pull the skin taut and stabilize the vein, and decrease reliance on freehand approximation of the approach angle, insertion of the needle, and advancement of the catheter. The device enables greater control in the needle/catheter assembly for approach and advancement, facilitates small movements of the needle/catheter or either part individually, and prevents unwanted movement, all without interrupting the flow of the IV start procedure. This facilitates more efficient IV placement and success rates, and decreases vessel trauma, IV failure, and patient discomfort.
Having now fully set forth the preferred embodiments and certain modifications of the concept underlying the present invention, various other embodiments as well as certain variations and modifications thereto may obviously occur to those skilled in the art upon becoming familiar with the underlying concept. It is to be understood, therefore, that the invention may be practiced otherwise than as specifically set forth herein.
Number | Date | Country | Kind |
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PCT/US16/14250 | Jan 2016 | US | national |
The present application derives priority from U.S. Provisional Patent Application 62/345,593 filed 3 Jun. 2016, and derives priority from International Application PCT/US16/14250 filed 21 Jan. 2016, which in turn derived priority from provisional application No. 62/106,403 filed 22 Jan. 2015.
Number | Date | Country | |
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62345593 | Jun 2016 | US |