RobertMM, I really appreciate your sharing of your experience with this. I was showing some nurses the technique today using a Fenix PD30 on turbo. It doesn't get very hot, but is not all that bright, 257 lumens on turbo. They showed me a vein finder they have: looks like 2 prongs, each of which has 3 or 4 (dim) LED's and you are supposed to find the vein between the prongs. The PD30 is much better than the so-called vein finder. They were impressed and immediately used it to put an IV in a very large patient with no trouble on the first stick. I found that having two powerful flashlights side by side on a large forearm mimics the concept of the vein finder but works far better.
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Anyway, the nurses asked me some questions that I couldn't answer so I thought I would ask you to share more of your experience, if you don't mind. Questions (theirs and mine):
1. Do you mark the vein with a pen after you find it, or do you put the needle in with the other hand in real time?
2. Does a wider reflector work better than narrow reflector? Depth of reflector make any difference?
3. What light are you using and at what setting?
4. Do you hold the light directly perpendicular to the skin or do you find that angling it is helpful?
This is really great and a benefit to our patients. Thanks again for sharing.
Hi Doc. Please bear with me, I usually CPF with my smartphone so I have a hard time elaborating. Our hospital has two "wee sight" brand vein finders that you put under children's hands and turn off the lights to use, it has three 5mm(I know
)red LEDS bunched together. Works fine on new batteries, but on older children and adults it fails miserably.
1. I don't mark the vein, I hit them real time, light under the hand(Surefire E1e with Tana LED module or Fenix PD20 work great due to short length). Covering overhead lighting with my hand usually is enough to let me see the light from below, but sometimes I do it with lights off (to the surprise of some parents,they think it's some trick). For fidgety children I have relatives hold down other limbs.
2. Small reflectors are enough, the big ones sometimes let light escape at the side of the hands of small children and blind me at inopportune times.
3. I have used a Nitecore EA4(too large)on high only, too hot on turb, a Surefire LX2 on low and high, the aforementioned SF E1e (120 lumen high, enough for most cases),a Fenix PD20 on high with short turbo bursts, a Quark QTA with XPG2 on turbo(doesn't get very hot). I have also used a Surefire 6P with Solarforce XML, medium mode only works well, 500lumen turbo too hot. Surefire G2led(single mode) gets hot too so I stopped using it.
The small lights work better, as expected. The LX2 heats up so no use for prolonged vein searching, and no turbo use for the others as well except for short bursts on really heavy/edematous patients.
4. I hold it under the hand, or if too fat,or if using the antecubital area, perpendicular. I use the light to "scan" and when I see a shadow I focus on that,see if the vein is wide enough or has a long enough straight area to accomodate the catheter.
One thing about transilluminating veins is that I see when veins pop because they are too fragile, no mistaking the blood you see spreading around the puncture site, under the skin.
I'd like to leave a final note, though: I don't let anyone use my lights to do this except for the QTA or E1e, for fear they might cause burns when used too long on turbo by those who don't listen to my directions. Those two only get warm.
Hope this helps.
