Luxeon Saves Patient Discomfort and Risk in the OR

My freshly built, first mod flashlight (Brinkman Legend stretched to use 3 AA's in direct drive) just saved the day. Sometimes, a patient who simply has no visible veins arrives at the operating room. The ensuing "line party" during which the poor person endures multiple attempts to start an IV isn't fun for either care givers or patient. None the less, a line must be placed for safe induction of anesthesia. Because the fall back when a peripheral IV cannot be placed is a riskier and more uncomfortable central neck line, every effort is expended to place a regular IV. That means the person gets stuck multiple times in vain before givein up and putting in a central line. Such a "line party" was going on when I happened upon the scene. Fortunately, I had my new light and had played with it against my skin the night before so I had an idea.

I had the room lights turned off and then placed my super bright luxeon mod against the patient's arm. Behold, I could see otherwise invisible veins and in very short order placed an IV so surgery could begin. That saved the patient from multiple more pokes and probably from having a central line placed in her neck.

Chock up one less risky invasive line to luxeon star's super bright, compact, and cool to the touch light output. The gasps at the light brightness were also entertaining. Now if I could only get one of those more compact Lambda's...

I've wondered about that. My son has been in the hospital many times both on floor and ER. Sometimes IV's go easily other times they call in the experts. Never heard the term "line party" but it is appropriate. I would think even a "hot" flashlight would work. Did you have to keep it on the skin for a while? Thanks for making that patient more comfortable--it is important.

I see the beginnings of a new hospital tool here. Someone better jump on the manufacturing rights quick...and I am absolutely serious, especially if this "veinless" situation occurs in the medical business frequently enough to earn its own jargon.

I'm somewhat shocked that using a bright light hasn't been considered before. Hospitals do have lights around, don't they? It seems that if this was a common issue, and the solution was so easy, hospitals would line up to buy your mod!

Seriously, maybe you can instigate change that will help ALL patients who are in the same predicament, even when you and your LS aren't available. What better legacy could you have?

I'm shining my LI through my arm right now. And my E2... Your mod must be VERY bright. I can't see the LI through my arm. Can't even see it through my hand in a darkened room. I can see it through my fingers though. I can see my E2 through my hand, but again, not through my arm (no, I'm not a longshoreman, nor am I Popeye).

We have had a discussion about this before, long, long ago. Apparently, the medical term for the principle is Transillumination.
It was said that ~200 Lu is necessary to make it easy to use. I think that it's also referred to on SFDB.

lightlover

Are you actually looking THROUGH the arm or AROUND the area where the light is pressed on the arm?

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR>Originally posted by Roy:
Are you actually looking THROUGH the arm or AROUND the area where the light is pressed on the arm?<HR></BLOCKQUOTE>

The light couldn't be going through the patient's arm!

I would think that the ultra white light of the Luxeon would be different enough from the yellower incandecents to show the blue vein.

I am going to try this when I get home!

I work in a hospital, so if this works, I am going to meet with our VP of nursing!

*something ridiculous ? I am also going to do a search on is Transillumination!

Thanks!

Around the light head, not through the arm. An area about three inches in diameter lights up and there show up the veins, even deep ones.

Man! I wish I had heard of this last October when my wife had our second child. It took them eight attempts to start an IV.

To think - a flashlight could have spared her.

All the more reason to carry a "bright one" around. I would have been happy to loan it to any doctor or nurse.

My question is, how did you stretch a Brinkman Legend to 3AA? I don't know enough about this regulation business to get into it so my first mod will end up being direct drive.

We use this all the time at UCSF for pediatrics, using the wall mounted lights though. The LED would be better since it won't heat up the skin or burn the patient.

I cringe every time I see someone pull out a maglight with a donut light pattern.

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR>Originally posted by Guy Kuo:
My freshly built, first mod flashlight (Brinkman Legend stretched to use 3 AA's in direct drive) just saved the day. Sometimes, a patient who simply has no visible veins arrives at the operating room. The ensuing "line party" during which the poor person endures multiple attempts to start an IV isn't fun for either care givers or patient. None the less, a line must be placed for safe induction of anesthesia. Because the fall back when a peripheral IV cannot be placed is a riskier and more uncomfortable central neck line, every effort is expended to place a regular IV. That means the person gets stuck multiple times in vain before givein up and putting in a central line. Such a "line party" was going on when I happened upon the scene. Fortunately, I had my new light and had played with it against my skin the night before so I had an idea.

I had the room lights turned off and then placed my super bright luxeon mod against the patient's arm. Behold, I could see otherwise invisible veins and in very short order placed an IV so surgery could begin. That saved the patient from multiple more pokes and probably from having a central line placed in her neck.

Chock up one less risky invasive line to luxeon star's super bright, compact, and cool to the touch light output. The gasps at the light brightness were also entertaining. Now if I could only get one of those more compact Lambda's...<HR></BLOCKQUOTE>

I had read somewhere about emergency personel carrying a pen flashlight for this very purpose, using a less bright Nichia. Something about the brightnes and whiteness of the light.

I wonder if different colors, perhaps red or blue, might work even better. Infrared light penetrates through the flesh very well, and with a common web eye, perhaps the veins would show up even better?

Seems like a good idea and applicaton here.

Wayne www.elektrolumens.com

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR>Originally posted by Guy Kuo:
Around the light head, not through the arm.<HR></BLOCKQUOTE>Oh. Oops. Let me go grab those lights again...

I can't believe I'm posting this...

I just had to try this to see of a red flashlight would penetrate better than a white flashlight. The two flashlights I tried are:

minimag mod - 500mA White LS.

2D3C Maglight with red/orange HD

Not sure why, but, the minimag seems to penetrate better. Could be the 2D3C has a larger lens area and spreads the light out more.

Just my observations.

-WayneY

The way I went about stretching the Brinkman was a little wasteful, but easy. I used two of them. A slightly longer than a single AA cell long segment from the end of one was sliced off the end of one flashlight. That end was then ground down to fit tightly into the end of the other, uncut flashlight. The joint was afixed with conductive epoxy since I couldn't solder aluminum. Any way, you end up with a 3 AA long Brinkman Legend body which can direct drive a Luxeon.

<BLOCKQUOTE><font size="1" face="Verdana, Arial">quote:</font><HR>Originally posted by Guy Kuo:
The way I went about stretching the Brinkman was a little wasteful, but easy. I used two of them. A slightly longer than a single AA cell long segment from the end of one was sliced off the end of one flashlight. That end was then ground down to fit tightly into the end of the other, uncut flashlight. The joint was afixed with conductive epoxy since I couldn't solder aluminum. Any way, you end up with a 3 AA long Brinkman Legend body which can direct drive a Luxeon.<HR></BLOCKQUOTE>

Hey guys, they do make 3AA Brinkmans. I've got one here Dan sent me, I modded it with the Illuminator circuit. Very bright for such a little thing.

Perhaps this should be tried to see if a little more light helps out............

I think one of the reasons the LS or any bright LED lights work better is the color of the light. It tends to make veins stand out against the color of skin, even a brighter light like an E2 doesn't make them as visible. I have often tried to get my wife to use this method to find veins (she is an ER nurse) she is the one just about everyone in the hospital goes to too start the hard "sticks". She swears by starting them by feel rather then sight, but for some people a LED would be a great tool.

I'll have to give this a try the next time one of my patients needs a line (although by the time I get called, it's for central access). Sometimes feel is better than sight - you can often feel the path of the vein in the subcutaneous fat. And then there are always the external jugular veins, which can be a life-saver (literally) at 2am

Our Anesthesia staff typically uses a Site-Finder ultrasound device if the person is truly a tough stick.

Sam

The small diameter, bright white light light means that a larger area of tissue is illuminated without a big flashlight head in the way. I used it for going after a tiny, impossible to feel "spider" vein after another anesthesiologist and two surgeons had been poking away on all four limbs. It's definitely staying in my bag of tricks. If I can save a central line on an ambulatory patient then its is worth trying. The EJ and cephalic vein at the shoulder I use as fallback sites, but this opens up more possibilities. Nobody likes having their neck poked.

I found the 3AA Legend on the Brinkmann website.
www.brinkmanncorp.com

Is the headroom on the Legend anything like the Mini-mag? Is hacking down the aluminum heatsink on the LS difficult? If it's too tricky I may just try a Mag 2D3C.