Patients presenting with difficult intravenous access (DIVA) has been the subject of over 100 clinical studies in the past decade (1), Cannulation (accessing a vein for medical reasons) is performed 32 million times a year in the UK (8,767 a day) and over 1.2 billion a year globally (2,3,4,5). The Airglove Arm is a disposable double walled glove that warms a patients arm to a controlled range in just 3 minutes – to provide the best chance of achieving first time cannulation – by warming the blood vessels Airglove optimises vein location in the hand and forearm.
The Airglove Arm is a simple yet disruptive solution for DIVA. A recent service evaluation shows that Airglove patients achieve 87.5% first time cannulation success against a 68-75% success rate (6,7) with current widely adopted practice.
Current technologies focus on visualisation but do not consider changing the physiological state of the vein. Challenges associated with current approaches to cannulation include phobias, missed treatment, injury and infection (8,9,10, 12, 13, 14, 15, 16).
Airglove, having now been used in over 140 hospitals, reduces failure rates associated with cannulation. A budget impact analysis shows that over three years its adoption could save the NHS £31m in oncology alone.
As the Clinical Research Oncology Nurse Manager at a large teaching hospital in Scotland I am impressed with the results we have had when using the Airglove on our oncology patients… we now use the machines in our oncology department with outstanding results.
Airglove can help maintain quality and safety when cannulating, specifically for patients presenting with difficult intravenous access. Better vein preparation increases the chance of first time access. It enhances the experience for nurses and practitioners delivering cannulation and helps to improve mental health outcomes for patients by reducing stress and anxiety caused by difficult cannulation (17).
Health Innovation East has supported Airglove since November 2020, together we have;
Trailed Airglove across 11 NHS trusts in the East of England including but not limited to – Cambridge University Hospitals NHS Foundation Trust (Addenbrookes Hospital), Bedfordshire Hospitals NHS Foundation Trust (Bedford Hospital), Mid & South Essex NHS Foundation Trust (Chelmsford Hospital), North West Anglia NHS Foundation Trust (Hinchingbrooke Hospital) and East & North Hertfordshire NHS Trust (Lister Hospital) and West Suffolk NHS Foundation Trust (West Suffolk Hospital).
Completed a Budget Impact Analysis, alongside Health Enterprise East.
Conducted a patient and staff cannulation survey within the Edinburgh Western General Cancer Centre.
Developed a value proposition and infographics, bid writing and by enabling access to key NHS stakeholders.
Round one of Airglove’s funding secured £250,000 and is soon to conclude Tranche 2 of its fundraising which has secured a further £250,000 co-investment from Scottish Enterprise and private investment, which totals £500,000. Airglove has created two new job posts and sustained two further posts.
Building on the success of the first stage of Airglove’s development, Airglove Medical ltd. will launch Airglove V2 in April 2025, with a view to reaching all UK Cancer Networks and opening discussion with ICB’s and Trusts to assist with all DIVA patients and build a Value Based Procurement model of adoption – with a view to landing at least one Airglove product in every UK hospital.
Following Airglove V2’s launch the company will begin the research and development process for Airglove for peripheral arterial disease (PAD). Working with Prof. Philip Stather, Consultant Vascular and Endovascular Surgeon, Norfolk and Norwich University Hospital.
Read how Airglove is improving cannulation in the East of England in our impact story.
References
(1) Defining risk factors associated with difficult peripheral venous Cannulation: A systematic review and meta-analysis Data. Heart & Lung, ISSN: 0147-9563, Vol: 49, Issue: 3, Page: 273-286. Publication Year2020.
(2) Pain upon inserting a peripheral intravenous catheter: Size does not matter. Fredericus Hj van Loon 1 2 3, Lisette Apm Puijn 3, Wesly H van Aarle 3, Angelique Tm Dierick-van Daele 1 2, Arthur Ra Bouwman 3 4.
(3) Peripheral venous catheters: an under-evaluated problem. Zingg W, Pittet D. Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents. 2009;34 Suppl 4:S38-42. [PubMed].
(4) The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study. Piper R, Carr PJ, Kelsey LJ, Bulmer AC, Keogh S, Doyle BJ. The mechanistic causes of peripheral intravenous catheter failure based on a parametric computational study. Sci Rep. 2018 Feb 21;8(1):3441. [PMC free article] [PubMed]
(5) Evan Alexandrou RN, BHealth, ICU Cert, MPH, PhD, Gillian Ray-Barruel RN, BSN, BA, ICU Cert et al. International prevalence of the use of peripheral intravenous catheters. Journal of Hospital Medicine, 10 (8).
(6) Marsh N, Webster J, Larsen E, et al. Expert versus generalist inserters for peripheral intravenous catheter insertion: a pilot randomised controlled trial. Trials 2018;19:564. 10.1186/s13063-018-2946-3
(7) Mörgeli, R., Schmidt, K., Neumann, T. et al. A comparison of first-attempt cannulation success of peripheral venous catheter systems with and without wings and injection ports in surgical patients—a randomized trial. BMC Anaesthesiology 22, 88 (2022).
(8) Miliani K., Taravella R., Thillard D., Chauvin V., Martin E., Edouard S., Astagneau P., CATHEVAL Study Group Peripheral venous catheter-related adverse events: Evaluation from a multicentre epidemiological study in France (the CATHEVAL project) PLoS ONE. 2017;12:1–17.
(9) Melanie Crowley, Carla Brim, Jean Proehl, Susan Barnason, Sherry Leviner, Cathleen Lindauer, Mary Naccarato, Andrew Storer, Jennifer Williams, AnnMarie Papa, Emergency Nursing Resource: Difficult Intravenous Access, Journal of Emergency Nursing, Volume 38, Issue 4, 2012, Pages 335-343, ISSN 0099-1767.
(10) Bensghir M., Chkoura K., Mounir K., et al. Peripheral intravenous access in the operating room: characteristics and predictors of difficulty. Ann Fr Anesth Reanim. 2012;31:600–604.
(11) Angles E., Robin F., Moal B., et al. Pre-operative peripheral intravenous cannula insertion failure at the first attempt in adults. Development of the VENSCORE predictive scale and identification of risk factors. J Clin Anesth. 2021;75 doi: 10.1016/j.jclinane.2021.110435.
(12) Carr PJ, Rippey JCR, Cooke ML, et al Development of a clinical prediction rule to improve peripheral intravenous cannulae first attempt success in the emergency department and reduce post insertion failure rates: the Vascular Access Decisions in the Emergency Room (VADER) study protocol BMJ Open 2016;6:e009196. doi: 10.1136/bmjopen-2015-009196.
(13) Carr PJ, Rippey JA, Budgeon CA, et al. Insertion of peripheral intravenous cannulae in the emergency department: factors associated with first-time insertion success. J Vasc Access 2015. doi:10.5301/jva.5000487. [Epub ahead of print 4 Dec 2015].
(14) Cuper NJ, de Graaff JC, van Dijk ATH, et al. Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary paediatric hospital. Paediatr Anaesth 2012;22:223–9. doi:10.1111/j.1460-9592.2011.03685.
(15) Jacobson AF, Winslow EH. Variables influencing intravenous catheter insertion difficulty and failure: an analysis of 339 intravenous catheter insertions. Heart Lung 2005;34:345–59. doi:10.1016/j.hrtlng.2005.04.002.
(16) O’Neill MB, Dillane M, Hanipah NFA. Validating the difficult intravenous access clinical prediction rule. Pediatr Emerg Care 2012;28:1314–16. doi:10.1097/PEC.0b013e3182768bc9.
(17) Peripheral intravenous cannulation: managing distress and anxiety. October 2014, British Journal of Nursing 23, Suppl 19 (Sup19): S4-9 DOI:10.12968/bjon.2014.23.Sup19.S4.
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