80% of hospital admissions are accompanied with a peripheral intravenous cannulation (PIVC) (1) – a procedure where a thin plastic tube is inserted into a vein to administer medication, fluids or to take blood samples from the patient.
As the most prevalent healthcare procedure, 32,000,000 cannulations are performed on patients every year in the UK (2). While for some patients this is a straightforward and simple procedure, for others – such as those receiving repeated courses of chemotherapy – PIVC can be distressing and painful with a failure rate between 33-69% (2).
PIVC failure is not only difficult and potentially traumatising for the patient, it can also delay their treatment. As cannulas cannot be reused after an unsuccessful attempt, the hospital also incurs the cost of re-cannulation, the cost of nursing time spent trying to successfully cannulate the patient and the cost of clinical waste disposal. Currently methods to increase chances of a successful PIVC typically lack temperature or time control and include techniques such as immersing the arm in warm water, using heat pads or even using a hair dryer to warm the area to expand the blood vessels in the arm. These methods run the risk of burning or overheating the area and even increase the risk of infection.
Airglove™, created by Green Cross Medico, is an air warming system developed to enable easier cannulation of veins in the arm. The patient places their lower arm within a double-walled ‘glove’ which is attached to the Airglove unit. The device gently warms the arm on a three minute cycle which vasodilates the veins in the arm.
Airglove has three temperature settings (31.5c, 35.5c 38.5c) to tailor the heat level to the patient’s skin type/requirements while the double-walled glove allows the warm air to circulate around the inner and outer glove ensures no direct air contact on the patients skin. The device also works in line with hospital infection control policies.
Health Innovation East partnered with Green Cross Medico, and supported the pilot of Airglove across 11 oncology departments in the Eastern region, demonstrating real-world benefit for patients and staff.
To establish the cost benefits of Airglove, Health Innovation East also supported an independent economic assessment by Health Enterprise East which showed potential savings of £31.1m over 3 years in oncology alone (£14.6m consumables and £16.5m in nursing time). (2)
Currently we are working together on an online patient/staff experience cannulation survey with Heather McVicars, Clinical Research Nurse Manager at Edinburgh Western General Cancer Centre, St Johns Hospital Livingston and Dr Karen Harrold at Mount Vernon Cancer Centre.
Heather McVicars shared:
“We are at the halfway point of survey and the information collected so far is really interesting. It shows 25% of patients are anxious about cannulation with 42% reporting difficulties in the cannulation process. So far the survey responses demonstrate the potential impact Airglove could have in elevating patients worries and improving their experience of being cannulated.”
“I used the Airglove for a lady with breast cancer and difficult access, I’d not been able to find a vein at all and used Airglove as a last resort without much hope that it would help – managed to cannulate her first time.” – Radiographer, South Tees Hospital NHS Foundation Trust
Airglove is now used in over 140 NHS Trusts, with over 200 units in use covering 11 clinical areas including oncology, haematology, infusion, radiology, nuclear medicine, plasma exchange therapy, apheresis, acute assessment, clinical skills, PET scan and blood donation.
The technology was used in a patient service evaluation trial at Maidstone and Tunbridge Wells NHS Trust that demonstrated an 87.5% success rate with first time cannulation after using Airglove with their most difficult to cannulate patients in oncology. This was compared to 60% rate success in a reverse audit when using warm water immersion at the Beatson, West of Scotland Cancer Centre. Staff have also reported that the ‘arm stays warmer and the veins palpated for longer’ when using the device in comparison to warm water submersion which was proven in ultrasound trials at Glasgow Caledonia University.
Following their pilot of Airglove, Cambridge University Hospital NHS Foundation Trust purchased four Airglove units for use by services beyond oncology in haematology, apheresis and infusion to increase its adoption across the Trust. All 11 oncology departments in the Eastern region who trialled the device adopted the innovation based on data from the pilots.
“Airglove has helped out with some really difficult cases where we would sometimes have to move to central lines.” – Paul Boraks, Lead Nurse E10 Apheresis Unit, Addenbrookes Hospital
The NHS has committed to a 10% reduction in clinical single-use plastics in the short term, eventually saving a total of 224 ktCO2e (3). Airglove has the potential to support the NHS in reaching this target with the consumable waste savings predicted to be £14.6m over 3 years in oncology alone due to higher success rates for cannulations. There are even further potential CO2 savings with reduced clinical waste disposal.
Going forward, Airglove will have a bio-degradable glove which can be disposed of with no impact on the environment and to further reduce the environmental impact, a second version of Airglove with a repairable unit will be launched in 2024.
As well as creating a bio-degradable glove and a repairable unit, to meet the needs of younger patients, the second version of Airglove will also be available for paediatric patients.
Future development of Airglove includes the creation of an Airglove Leg for Peripheral Arterial Disease (PAD) where there is narrowing or blockage of the vessels that carry blood from the heart to the legs. Airglove Leg is currently being developed alongside Professor Philip Stather at the Norfolk and Norwich University Hospitals NHS Foundation Trust.
View the Airglove infographic here.
Green Cross Medico offers a free four-week trial for any hospitals/healthcare centres looking to trial Airglove. To find out more please get in touch with Jo Dempsey, Principal Advisor, Commercial Enterprise Lead, Health Innovation East, by emailing joanna.dempsey@healthinnovationeast.co.uk.