Esmarch bandage does not increase peripheral vein size
Abstract:
Introduction: Ultrasound is used for peripheral intravenous (PIV) cannulation in patients with difficult landmark-guided IV access in the Emergency Department. Distal-to-proximal application of an Esmarch bandage on the target limb has been suggested as a method for increasing vein size and ease of cannulation.
Methods: This study was a single-blinded crossover randomized controlled trial comparing basilic vein size under ultrasound with use of an Esmarch bandage in addition to standard IV tourniquet (“tourniquet + Esmarch”) compared to use of a standard IV tourniquet alone. Participant discomfort with the tourniquet + Esmarch was also compared to that with standard IV tourniquet alone.
Results: Twenty-two healthy volunteers were used to measure basilic vein size with and without the Esmarch bandage. There was no difference in basilic vein size between the two groups, with a mean diameter of 6.0 ± 1.5 mm in the tourniquet + Esmarch group and 6.0 ± 1.4 mm in the control group, p = 0.89. Discomfort score (from 0 to 10) was different between the groups, with a mean discomfort score of 2.1 in the tourniquet + Esmarch group and 1.1 in the standard IV tourniquet alone group (p < 0.001).
Conclusions: This study showed that the use of an Esmarch bandage does not increase basilic vein size in healthy volunteers but is associated with a mild increase in discomfort.
Reference:
Paterson R, Euerle B, Salerno A, Miller T, King S, Gatz JD. Use of Esmarch bandage does not increase peripheral vein size in healthy volunteers: A randomized clinical trial. Am J Emerg Med. 2024 Jun 25;83:20-24. doi: 10.1016/j.ajem.2024.06.033. Epub ahead of print. PMID: 38943708.