The Advanced Venipuncture Arm can be used to accurately simulate venipuncture, IV cannulation, and IV infusion.
Limbs & Things venipuncture arms accurately represent the key haptics of veins in a male right arm. Using palpation, trainees can determine the location of the veins to draw a blood sample or administer an intravenous injection.
The mock blood system offers a real-life training experience. Trainees will experience realistic blood pressure, blood flashback when entering the vein, and stemmed flow with digital pressure.
Improvements for a better training experience
This model retains popular features of the original venipuncture range, including, realistic blood flashback, vein haptics and soft flexible skin. To increase user experience within the classroom, enhancements have been made to improve its ease of use and durability.
Vein Gripping System - Simplifying the re-veining process, the underlying arm now includes recesses for the veins. This allows for an accurate and secure placement with little to no chance of movement when re-applying the arm skin.
Modular Veins - The veins have been split into two separate pieces, the Metacarpal Vein Module and the ACF Vein Module. Having the two vein modules rather than one, trainees are able to use each section until it needs replacing, reducing waste and making the product more cost effective.
Veins of the basilic, cephalic, dorsal metacarpal and median cubital regions are all present in the advanced model.
Unique Skin Locking System – New skin designs (for both light and dark skin tones) utilise a peg system which secures the edges of the loose skin close to the underlying arm. Carefully positioned on the underside of the arm, the pegs won’t interfere with any training scenarios.
Pressurized System – The improved fluid system operates at a realistic blood pressure, this reduces blood leakage from the veins and prolongs the life of the individual modules.
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The blood used with this product now contains a new preservative approved for use by EU cosmetic regulations which means that, once diluted, it is safe for extended skin contact.Â
We still recommend the use of gloves, as the pigments may stain skin and clothes.
Overview
- Vein structures are now modular with a separate ACF vein and Metacarpal Vein, allowing for replacement of individual parts
- New and improved skin-locking system (patent pending) improves arm re-skinning after replacing a vein module
- New vein gripping system allows for easy re-fitting and positioning of veins
- Advanced Pump System reduces internal leakage for a more user-friendly experience
- Veins are palpable with realistic haptics for accurate clinical use
- Infusion tube allows for intravenous fluids to be administered
- Includes pressurized blood system
Realism
- Arm provides a realistic blood flashback upon insertion of needle
- Improved arm skin offers a more realistic look and feel
- Veins in the metacarpal & ACF modules are palpable
- Realistic representation of the antecubital fossa (SCF) and metacarpal regions
- With the Advanced Pump, the advanced venipuncture arm operates at an accurate blood pressure
- Gripping systems secures veins in a true-to-life position
Versatility
- Arm is compatible with vacuum blood collection systems, needles & syringe, and IV cannulas
- Extended tubing allows for extra maneuverability in the classroom for use with a simulated patient
Cleaning
- Flush liquid from the vein and fluid system before storing your product
- Clean the skin surface with a damp soft cloth, using warm water and mild detergent
- Allow skin to thoroughly dry before storing
Safety
- Only use Concentrated Venous Blood supplied with the arms, or product numbers 00020 & 00021, other fluids may weaken or damage the venipuncture simulator
- Use water-based lubricant to fit arm skin over the venipuncture arm base
- Veins contain latex, however, these are covered by the silicone arm skin during procedures
Simulated Patient
- Suitable for use with a simulated patient to test communication skills
Anatomy
Sites for peripheral venous cannulation
- Dorsal metacarpal vein in the hand
- Antecubital Fossa (ACF) vein in the arm
Metacarpal Vein Module anatomy 
- Basilic vein 
- Cephalic vein 
- Dorsal metacarpal veins 
ACF Vein Module anatomy 
- Basilic vein 
- Cephalic vein 
- Median cubital vein 
Skills Gained
- Intravenous Cannulation in dorsal metacarpal and ACF sites
- IV infusion
- Venipuncture
- Practice of aseptic techniques
- Communications skills when using a simulated patient
Product Contains
Comparison |
Basic | Standard | Advanced | |
---|---|---|---|---|
What's included | 70304 | 70302 | 70300 | |
- | Venipuncture Arm Core | Yes | Yes | Yes |
70312 | Venipuncture Arm Skin (Light Skin Tone) | Yes | Yes | Yes |
00302 | Venipuncture Arm Rest | Yes | Yes | Yes |
00020 | Concentrated Venous Blood | Yes | Yes | Yes |
00335 | Venipuncture Arm Infusion Tube | Yes | Yes | Yes |
70309 | Basic Venipuncture Arm Vein | Yes | No | No |
70306 | ACF Vein Module | No | Yes | Yes |
70307 | Metacarpal Vein Module | No | Yes | Yes |
70316 | Gravity System Blood Supply | Yes | Yes | No |
70315 | Pressurized Venipuncture Supply | No | No | Yes |
- | Micropore Tape | Yes | Yes | Yes |
- | Lubricant Sachets (x3) | Yes | Yes | Yes |
00303 | Refill Bottle | No | No | Yes |
References
AAMC Preclerkship Medical Skills Venipuncture is listed on the foundation list of basic clinical procedures for the preclerkship student. Specific skills identified: • Insert needle at proper angle • Withdraw appropriate amount of blood • Withdraw needle and check for bleeding • Dress area appropriately • Dispose of needle appropriately AAMC Undergraduate Clinical Skills Also listed in Undergraduate skills: Cardiovascular: Venipuncture/Venous cannulation (needle, catheter)
ACGME Emergency Medicine Milestones ACGME recommendations in milestone documents. Examples: Other Diagnostic and Therapeutic Procedures: Vascular Access (PC14) Successfully obtains vascular access in patients of all ages regardless of the clinical situation. Level 1: Performs a Venipuncture, places a peripheral intravenous line, performs and arterial puncture. ACGME Surgery FAQ Defined tasks for PGY-1 residents may be supervised indirectly for the following procedural competencies: a) performance of basic venous access procedures, including establishing intravenous access b) placement and removal of nasogastric tubes and Foley catheters c) arterial puncture for blood gases
MN Phlebotomy Technician Certificate Program Curriculum During the 10-week program, students are required to perform approximately 100 successful phlebotomy collections within the outpatient setting prior to advancing to the inpatient setting. Students then continue with venous collections, though they are also exposed to arterial punctures, collecting specimens from arterial lines and assisting nurses with central line collections. Students must complete approximately 160 total clinical training hours.
US Department of Health and Human Services, IV Fluid therapy in adults in hospital Skilled and competent healthcare professionals should prescribe and administer IV fluids, and assess and monitor patients receiving IV fluids.
National Standard EMT-Paramedic Curriculum EMT-Paramedic: National standard curriculum: Venous Access and Medication Administration
Clinical Skills in the Undergraduate Medical Curriculum 2013, University of Otago Punctures and Aspirations: Venipuncture - for routine blood tests • can independently perform the skill safely and effectively in the clinical setting in Years 4/5/6/TI Peripheral intravenous cannulation • In years 4/5 student should be able to demonstrate performance of the skill but does not indicate or equate to competence at the skill. • Can independently perform in clinical setting in Yr 6/TI
Doctors should be able to provide safe treatment to patients through competently performing certain procedural and/or assessment skills Intravenous Venipuncture Intravenous cannulation
Outcomes for graduates (Tomorrow's Doctors), Appendix 1 - Practical procedures for Graduates, p.12-14: 4. Venipuncture. Inserting a needle into a patient's vein to take a sample of blood for testing, or to give an injection into the vein. 17. Establishing a peripheral intravenous access and setting up an infusion; use of infusion devices. Puncturing a patient's vein in order to insert an indwelling plastic tube (known as a cannula), to allow fluids to be infused into the vein (a drip). Connecting the tube to a source of fluid. Appropriate choice of fluids and their doses. Correct use of electronic devices which drive and regulate the rate of fluid administration.
UK Foundation Programme Curruculum, August 2014, p.50: Table 2. Commonly requested investigations • Venipuncture • IV cannulation • Preparation and administration of IV medication and injections and fluids F1 outcomes • Competently performs and, when sanctioned by a supervisor, teaches medical students in the ... procedures ... either in the workplace or on simulated patients F2 outcomes (in addition to F1) • Maintains and improves skills in the core proced- ures e.g. reliably able to perform venous cannulation in the majority of patients in more challenging circumstances such as during resuscitation • Demonstrates extension of the range of procedures they can perform GMC Outcomes for provisionally registers doctors with a licence to practise (The Trainee Doctor), 2015, p,8: Core clinical and procedural skills ...: Venipuncture, IV cannulation, Prepare and administer IV medications and injections...Intravenous infusion including the prescription of fluids, Intravenous infusion of blood and blood products
Specialty Training Curriculum for Core Medical Training, August 2013, p.165: The CMT STR is expected to be competent, and maintain competency, in the following practical procedures in the Foundation curriculum during Core Medical Training: … Venipuncture
THE ROYAL COLLEGE OF EMERGENCY MEDICINE Curriculum and Assessment Systems For Training in Emergency Medicine 2015 (Revised 2016): CMP4 Septic Patient … takes blood cultures and administers … intra-venous fluids in accordance with 6 hr sepsis bundle ICM Competency: Demonstrates aseptic peripheral venous cannulation • Demonstrate the ability to establish peripheral venous cannulation using an appropriate technique, demonstrating effective infection control measures and proper regard for patient safety and well being
NHS National Practitioner Program: Matrix Specification for the Physician Associate (2016). p.127: Core Procedural Skills: Venipuncture; IV cannulation; Arterial Blood Gas Sampling
RCN Standards for Infusion Therapy: Nursing involvement ranges from caring for an individual with a peripheral cannula in situ, to … Infusion nursing is not limited just to the care of the patient and the device. Increasingly nurses are responsible for the insertion and removal of the device Veins that should be considered for peripheral cannulation are those found on the dorsal and ventral surfaces of the upper extremities including the metacarpal, cephalic and basilic p 26 p35 Vascular Access Device Removal The removal of any vascular access device must only be undertaken by an appropriately trained practitioner. Those commonly removed by nurses include cannulas, 8.11 Blood Sampling p.58 Blood sampling (Venipuncture, blood cultures, capillary blood sampling or via vascular access devices) should be performed on request of a clinician and/or health care professional or according to established protocols, using aseptic technique and observing standard precautions. NMC Future nurse: Standards of proficiency for registered nurses, 17 May 2018, p.32: 2.2 undertake Venipuncture and cannulation and blood sampling, interpreting normal and common abnormal blood profiles and venous blood gases
The Cavendish Review - An Independent Review into Healthcare Assistants and Support Workers in the NHS and social care settings - July 2013, p18 Advanced tasks 3.7.1. Partly as a consequence of nurses spending increasing time on organisational tasks, some HCAs are now doing a wide range of more advanced tasks traditionally undertaken by registered nurses. These include … cannulation (the insertion of an IV drip or tracheotomy tube)…. setting up infusion feeds … taking blood samples…
Direct gov careers website says: Training and development: You will usually receive on-the-job training, which can take up to six months and include: … • methods of blood collection and labelling • choosing appropriate sites for taking blood samples (Venipuncture) … UCL 1 day phlebotomy course This course is designed for any healthcare professional or research scientist who is required to take blood from patients in a clinical or research environment. We also accept members of the public who are planning to pursue a career as a hospital phlebotomist: “Participants will practise on simulation arms – never more than 2 participants per arm. After practising the skill on a manikin you will have the opportunity to take blood from a fellow participant providing they give consent. By the end of this session, candidates will be able to: Demonstrate appropriate infection control principles when performing phlebotomy. Use both the butterfly system and the vacutainer system to collect a blood sample. List the potential complications during and after taking blood. Take blood from a real person under supervision. You will NOT receive a certificate of COMPETENCE; only of Attendance. You cannot claim that you are competent in phlebotomy after only one successful attempt on a real person. Competence will be deemed by future employers and can vary between institutions.”
How are these different to the previous venipuncture arm models?
While the idea of the model is the same, the components have been updated to improve the teaching and learning experience. With the new skin locking system and modular veins of the Advanced Arm, set-up is much easier. The modular veins also mean that you only need to replace the individual section when needed, reducing the ongoing cost of consumables.
We already have the Limbs & Things Standard Venipuncture Arms, are we able to upgrade to the advanced model?
Yes. Adding the Pressurized Venipuncture Arm Mock Blood System to your Standard Arm set-up will give you the most true-to-life learning experience.
Can trainees perform intravenous cannulation on this venipuncture and injection arm?
Trainees can practice IV cannulation with this model. Used with a simulated patient, you can also practice aspects of the procedure that are commonly tested with this skill.
Can we purchase the advanced venipuncture models in bulk?
Yes. Limbs & Things offer packs of the Advanced Venipuncture Arms, these contain 5 AVA Trainers (70300), 5 ACF Vein Modules (70306 and 5 Arm Skins (70312)). Advanced Arm value packs can be purchased in Light Skin Tone or Dark Skin Tone versions.
Troubleshooting
My advanced pump doesn’t pump up very high, I find it continually needs to be ‘re-pumped’
Check that the clip on the arm tube leading into the advanced pump is closed. If this clip is open, no pressure can be built up.
The advanced arm pump has been designed to stop pressure from overbuilding in the veins. This extends the use of the veins dramatically but at the cost of requiring more regular re-pumping.
The gauge dial on the front of the pump is not supposed to exceed the green zone and the arm should still provide flashback on cannulation as long as the dial is above the red zone.
My advanced pump will not prime the arm with blood
Check the following things on your trainer:
- Both white clips on the arm tubing are open
- The red slider on the advanced pump is all the way to the left
- Check that the veins inside the arm are not kinked or blocked
- Squeeze the pump bulb 5-10 times to initiate blood flow
If blood still does not flow, there may be an issue with the valve inside the advanced pump. Contact customer services or your local rep regarding the issue.
Can I use the blood delivery systems from my old venipuncture arm units on my new arm trainers?
While it is possible, the higher pressure may cause damage to the newer arms and void your warranty.
What has changed between the new advanced pump and the older version?
Improvements to lower the pressure in the arm were implemented into the advanced pumps. This gives a more realistic flashback on cannulation and extends the usage life of the veins.
My advanced pump is leaking blood during use
There are two common causes of a leaking pump:
- The pump is overfilled - No more than 300ml of blood should be in the pump at any one time
- Fittings and tubes are only partially connected - Check joins around the suspected leak. You may need to open up the pump to check some joins
There's blood pooling under the arm skin during use
Check the connections between the vein modules. If there's no evidence of leakage, check the veins around the common injection points, it may be a sign that the vein module needs to be replaced.