70300

Advanced Venipuncture Arm (Light Skin Tone)

Skin Tone

Model

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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.

The Advanced Venipuncture Arm can be used to accurately simulate venipuncture, IV cannulation, and IV infusion.

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

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.

Take a look at how easy it is to re-skin and re-vein our IV arms. (Limbs & Things YouTube channel, runtime 1m 10s.)

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.

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

Product Contains

Light
Dark

Venipuncture Arm Skin (Light Skin Tone)

Venipuncture Arm Rest

Concentrated Venous Blood - Starter Pack

Venipuncture Arm Infusion Tube

ACF Vein Module

Metacarpal Vein Module

Pressurized Venipuncture Arm Mock Blood Supply

Refill Bottle

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

Undergraduate

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)

Postgraduate

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

Plebotomy Technicians

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.

Nursing (LPN with certification and RN)

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.

Paramedic/EMT

National Standard EMT-Paramedic Curriculum EMT-Paramedic: National standard curriculum: Venous Access and Medication Administration

Undergraduate

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

Postgraduate, Residency, Junior Doctors

Doctors should be able to provide safe treatment to patients through competently performing certain procedural and/or assessment skills Intravenous Venipuncture Intravenous cannulation

Undergraduate Medicine

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.

Postgraduate

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

Core Medical Training

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

Emergency Medicine Trainees

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

Physician Assistants

NHS National Practitioner Program: Matrix Specification for the Physician Associate (2016). p.127: Core Procedural Skills: Venipuncture; IV cannulation; Arterial Blood Gas Sampling

Registered Nurses

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

Healthcare Assistants

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…

Phlebotomists

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.