Abstract
This study aimed to evaluate a two-stage tourniquet that applies the muscle-milking mechanism of the upper arm. We hypothesized that the milking effect increases blood flow and makes it easier to dilate the peripheral veins because muscular motion compresses a wide range of veins.
Method：This study included 38 clinical nurses. A two-stage tourniquet, combining an elastic with an 80 mmHg blood pressure cuff, was compared to a conventional elastic tourniquet. The nurses marked as many veins as possible for peripheral intravenous catheterization ( PIVC ) . The marked veins were evaluated using ultrasound image analysis, video analysis with a near-infrared camera, and a subjective palpable scale.
Results：Data analysis was conducted on 37 participants. The time required to determine the puncture site for the PIVC was significantly shorter with the two-stage tourniquet, and the nurse-assessed palpable scale of the vein was significantly higher. No significant differences were observed in the depth from the skin surface to the top or cross-sectional area of the vein.
Conclusion：The two-stage tourniquet enhanced the nurse-assessed palpation scale and reduced the duration required to select the peripheral vein for PIVC. This method is expected to improve the first-time success rate of PIVC and aid the development of medical devices that assist in venipuncture, such as electronic tourniquets.
