Use of Esmarch bandage does not increase peripheral vein size in healthy volunteers: A randomized clinical trial

Am J Emerg Med. 2024 Sep:83:20-24. doi: 10.1016/j.ajem.2024.06.033. Epub 2024 Jun 25.

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.

Keywords: Catheterization; Emergency medicine; Emergency service; Hospital; Humans; Interventional/methods; Peripheral/methods; Phlebotomy; Ultrasonography; Veins/diagnostic imaging.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bandages
  • Catheterization, Peripheral* / methods
  • Cross-Over Studies*
  • Female
  • Healthy Volunteers*
  • Humans
  • Male
  • Middle Aged
  • Single-Blind Method
  • Tourniquets*
  • Ultrasonography, Interventional / methods
  • Veins* / anatomy & histology
  • Veins* / diagnostic imaging
  • Young Adult