title: A technique for ultrasound-guided blood sampling from a dry and gel-free puncture area.
abstract: OBJECTIVE
  Vein punctures are performed daily to sample blood. Ultrasound (US) offers an alternative to the blind landmark technique for difficult vascular access. A challenge for this procedure is the presence of US gel in the puncture area. We present a technique for US-guided puncture from extremity veins not palpable or visible to the human eye, while keeping the puncture area dry and gel-free.
  
  
  METHODS
  Ten healthy volunteers underwent two US-guided vein punctures from veins that were neither palpable nor visible. One was drawn from an antebrachial vein and another from a brachial vein. A sterile barrier drape was made from a commercially available dressing and a piece of transparent sterile plastic. The barrier drape consists of an adhesive part placed on the skin designed for sonography and a free transparent flap constituting the barrier between the unsterile sonographic site and the sterile gel-free puncture site.
  
  
  RESULTS
  The success rate for vein puncture was 100% in both locations. A total of 22 skin punctures were performed (11 antebrachial and 11 brachial). Gain output was increased 7% (4-12%), and 8% (4-15%), respectively, to compensate for attenuation of the US signal due to the drape. Alignment of the centre of the transducer with the long-axis of the target vein during the procedure was reported as a challenge.
  
  
  CONCLUSIONS
  US-guided blood sampling from a brachial and antebrachial vein was possible with a 100% success rate, while ensuring a dry and gel-free venipuncture area on one side and the transducer on the other side of a sterile barrier.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus - Denmark.
authors.forename: Sofie
authors.initials: S
authors.lastname: Thorn
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus - Denmark.
authors.forename: Nigopan
authors.initials: N
authors.lastname: Gopalasingam
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus - Denmark.
authors.forename: Thomas Fichtner
authors.initials: TF
authors.lastname: Bendtsen
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus - Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Knudsen
authors.affiliation: Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus - Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Sloth
mesh_terms: D000328:Adult; D003718:Denmark; D004209:Disposable Equipment; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D018962:Phlebotomy / Q000295:instrumentation / Q000379:methods*; D011677:Punctures; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000295:instrumentation; D034941:Upper Extremity / Q000098:blood supply*; D014680:Veins / Q000000981:diagnostic imaging*; D055815:Young Adult