My experience of treating patients under sedation has been that once the venous access has been achieved, the session becomes easier from that point. The patient is relaxed, the team is relaxed and all is well. But finding that elusive vein can be very stressful!
At the initial consultation, the patient may be more relaxed and the vein obvious. But when then come for treatment for the first time, everything shuts down and the nice vein you noted previously has disappeared! What you really dont want is to be straggling around puncturing holes which will only increase the patients stress levels and reduce their confidence in your skills!
There are some great techniques that Ive come across over the years to help find decent access.
One of the simplest ways is to get venous pooling. Using a manual blood pressure cuff (still my favourite), hold the pressure between systolic and diastolic. The blood will pool and the veins will become engorged and therefore much more obvious.
If that fails, there are some great devices (gadgets) out there to help find the decent veins in the first place, even deep in the forearm. I love the VeinLite EMS, sold by Medisave. More details can be found at https://www.veinlite.com/.
This fantastic tool allows not only visualisation of the venous architecture, but when turned around, will hold the skin firm and anchor the vein down, so you cannulate through the access window in the device itself.
It costs around £160 but saves so much guesswork, feeling around for veins and failed access situations. I have used it several times on patients who have said “good luck finding a vein!”