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Technology

Training Nurses With Virtual Veins 171

meganthom writes "UK Haptics is developing a virtual hand to help nurses learn how to draw blood and put in IVs in a realistic manner. Though plastic models are currently used, these do not give new nurses the 'feel' for how much pressure to apply to the needle, and they cannot alert the nurse about pain. The system currently under development, which uses haptics, would make the learning experience considerably more realistic, even telling the nurse when too much pressure was applied."
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Training Nurses With Virtual Veins

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  • Sweet (Score:5, Funny)

    by Rupan ( 723469 ) on Friday August 20, 2004 @11:41AM (#10024447) Homepage
    Maybe now my dentist can learn how to inject novocaine without stabbing me painfully 6 times :) (I just had $6k of dental work done... :( )
    • Re:Sweet (Score:4, Informative)

      by Anonymous Coward on Friday August 20, 2004 @11:51AM (#10024566)
      He's not aiming for veins (which would be pretty pointless anyway, since they take blood back to the heart, not out to the cells locally) he's distributing the anesthetic around the area to assure the nerves are blocked. It's a subcutaneous injection (or intramuscular or intraligament - my dentist sometimes uses "intralig" injections on me), not intravenous or arterial.

      Did he apply a topical before the injection? That usually helps a bit.
      • Re:Sweet (Score:3, Interesting)

        by realdpk ( 116490 )
        That reminds me of when I had my root canal done. The most painful thing I have ever experienced in my life was when he put that needle to my swollen gum, to numb the area for drilling.

        On the followup appointment (to put a plug in the tooth that was draining), I told him just to use extra topical and skip the injection. Barely felt a thing then.

        Any time a friend is having a root canal I tell them this story, just in case they have a similar experience, I hope to save them at least some pain. :)
    • Re:Sweet (Score:5, Funny)

      by danamania ( 540950 ) on Friday August 20, 2004 @12:22PM (#10024895)
      I love the names for some of these medical training aids [vatainc.com].

      Perhaps the most curious is the Seymour Butts 900 [vatainc.com], a lifelike elderly rear end, complete with just about every affliction that could affect an arse.

      The model number has me wondering if there were previous lesser butts - a Seymour Butts 500 perhaps. I dare not think about the ailments on the Seymour Butts 2000.
    • True story:

      I used to go to a technical school that offered various vocational training. There was my floor with the computer dept. It was 60% guys. A couple of floors up was the medical / nursing area. All girls.

      They had to practice giving shots and such on live human beings. Once they were tired of stabbing each other they would wander down to the geek farm in search of brave young men willing to sacrifice their arms to advance medical science.(i.e. suckers) They figured that just because they were

  • by Solder Fumes ( 797270 ) on Friday August 20, 2004 @11:43AM (#10024467)
    It's simple, you just take a nice red Sharpie....
    • Funny :) (Score:5, Funny)

      by purduephotog ( 218304 ) <(moc.tibroni) (ta) (hcsrih)> on Friday August 20, 2004 @12:38PM (#10025128) Homepage Journal
      I have a mole on my arm that reads "STAB HERE FOR VEIN". Seriously. Nice and well placed, all they have to do is come close and they'll get a perfect stick.

      So this nurse in Indiana screws it up. She stabs THRU the vein. Blood sprays all over the tube. She gets another tube, stabs, misses, sprays again.

      after the 5th stick I'm pale white and about to pass out... I get up to leave, and this old, black nurse comes in and says "Honey you sit yourself right down, i'll get it and you won't even know".

      I raise my arm to protest, she grabs it and sticks it in one smooth motion, so smooth I never felt the needle.

      Man I love that woman.
  • by JBMcB ( 73720 ) on Friday August 20, 2004 @11:44AM (#10024479)
    My wife had a plant safety class where they learned CPR from a paramedic who specializes in training. She had tattoed instructions on her arm how to do CPR, with an X on her wrist saying "Check here for pulse" and an X on her chest over her heart saying "Push here"

    People should come with operating instructions :)

  • Nice (Score:5, Interesting)

    by butane_bob2003 ( 632007 ) on Friday August 20, 2004 @11:44AM (#10024480) Homepage
    Last time I had blood taken, they let the trainee practice on my arm. She managed to spear through a major vein a few times, but never actually got in there. After making that vein completely useless, the head nurse came over and tried on the other arm. The trainee was still shaking, I'm not sure if she was nervous or just a shaker.
    • Re:Nice (Score:4, Informative)

      by stefanlasiewski ( 63134 ) * <slashdot@nosPam.stefanco.com> on Friday August 20, 2004 @11:57AM (#10024635) Homepage Journal
      I'm not sure if she was nervous

      She was probably nervous, which made her a shaker.

      Most nursing and medical students will tell you that learning how to insert a needle is very stressful. Veins can be hard to find on most people (especially overweight people), it is usually taught towards the beginning of your training and is required for many tasks later on, you have a very attentive audience-- any mistake will certainly be noticed by the patient or the doctor, and nobody likes needles.

      My wife is a labor and delivery nurse. Imagine having to learn how to insert a needle into brand newm, wiggly newborn with teeny-teeny veins.
      • Re:Nice (Score:5, Insightful)

        by BrookHarty ( 9119 ) on Friday August 20, 2004 @12:06PM (#10024730) Homepage Journal
        My wife said they would practice on each other, drawing blood in class, thats how they got experience.

        Now my wife is working, she stated docters hate giving shots, and only the people certified can give shots. And with the current trend to hire 1 nurse to 10 medical assistants, you better hope some have experience.

        • While most nurses practice on each other, sticking a needle into a patient adds some exciting variables. The nurses have a good idea what's going on and some time to psychologically prepare.

          And most nurses don't fear needles as much as the patients :)

    • Trainees (Score:3, Informative)

      I once had infected sinuses and they were treated by puncturing the nasal wall with a damn long needle and flushing out the crap that had accumulated in the cavities beyond.

      Prior to the operation, local anesthetic was of course applied on the nasal wall. Incidentally, this last procedure was also conducted with a damn long needle shoved straight up my nose and it hurt like hell each time they did it. Yes, each time they did it. A trainee tried to do it four times until his supervisor finally took over and

      • Dude, I wouldn't let the trainees do that! They could stick a needle in your brain!
        • Yes, that disturbing thought occurred to me as well when I was first shown the needles...

          I don't know if it was supervisor's intention to let the trainee to do the actual puncturing. As I said, he took over the procedure after trainee's four failed attempts and he did the puncturing as well - fortunately.

    • Re:Nice (Score:2, Insightful)

      by stratjakt ( 596332 )
      The real problem for trainee nurses is the reluctance, we're programmed since birth that you dont go around stabbing sharp metal things into people. The skill itself is trivial, hell if a strung out junkie can inject themselves, how hard can it be?

      Practicing on dummies will never replace practicing on other students, boyfriends, etc. That addresses the real problem, the fear of hurting someone. Which was likely the reason your trainee was so nervous.
      • The real problem for trainee nurses is the reluctance,

        Truer words never spoken. As a 15 year veteren of ER, and teacher to many a newbie nurse, first words of wisdom "Don't be afraid to hurt the patient". If your afraid, your timid, and that leads to missed vein, and more pain for the patient. Relax, take your time, think about the physics of what your doing (round needle into round vein). No software can duplicate the look and feel of a good stick.

    • Re:Nice (Score:5, Informative)

      by Daniel Boisvert ( 143499 ) on Friday August 20, 2004 @12:05PM (#10024725)
      I don't give blood anymore for this reason. I had a bad experience a few years ago with a new nurse who put the needle through the blood vessel in my arm, and into the nerve in my elbow. It took 6 months before my hand felt normal and regained full strength after that. I've read plenty of tales of folks who didn't regain full feeling after an experience like that, and don't want to take the risk of it ever happening again.

      If these things can help them learn to take blood without injuring folks like me, I'm all for it. I still probably won't ever give blood again, but if this became commonplace and I was assured of a really well-trained nurse, I *might* consider it..
      • If you mention this at the blood donation center and tell them that the only way you will donate is if you get a very experienced phlebotomist, they will oblige you if there is someone available.

        And if there's not, leave and come back another day - that's what I did for quite a while after having my vein blown.
    • Trainees (Score:5, Interesting)

      by Tenebrious1 ( 530949 ) on Friday August 20, 2004 @12:35PM (#10025082) Homepage
      While I was in an ICU unit, the doc came by with some students. Since I have nice beefy arms and huge veins (the blood donation folks love me), the doc asked if I minded the students practicing on me.

      Well, seeing that the trainees were young and cute, I said "sure" and let them stab me several times. Ok, they did pretty well, probably because their "patient" wasn't freaking out.

      • Fool! You didn't ask for the sponge bath instead?!
      • Ah, got me the same way, and for the same reason. Watching the doe-eyed nurse in training fence with my veins for a minute or two was not unpleasant, I do love when pretty nurses lean against and administer pain in the way that only nurses can.
    • She was nervous. A previous vocation of mine was being a lab technician, and when I worked in Haematology I went on the "blood run" three times/day + emergencies. When I was training the first few times was some of the most stressful & nerve wracking tasks of my life. You can't feel the veins, you don't know how much pressure to apply or how deep to go. In the back of your mind you're thinking "what if I miss, what if I hurt him, what if I miss and hit a nerve or artery, etc, etc" You shake, you co
  • now they tell me (Score:5, Interesting)

    by boskone ( 234014 ) on Friday August 20, 2004 @11:45AM (#10024495)
    I just gave blood yesterday and volunteered to be the guinea pig for a new trainee. I was her first human stick!

    (She did great, but nevertheless, I would have felt better if she could have trained with one of these first.)
  • Holy moly (Score:1, Redundant)

    by savagedome ( 742194 )
    Kinda like realdoll for nurses, isn't it?

    *grin*
  • by tao_of_biology ( 666898 ) <tao.of.biologyNO@SPAMgmail.com> on Friday August 20, 2004 @11:47AM (#10024526)
    OK, my wife just graduated from nursing school a couple of years ago... which means I've had blood drawn and IV's started at least two dozen times... and a majority of those were done very very poorly.

    I swear, I looked like a total friggin' addict. I heard to wear sweaters to keep that crap covered up on my arms for like 2 years.

    Apparently, citrus fruits make a good replacement for human veins. She spent a lot of time practicing on oranges, grapefruits and whatnot.

    I hope, for all husbands and roommates everywhere, that these come out soon and that they're very very cheap.

  • by z0ink ( 572154 ) on Friday August 20, 2004 @11:47AM (#10024530)
    I almost had the first post, but I was too busy using the virtual hand to give myself a virtual hand jo^H^H^H^H^H^H^Hback massage....
  • in related news: the nurses training with the virtual veins become virtual junkies and have to go to virtual rehab.

    next.

  • How silly (Score:5, Insightful)

    by wolfemi1 ( 765089 ) on Friday August 20, 2004 @11:48AM (#10024533)
    My mother is a nurse. This will NEVER be as cheap, or as realistic, as having the students practice on each other, like she did in medical school.
    • Re:How silly (Score:3, Interesting)

      Just recently had a emergency room experience with my 15 month old son. He is a BIG BOY, im talking 30 lbs. With a good solid coating of baby fat and not a vein in sight. None of the regular nurses could get an IV into him, but when the IV team comes around the vein fishing stops. I'd like to see poking a dummy rival the real life experience of trying to IV a screaming strong baby. Picture this: 2 parents holding him down, he is screaming loud enough to make the most emotionless person break out in a swea
      • When my wife was in for the youngest kid, the nurses couldn't get an IV line in. They eventually called in the anestheseologist, an old Chinese looking guy. He took her arm and lined it up and got the vein on the first try.
    • I thought you were talking about sex.
  • I realized this after taking a death and dying class a little while ago, but I almost always misread "nurses" as "ncurses", at least initially. If somebody wants to make a "Top ten signs you've read too many Unix docs", I'd estimate this would be about #4.
    • > "Top ten signs you've read too many Unix docs",
      > I'd estimate this would be about #4.

      That's funny, none of my UNIX systems have ncurses installed. Just good old fashioned curses, like me grandpa used to hurl.

      Oddly enough, they changed the man page section recently, now it's in -s 3CURSES rather than -3 or -3X.

      I always figured the really good curses were in section 3X, but it just seemed to be more of the same crap.

      Who the hell ever came up with that interface, anyhow??
  • you gotta hand it to them, this is pretty cool use of technology.
  • Limited Usefulness (Score:5, Informative)

    by klausner ( 92204 ) on Friday August 20, 2004 @11:53AM (#10024593)
    As a retired paramedic who has stuck needles into literally thousands of veins, I can tell you that this kind of tool is of limited value. Even if they can exactly mimic the tactile sensations of a needle penetrating skin and then entering a vein, that's only part of the issue. A much bigger obstacle to be overcome is the social indoctrination that you don't go around stabbing people and making them bleed. Once most nursing/medical/paramedic students learn to just DO IT, their problems drop way off.

    The traditional training method of having students practice on each other has a lot to reccommend it as a means of overcoming such reluctance. Anyway, a practice model would only get used in class a few times per student, and then they will be out assaulting real patients anyway. Increased training costs for limited benefit.
  • Having personally had nurses break off two needles in my arm, having one hit an artery instead of a vein, and having more than one dig around with the needle half in arm trying to find the danged vein... teaching them to do it right without human sacrafice is a blessing.
    • by Anonymous Coward
      I'm wondering if they can simulate collapsed veins properly.
      I was in the ER 3 months ago because of massive blood loss due to an ulcer (down to 1/3rd what I was supposed to have), the nurses got one IV in fine in my right hand, but they tried digging for 5 minutes in my left trying to get the vein, finally giving up and sticking it in my right arm instead.

      Would be nice if they could practice on simulated near death patients instead of waiting for one to come in.
    • Not that I'm calling you a liar or anything, but I am a nurse and when you start an IV you use the needle to get into the vein and then withdraw the needle leaving a tiny plastic catheter. I have started thousands of IVs and have never seen or heard of "needles breaking off". Furthermore, if a needle "broke off in your arm" it would have to be removed surgically, which you didnt mention. I need more detail really to not doubt the validity of this comment. I have however seen IVs hit artieries before and
  • Every time blood gets drawn from me, they try to use that huge needle that doesn't work. Each time I tell them: "it won't work, use a butterfly." Each time I get stuck 3-4 times before he/she tries a butterfly. (You know, the ones with the tiny needle and a little handle that looks like a...guess.)

    Then they always ask how I would know it would work, and I'm helpless to do anything but stare...
    • Argh! I know this is off topic but it's a huge pet peeve of mine

      A butterfly needle and a straight needle are both the same in diameter. On the ambulance, everyone asks for a butterfly needle because the nurses at the hospital tell them it's smaller, and each time, I get a straight needle into their "impossible to hit without a butterfly" vein. IV competence is IV competence, no matter which style of needle you use.

      As I ask each of my patients who think they know more about medicine than I, What medi
  • So what's next? The virtual penis and virtual vagina to teach them how to properly insert a catheter into our most precious of orifices with a bit less discomfort? One can only hope...
  • Bah (Score:3, Insightful)

    by The Bungi ( 221687 ) <thebungi@gmail.com> on Friday August 20, 2004 @12:00PM (#10024666) Homepage
    When I was in college studying clinical biochemistry we didn't have no damn dolls or virtual veins. Heck, we didn't even have Vacutainer(TM) draws. We had a standard syringe with a big ass needle and a few hundred hapless students who have to give blood as per school regulations (this is not the US obviously).

    After the first 20 or so victims you eventually figured out how to avoid leaving that nasty black welt on the inside of their arms (which incidentally also gave the impression they were doing drugs). Do a few hundred or so (myself and 6 other fifth semester students had to process about 2,000 people, including admin aides and misc school workers) and you get pretty good at it. You also develop this uncanny skill at tying the rubber pressure band around people's arms so quickly that they're being pricked faster than they can yell "HOLY CRAP THAT HURTS"

    The hardest part was drawing from overweight female students. No veins visible anywhere in the arm. Sometimes we had to draw from a leg or hand vein or weird shit like that. Still, it was fun (hey, I wasn't the one being punctured) and it beat termodynamics lab for sure. We eventually wrapped it up in a couple of weeks and got some school t-shirts for our troubles.

    Oh, and here's the obligatory old fart "we had to walk barefoot in the snow uphill (both ways) at 5:00 AM every day to get to school and we liked it" and all that.

    • Blockquoth the poster:
      After the first 20 or so victims you eventually figured out how to avoid leaving that nasty black welt on the inside of their arms (which incidentally also gave the impression they were doing drugs)

      I have one of these from doing plasma that's been there a few months.

      How do I get rid of it?
  • by Anonymous Coward
    by HT Medical (now Immersion Corporation) [immersion.com] and Plattsburgh State University [plattsburgh.edu]?

  • medical technology (Score:2, Interesting)

    by chaosmage42 ( 716255 )
    This is a field where force feedback VR is truely useful. Not only can it be used for safer training {thou probably more expensive, as another commenter pointed out}, but it makes remote surgery much safer and more practical.

    Medical imaging is a field that is still in need of tech advancements. Matching two scans of the same patient is hard to do. I worked on early stages of a project making a 'statistical atlas' of the femur. These are extremely useful but barely developed. Also I've looked into rob
  • Why didn't they just use Thing from The Addams Family? He always seemed willing to lend a helping hand.

    boom-cha!

    Thanks, I'll be here all week!
  • Perhaps we could give out free virtual vein kits at drug clinics to teach addicts how to properly use a needle. After all, rather than discourage drug use, we give away free needles in many areas in an a sort of "well, they're gonna do it anyway... may as well not spread disease when they do". And in Amsterdam they have designated *usage* areas. Why not teach them how to do it right. I'm mean, after all, its kind of like driving drunk. Most people that've been driving for 10+ years can drive safely while a
    • Well, I would have modded you up were it not for that last line. Over in the Netherlands, the death rate amongst injecting drug users is approximately 0.05% per year. In "civilized" America, it's nearly 2%. Whether you approve of drug use or not, harm reduction is the only sensible, humane approach.
      • Well, I for one don't think that teaching people how to do illegal and/or stupid things safely helps the problem. Yet, as we see and as I mentioned... we give needles to junkies to stop the spread of disease... we give condoms to high schoolers to stop disease and pregnancy. Basically, we condone the actions that are, in fact, against the law in many areas. Drug use is a crime, not always arrestable, but at minimum ticketable, anywhere in the US. Two minors having sex is considered "statutory rape of a mino
        • There is a very obvious difference. Consentual sex between minors harms no-one but the participants. Drug use does not directly harm anyone but the user. Driving drunk may well kill others. Laws against drug use are applying public morals to a private act. Laws against drunk driving are applying public morals to a public act. There is a big difference.
          • "Consentual sex between minors harms no-one but the participants"

            "Drug use does not directly harm anyone but the user"

            "Driving drunk may well kill others"

            BULLSHIT!!! Consentual sex between minors that leads to an unexpected pregnancy affects the family, the parents, the baby, and the kid who's probably still in school. Bullshit it only harms the participants.
            BULLSHIT drug use only hurts the user. My sister was killed by a guy that dropped two hits of LSD then went for a drive. The differences you s
  • Matrix (Score:2, Funny)

    by Nuttles ( 625038 )
    Why can't we all just have implants...remember Neo and his IV...looked pretty simple to apply an IV

    beside, if we had the head implant, the people with enough bio-RAM might be able to play Doom 10...I mean I mean, doctors may be able to explore and fix issues with our brain

    Nuttles,
    Saved by Grace
  • When I learned it... (Score:5, Interesting)

    by Ungrounded Lightning ( 62228 ) on Friday August 20, 2004 @12:15PM (#10024820) Journal
    When I learned IV insertion we practiced on a loose-fitting concentric rubber tubes with liquid between them. The inner tube squirmed around about as much as a normal vein.

    It's nice to see that they're getting more realistic.
  • Measure of pain (Score:1, Interesting)

    by Anonymous Coward
    How a system can measure the pain? Everybody has a different level of tolerance. The only way to learn this is with real subjects.
    • that's why i always tell the nurse or the doctor to stick the needle in without warning, so that the surprise will lessen the pain of the needle going in.

      works all the time, except when they warn me out of habit, because they can't help it.
  • My grandmother used to tell me that Nurses were always better at sticking you than doctors, because Nurses practiced on each other, and Doctors practiced on oranges.

    My experiences have always borne out that nurses were quite good at it.

    Well, except for that one at the Bloodmobile a few months back. She should have gotten a job at Abu Ghraib....

  • Heres [blender3d.org] another nurse training system... at the bottom of the page..
  • You either have it or you don't. My wife's an ER nurse. She "starts lines" all the time. Yet there are some nurses working with her in the ER who have many years of experience and still have difficulties starting a line. The truly amazing people are anesthesiologists and anestothists. They seem to "always" be able to start a line.
  • It seems like my multiple physical disabilities make drawing blood a lot harder for trained nurses and doctors because of the ways my veins are even after heating my arms! The most attempts was on 7/23/1998 according to my journal/log/blog entry [zimage.com] for 7/27/1998:

    At around 6:30 AM or so, I had to change my cloth and get IV shots. This part was not fun. It took about 13 needle shots to find my tiny veins. I have had never gone through this many. Sheesh, the doctors, nurses, and I were all frustrated. I finally
  • Emit a virtual "Ow, you fucking vampire!" when the trainee screws up?
  • It'll be realistic enough only when it can blurt "Ow! Shit!", and yank away when they hit a nerve.
  • Seriously. My mom is a professor of nursing, and as such whenever i had to have surgery (bi-lateral arthoscopic knee surgery in this particular case) she would bring all her little nursing studnet to see me.

    Which isn't so bad right?

    Wrong. Not only did they come see me, they got to practice giving IVs. Now, usually the nurses do a great job of this. After years of practice.

    Fresh nursing student, are not so good. in fact, the first time they work on a real patient, they are bad. Really bad. Really
  • My ex was a nursing student while we were dating, and I was the (semi) willing subject of quite a few needle sticks.

    The public should be thankful that she went into a subset of nursing that doesn't require her to poke a needle in someone :)

  • I've tested somthing similar to this back in the late nineties. Not sure if it ever was produced or if it is related to this article, but the device gave tactile feedback to a real catheder. Veins could be from a child, middle aged, old person, and my favorite, the heroin addict. The simulator even yelled "ouch" if you poked it too hard. Very cool indeed!
  • But make sure the needles are clean too. Anyone remember this story? [cnn.com]
  • Force feedback medical simulators are nothing new.

    See Here [immersion.com] for an existing (and selling) product.
  • Haptic?! (Score:2, Informative)

    by Rich Klein ( 699591 )
    Hey, how about giving us laypersons a definition of haptic before you toss such jargon around willy-nilly? According to Merriam-Webster [m-w.com] it means:
    relating to or based on the sense of touch
  • being hairy, getting a needle in a spot that has gotten stuck a lot, which causes scar tissue, and other things, like being right on a a nerve can be really painful and annoying.

    If the creator of this thing reads this, tell him to do something about these 3 things becuase since I have to give myself home infusions for a certain condition, I know all about it.

  • Just going by the headline, it's actually ambiguous about what is meant. Does it really mean training nurses by _USING_ virtual veins? Or does it mean training nurses who _HAVE_ virtual veins?

    Just being a mild PITA about grammar.

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