Turning IV failures into successes

For many hospital patients, intravenous tubes, which supply nutrition or medications, are actual lifelines. Unable to eat normally because of their conditions, or in constant need of medication, the tube is the only way they can receive life-sustaining nutrients or drugs.

In many cases, however, interfacing a tube with the body – by hooking it up to a blood vessel – is a major hurdle for medical staff. Over 40% of IV insertions are “failures,” the term applied to an IV insertion that “misses” the first time, said Dr. Yaakov Nahmias, the director of the Hebrew University of Jerusalem’s Center for Bioengineering.

Overcoming that problem is precisely why Hebrew U researchers, along with teams from Hadassah Medical Center, developed Sagiv, a semi-automatic handheld device for rapid and safe IV insertion. The device uses infrared sights and electrical sensing to identify veins, insert the needle into the correct location, and withdraw it in a single, rapid movement, hitting the right spot the first time, without causing pain for the patient — the almost inevitable outcome of IV insertion failures.

“Finding a proper vein in which to insert a catheter is one of the biggest challenges nurses and doctors face,” said Nahmias. “For kids, inserting an IV can be a nightmare, because their veins are much smaller and less developed than those of adults. Almost always, multiple attempts are necessary, with the attendant pain and fear. I know of many parents who refused to bring their children to the hospital for important tests and procedures specifically because of fear of the IV.” It’s also a major issue for nurses and paramedics who are tasked with what is considered one of the most unpleasant jobs in the hospital, according to medical personnel online forums.

Sagiv is just one of several projects introduced by Hebrew U and Hadassah Hospital, in a program established by Nahmias and Prof. Chaim Lotan, the director of Hadassah Medical Center’s Heart Institute, called BioDesign. Four projects have emerged from the research done by BioDesign teams, and all of them have commercial potential, said Nahmias – with Sagiv, as a medical device, likely to be the first of the four to come to the market, as the approval process for medical devices is less onerous than for pharmaceuticals or devices for medical procedures, such as the Metaboshield, a device that could help the obese lose weight.

The one-year-old Biodesign is a multi-disciplinary, team-based approach to medical innovation which takes top medical fellows, bioengineering and business graduate students, and tutors them in the science and practice of bringing a medical innovation to the market, said Nahmias. The teams receive a list of clinical problems, collected from Israeli and American hospitals, and critically evaluate their commercial potential. Once they identify a clinical need with commercial potential, they find an engineering solution that can be protected by a patent application. BioDesign projects are assigned to the tech transfer companies of Hebrew U and Hadassah to prepare them for commercialization.

The Sagiv device is in advanced testing, and it could be on the market within a year and a half. And the market is huge; every hospital in the world is going to want one, or more, Nahmias believes. Already as word gets out, said Dr. Yotam Almagor, the group’s clinical expert, parents and patients are clamoring for Sagiv. “Some caregivers simply don’t have the dexterity to insert IV catheters successfully,” he said. “Children that used to be pricked numerous times in every visit can now be connected in a single attempt. We had a lot of excited parents asking that we use the device.”