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Venous Needle Dislodgement Monitoring Device

NHS Highland clinicians have developed a novel venous needle dislodgement (VND) monitoring device for hemodialysis with significant advantages over current technology. Responsive, accurate, highly reliable and safe, the new device represents a significant advance in the safety and monitoring of hemodialysis.
Hemodialysis treatments have become routine but it is well documented that substantial blood loss resulting from VND is a rare, but potentially fatal complication. At typical hemodialysis blood flow rates of 400-500 mL/minute, it can take only a few minutes for a patient to lose over 40% of their blood volume. With the incidence and prevalence of end- stage renal disease (ESRD) rising worldwide due to changing demographics, stringent guidelines and recommendations have been introduced to prevent these incidents. Monitoring devices have also been recommended but in clinical practice have been found to have a high incidence of false positive alarms, leading to compliance and confidence issues. In addition, the monitors are “stand alone” systems which don’t trigger if they fall off or are removed, nor do they communicate with the dialysis machine. Novel technologies are required that can provide more effective, intelligent monitoring of VND during hemodialysis that is user-friendly and safe.
NHS Highland clinicians have developed an intelligent monitoring device which overcomes the issues around current VND monitors.

The new system actively measures skin resistance during hemodialysis, calibrating according to the patient – a person’s skin resistance varies throughout the day and can go higher or lower. The alarm tracks these gradual changes and is controlled by a microchip programmed with custom software, monitoring for sudden changes in moisture. Sudden changes would occur during a VND episode but also if the patient became distressed and/or if the device itself became detached or removed by the patient. This not only provides a highly sensitive detection system for VND but also adds in monitoring for distress and removal of the system – patients with ESRD often have co- morbidities such as diabetes and dementia. Once triggered, the system feeds back to the dialysis machine and generates occlusion of the arterial line via a clamp.

The device has been successfully trialled by clinical staff on small scale. As well as being effective, sensitive and reliable, the device was found to be more user-friendly than current devices (easier to clean and recharge).
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