Advice

The technology

The technology

Airglove (Green Cross Medico Ltd) is an air warming system to improve access to veins for the delivery of drugs such as chemotherapy. It consists of a heating unit and tube containing a heat outlet, and single-use disposable double-walled polythene 'gloves'. The glove is placed on the tube and over the forearm; the glove seals on the forearm and heats it using warm air. Airglove has 3 temperature settings (31.5ºC, 35.5ºC, and 38.5ºC) designed for sensitive, normal and heavier skin types as well as a timer that automatically switches off the unit after 3 minutes. Warming the forearm raises the veins allowing for easier cannula insertion.

Innovations

The company claims that there are no other technologies available that warm the arm to help with improved cannula access. No similar technology was identified during the development of this briefing.

Current care pathway

There is no guidance on how to perform cannulation in people with hard-to-access veins. Mbamalu et al. (1999) reviews the evidence for methods of getting peripheral venous access in difficult situations. These include milking the vein, increasing pressure using tourniquets, warming the arm with hot water or pads, and using ultrasound to identify veins.

Population, setting and intended user

The technology would be used by healthcare professionals, including vascular access specialists, in settings where regular venous access is needed. It would likely be used when access was anticipated to be difficult, or after failed attempts, including in patients with hidden or fragile veins, such as in oncology. However, it is suitable for use in any setting - inpatient, outpatient or GP surgeries - where venous access is needed.

Minimal training is expected to be needed.

Costs

Technology costs

The heating unit costs £795, has an estimated lifespan of 3 years, and comes with a 1-year guarantee.

A single-use disposable glove costs £0.80.

Costs of standard care

The technology could potentially avoid repeated unsuccessful cannulation. The company estimates that it can take 3 attempts for successful cannulation in an oncology patient. The costs of the consumables (2 each of cannula, saline solution, needles, syringes, and sterilisation packs) for each attempted cannulation is estimated by the company to be £1.45.

Resource consequences

The technology has been used in a clinical trial at Maidstone and Tunbridge Wells NHS Trust hospital, and is currently used in 5 NHS hospitals in England.

The company has calculated potential annual cost savings of £57,627 for a typical oncology unit using the following assumptions:

  • It does 9,100 chemotherapy cycles a year.

  • Using Airglove avoids 2 unsuccessful cannulation attempts, each taking 6 minutes of an oncology nurse's time (at £1.44 for 6 minutes) and £1.45 in consumable costs.

  • For successful cannulation, using Airglove takes 6 minutes of an oncology nurse's time but avoids the need for warming with hot water, which takes 12 minutes of their time.

  • No changes in facilities or additional infrastructure are needed.