A Hand-Held Robot for Precise and Safe PIVC

Abstract

Peripheral intravenous catheterization (PIVC) is pervasively needed in hospitals. However, given the levels of precision and controllability needed for PIVC, this operation suffers from very low success rates. For young patients, about half of the first insertions fail. Robotic systems have great potential to effectively assist the operation and improve the success rates, which has led to the recent development of different robots to automate PIVC. These robots are equipped with various sensors and actuators, resulting in expensive, complex, and grounded machines. Yet, fully automating the operation is neither needed nor desired, as current clinical preference is oriented toward keeping the practitioner involved and in control of the operation. Therefore, in this study we proposed an innovative smart hand-held robotic device, named CathBot, that enhances intra-operative control during PIVC with automatic features that guarantee very high success rates. It exploits an electrical impedance sensor to detect the venipuncture and a crank-slider mechanism to automate the subsequent cannula advancement and needle retraction. Here, CathBot is first characterized through engineering experiments that demonstrate its capability to successfully perform the whole PIVC operation on a realistic baby arm phantom without human involvement. Subsequent experiments evaluate the device with naive subjects on the same realistic pediatric PIVC scenario. The results demonstrate that CathBot can significantly improve the PIVC performance. Naive subjects achieved an average 86% success rate, and 80% of the subjects succeeded in their first attempt. These results demonstrate the technology has potential to greatly improve both the clinician's and the patient's PIVC experience.