Development of a comb needle with five needles for securing access to large blood vessels during emergency resuscitation

Abstract

Animal tests have indicated that providing venous-arterial (V-A) bypass extracorporeal circulation immediately after cardiac arrest is a useful resuscitation technique for achieving resumption of a normal cardiac function and brain resuscitation. However, pulsation of the femoral artery cannot be felt in the case of cardiac arrest, and it takes a long time to puncture the femoral artery and vein. We developed a comb needle that has five 18-gauge metallic needles fixed in parallel on a plastic board. In this study, we investigated whether the comb needle would achieve puncturing of the femoral artery and vein in cadavers. The comb needle was used to puncture the femoral artery and the femoral vein in 45 donated bodies. We placed the center needle of the comb needle 2 cm perpendicularly caudal to a point approximately one quarter the distance along a straight line connecting the anterior superior iliac spine and the pubic tubercle. An autopsy was performed following puncturing, and it was determined whether needles of the comb needle punctured the femoral artery and/or the femoral vein. Puncturing of both the femoral artery and the femoral vein was achieved in 35 cases (78%). In the left groin, both the femoral artery and the femoral vein were punctured in 16 cases (94%), and in the right groin, both the femoral artery and the femoral vein were punctured in 19 cases (68%). Using a comb needle, one insertion can achieve simultaneous puncturing of the femoral artery and the femoral vein with a high success rate in cadavers.