The Effects of Local Warming for Difficult Peripheral Venous Access in Critically ill Patient

Main Article Content

Benjamad Chantasakda
Jansudaphan Boontham


This study was a quasi – experimental research aimed to comparative study  the peripheral intravenous cannulation between the local warming with electric hot towel before the cannulation and the normal technique in patients with difficult peripheral venous access. The hypothesis was that warming before the cannulation in critically ill patients with rare veins would be more successful than in the usual pattern. A sample was 160 patients in Phetcharat 4C unit, The Faculty of Medicine Vajira Hospital, Navamindradhiraj University. The sample was divided into control groups namely, 80 subjects who received peripheral intravenous cannulation by normal technique and 80 subjects in the experimental group that received the local warming with electric hot towel the local warming with 40-45 Celsius degrees electric hot towel for 15 minutes before before the cannulation. The sample was random by blocked using a computer program according to the inclusion criteria from 15 January 2022 to 31 March 2023.

The finding was found that the sample with local warming was able to access the peripheral venous at 98.8% and 70% success in the first time. The control group  with normal cannulation technique was able to open peripheral venous at 72.5% and success
in the first time at 30%. The success of peripheral intravenous cannulation between the experimental group and the control group was statistically significant different (p-value ≤ 0.001), and the number of successful peripheral intravenous cannulation between the experimental and control groups were significantly different (p-value≤0.001)

Article Details

How to Cite
Chantasakda, B., & Boontham, J. (2023). The Effects of Local Warming for Difficult Peripheral Venous Access in Critically ill Patient. Vajira Nursing Journal, 25(2), 17–26. Retrieved from
research article


Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015; 38(3): 189-203.

Marsh N, Webster J, Mihala G, Rickard CM. Devices and dressings to secure peripheral venous catheters: A Cochrane systematic review and meta-analysis. International Journal of Nursing Studies. 2017; 67: 12-9.

Eren H. Difficult Intravenous Access and Its Management. 2021.Retrieved from /75477.

Alexandrou E, Ray-Barruel G, Carr PJ, Frost SA, Inwood S, Higgins N, et al. Use of short peripheral intravenous catheters: characteristics, management, and outcomes worldwide. Journal of hospital medicine. 2018; 13(5).

Hilton E, Haslett TM, Borenstein MT, Tucci V, Isenberg HD, Singer C. Central catheter infections: single- versus triple-lumen catheters. Influence of guide wires on infection rates when used for replacement of catheters. Am J Med. 1988; 84(4): 667-72.

Biyik Bayram S, Caliskan N. Effects of local heat application before intravenous catheter insertion in chemotherapy patients. J Clin Nurs. 2016; 25(11-12): 1740-7.

Robinson-Reilly M. Application of heat prior to intravenous catheter insertion to improve comfort and safety for patients requires further research. Evid Based Nurs. 2017; 20(1): 15.

Homayouni A, Tabari-Khomeiran R, Asadi-Louyeh A. Investigating the effect of local warming on vein diameter in the antecubital area in adults aged 20-40 years. Br J Nurs. 2019; 28(8): S20-s6.

Kozier B. Fundamentals of nursing: concepts, process and practice: pearson education; 2008.

Potter PA, Perry AG, Stockert PA, Hall A. Fundamentals of nursing-e-book: Elsevier health sciences; 2021.

Yamagami Y, Tomita K, Tsujimoto T, Inoue T. Tourniquet application after local forearm warming to improve venodilation for peripheral intravenous cannulation in young and middle-aged adults: A single-blind prospective randomized controlled trial. International Journal of Nursing Studies. 2017; 72: 1-7.

Sarsar A, Kumari V, Sharma T, Sarin J. An experimental study to assess the effect of moist heat therapy on ease of peripheral venous cannulation among patients admitted in selected hospital of Ambala, Haryana. Int J Health Sci Res. 2019; 9(1): 104-11.

Tokizawa Y, Tsujimoto T, Inoue T. Duration of venodilation for peripheral intravenous cannulation, as induced by a thermal stimulus on the forearm. Biological research for nursing. 2017; 19(2): 206-12.

Rose Mary G, Hemant T. Effectiveness of moist heat therapy on the visibility and palpability of peripheral veins before peripheral venous cannulation among patients undergoing intravenous cannulation. Journal of Pharmaceutical Negative Results. 2022: 1823-33.

Simarpreet K, Ruchika R, Prabhjot S, Jasbir K. Effect of moist heat therapy on the visibility and palpability of veins before peripheral intravenous cannulation of patients undergoing chemotherapy. Int J Adv Res. 2018; 6: 230-6.

สุดารัตน์ สุวรรณเทวะคุปต์,พวงยุพา ยิ้มเจริญขวัญชนก ดาวฮามแป. ผลของการประคบอุ่นต่อความ ปวดระหว่างการเจาะเลือดของเด็กวัยเรียน.Thai Journal of Nursing Council. 2018; 33: 59-69.

Lenhardt R, Seybold T, Kimberger O, Stoiser B, Sessler DI. Local warming and insertion of peripheral venous cannulas: single blinded prospective randomised controlled trial and single blinded randomised crossover trial. Bmj. 2002; 325(7361): 409.

Korkut S, Karadağ S, Doğan Z. The Effectiveness of Local Hot and Cold Applications on Peripheral Intravenous Catheterization: A Randomized Controlled Trial. Journal of PeriAnesthesia Nursing. 2020; 35(6): 597-602.