Low-Cost Bicycle Lights vs. Cold Lights for Visualizing Neonatal Veins.

Objective: Difficult intravenous (IV) access can compromise patient care in neonatal practice, and transillumination is often used to improve the visibility of veins. Current devices are expensive, prone to bacterial contamination and unaffordable in low-resource settings. We conducted a study comparing the quality of transillumination provided by "cold lights" that are currently in use with low-cost (<1) pound red silicone LED bicycle lights. Methods: Photographs of the hands and feet of neonates were taken with parental consent: first without transillumination (control group), second by transillumination with a cold light, and third with a bicycle light. Thirty photographs were sent in a survey to pediatric doctors who were blinded to the method of transillumination. Survey respondents then rated the visibility of the veins (easily visible, moderately visible, barely visible and invisible). Results: Completed surveys of 114 respondents were included in the analysis. The majority (94.8%) of respondents rated the veins moderately to easily visible with the bicycle light compared with 87.6% with the cold light, and 42.6% in the control group with no transillumination. There was a strong evidence of an improvement in visibility with bicycle lights compared with cold lights (p<0.001). Conclusion: Low-cost red silicone LED bicycle lights were found to improve visibility of veins in neonates. Given their quality of transillumination, portability and reduced cost, they may provide a useful method of transillumination in all settings, but particularly in low-income settings, where there is currently no affordable alternative.