04 October 2025 : Clinical Research
Improving Peripheral Venous Puncture Outcomes in ICU via Vein Grading Management
Yanlin Wang ABCDEFG 1, Xianna Zhu BCDF 1, Tong Li ABCDEF 1, Shengnan Wang BCF 1, Jia Xu B 1, Xiaodan Liu B 1, Meili Li B 2, Yue Wang ABEG 1*DOI: 10.12659/MSM.948786
Med Sci Monit 2025; 31:e948786
Table 1 Grading criteria for peripheral venous vessels in the ICU.
| Project | Grade I | Grade II | Grade III | Grade IV |
|---|---|---|---|---|
| Edema | None | Mild | Moderate | Severe |
| Degree of fullness | Clearly protrudes from the skin under pressure | Slightly protrudes from the skin under pressure | Faintly visible under pressureNot visible under pressure | Not visible under pressure |
| Degree of fixation | Fixed | Slidable | Slidable | Slidable |
| Appearance diameter | >2 mm | 1~2mm | <1 mm | Not visible to the naked eye |
| Appearance length | >2 cm | 1~2 cm | <1 cm | Not visible to the naked eye |
| Touch sensation | Clearly palpable | Faintly palpable | Difficult to palpate | Not palpable |
| Elasticity | Soft and elastic | Slightly elastic | Partially hardened | Entire segment hardened, phlebitis |
| If a patient’s evaluation spans multiple grading levels across different criteria, the highest level (ie, the most difficult one) will be selected as the patient’s venous vascular grade. Edema grading is defined as follows: None – no swelling; Mild – slight puffiness without pitting; Moderate – swelling with shallow pitting; Severe – deep pitting with skin tension. Vein diameter estimation was supported by a reference scale card and, when needed, confirmed with palpation or bedside ultrasound. | ||||