WO2009023656A2

WO2009023656A2 - Vasculature visualization apparatus

Info

Publication number: WO2009023656A2
Application number: PCT/US2008/072859
Authority: WO
Inventors: Frank M. Fago
Original assignee: Mallinckrodt Inc.
Priority date: 2007-08-15
Filing date: 2008-08-12
Publication date: 2009-02-19
Also published as: WO2009023656A3

Abstract

A system for the visualization and access of the internal structure of a patient and related methods are disclosed. The visualization and access system may be operable to display images of the vasculature of a patient. The visualization system and access may include an infrared light source located within an armrest. The armrest may be interconnected to a portable chair and operable to project infrared light through an arm of the patient. A camera may capture the infrared light and the vasculature may be displayed on a monitor. The camera and monitor may be positionable with respect to either arm of the patient. The display of the vasculature and supplies stored on the visualization and access system may, for example, assist a practitioner in inserting a catheter into the venous structure of an arm of the patient.

Description

VASCULATURE VISUALIZATION AND ACCESS STATION

RELATED APPLICATIONS This application claims priority to US provisional application serial number 60/955,946 filed on 15 August

2007 and entitled VASCULATURE VISUALIZATION AND ACCESS STATION.

FIELD OF THE INVENTION

The present invention generally relates to visual examination of the internal structure of the human body, and more particularly, to the visualization of the vasculature of a patient.

BACKGROUND Venous access is a common procedure performed during medical diagnosis or treatment. Venous access may, for example, be performed to draw blood for analysis, to inject substances into a vein, to measure arterial blood gases, or to insert a catheter for intravenous delivery of fluids or drugs. Venous access is also used to deliver contrast media for imaging procedures such as Computed Tomography (CT) scanning and Magnetic

Resonance Imaging (MRI).

To insert a catheter, a flexible plastic tube that contains a needle is typically used to pierce the skin and penetrate the vein. The needle is then removed and the plastic tube remains in the vein to provide venous access. A healthcare practitioner such as a technologist, doctor, nurse or phlebotomist typically performs the catheter insertion procedure.

Various difficulties may arise when attempting to gain access to a superficial vein of a forearm of a patient. For example, the veins of the patient may have been damaged by previous access procedures. In certain patients, satisfactory veins may be difficult to locate. This may be due to the natural venous structure of the patient or due to other factors such as illness or obesity. Difficulties encountered during access may lead to increased patient discomfort and increased costs (e.g., due to increased practitioner time and/or increased supplies usage).

Furthermore, complications may arise such as damage to the venous structure of the patient during unsuccessful access attempts and fainting of the patient due to increased stress levels and/or discomfort. In cases where venous access is performed prior to an imaging procedure, the time required to gain venous access may take away from the time the imaging equipment is available for use (e.g., venous access procedures may be undertaken at the site of the imaging equipment), thereby possibly reducing the efficiency of use of the imaging equipment.

There are many products and techniques designed to assist practitioners in gaining access to the venous structure of a patient. For example, phlebotomy chairs, tables and stands are typically designed to support a patient's arm during an access procedure. Devices for the visualization of the venous structure of a patient are also known. However, many such systems are not portable and/or self-contained. Furthermore, many known systems require the positioning of components in proximity to the area where a vein is to be accessed, and thereby may interfere with practitioner access. Other known systems require additional separate members to support the patient during a venous access procedure.

SUMMARY

Accordingly, it would be desirable to provide a venous access system that is operable to provide a visual display of the vasculature of a patient, and furthermore to provide support for the patient during a venous access procedure without the need for a separate patient support device. As used herein, the phrase "the vasculature" or the like encompasses the entirety of the referenced anatomical structure, as well as any discrete portion of the vasculature (e.g., artery, vein) of the referenced anatomical structure (e.g., the phrase "the vasculature of the arm" is applicable to a discrete portion of the arm). That is and more generally, the term "the" is not intended to provide a requirement for an entirety of the referenced item unless otherwise noted (e.g., the phrase "to provide support for the patient" means any portion of the patient may be supported, and including the entirety of the patient - it does not require that the entirety of the patient be supported). This alleviates the need to use the phrase "at least portion of, "at least part of, or the like throughout the specification. It would also be desirable to provide a compact system integrated into an armrest that is capable of projecting light into an arm of a patient. As used herein, the term "arm" includes at least a portion of, and up to the entirety, of the anatomical structure that extends from the shoulder, and thereby includes without limitation the upper arm, the forearm, wrist, hand, and any combination thereof. A first aspect of the present invention is embodied by a vasculature visualization and access station. The vasculature visualization and access station may aid in the visualization of the vasculature of at least a region of an aim of a patient. The vasculature visualization and access station may generally include a chair in which a patient may be seated. The vasculature visualization and access station may also include a first armrest that includes a first patient interface surface operable to support an arm of the patient. The first armrest may include a first armrest light source disposed within the first armrest. The first armrest light source may be arranged to project light from within the first armrest through the first patient interface surface. In this manner, the light projected from the first armrest will be projected into a patient's arm resting on the first armrest.

The chair may have several advantageous features. For example, the chair may allow a patient to relax during a venous access procedure. The chair may include a back portion to support the back of the patient while the patient is seated. In this regard, if the patient does experience difficulties, such as lightheadedness or fainting, the chair may provide a stable platform to support the patient. The chair may have a relatively small footprint compared to a hospital bed or gurney. Moreover and in some embodiments, the first patient interface surface is contoured to "cradle" a corresponding portion of the patient's arm. The position of the first armrest relative to the chair may be adjustable. Various components may be interconnected to the vasculature visualization and access station. In an embodiment, the vasculature visualization and access station may include a rechargeable power supply interconnected to the chair. In an embodiment, the chair may be portable. Portability may be realized in any appropriate manner. For instance, the chair may inciude casters or wheels to ailow the chair to be easily relocated. The portable chair may be easier to maneuver than other healthcare equipment (e.g., a hospital bed or gurney) that may be used for a venous access procedure.

A storage apparatus for storing medical supplies may be interconnected to the chair. For example, the storage apparatus may be interconnected to the back of the chair and may inciude several compartments, which may be operable to store supplies used during venous access procedures. Similarly, a sharps container may be interconnected to the chair. Each of the above-noted "accessories" may be incorporated in any appropriate manner.

In some embodiments, the first light source may be operable to produce infrared light. Infrared light may be beneficial since blood within the vasculature of the patient may absorb this light at a higher rate than the surrounding tissue. However, it should be appreciated that other wavelengths may be appropriate. In an arrangement, a heat sink may be interconnected to the first light source. In an embodiment, the first patient interface surface may be textured and/or coated. This may reduce the level of scattering at the interface between the patient's arm and the first patient interface surface. In some embodiments, an output from the first light source may be collimated in any appropriate manner (e.g., to reduce scattering of light).

In some embodiments, the vasculature visualization and access station may include a camera and monitor. The camera may be operable to detect the light emitted from the first light source. The monitor may be operable to display a visual representation of the light detected by the camera. The display may represent at least a portion of the vasculature of the arm of the patient. For example, the first light source may emit infrared light that passes through the patient's arm (e.g., transillumination) and is detected by the camera and displayed by the monitor. Due to the differing infrared absorption rates of the blood in the vasculature and the surrounding tissue, the resulting display may represent a portion of the vasculature of the patient.

In various arrangements, the camera may include a visible light source operable to project visible light in the direction of the field of view of the camera. Various embodiments of the vasculature visualization and access station may include an image processing module operable to process an image signal from the camera. The image processing module may be operable to enhance the image displayed on the monitor to further assist the practitioner in visualizing the vasculature of the patient.

In some embodiments, the camera may be operable to capture images of the arm vasculature of a patient when the first arm is in contact with the first patient interface surface. The images captured may be real-time, still images or video footage. In an arrangement, the camera and monitor may be interconnected to a support arm.

The support arm may be interconnected to the chair, for example, at the back of the chair. The support arm may enable the camera and monitor to be selectively positionable relative to the patient and the first patient interface surface.

Other imaging-related features may be implemented. In some embodiments, the acquired images are stored in any appropriate manner and may be replayed at any appropriate time and in any appropriate manner

(e.g., a "playback" functionality). This would allow for the review of a procedure or any portion thereof. Multiple images may be presented in any appropriate manner in some embodiments. For instance, an image of a patient's arm vasculature may be presentee! along with an image of the patient's arm (e.g., multiple image signals may be multiplexed in any appropriate manner). Multiple images may be updated/generated at the same or different frequencies (e.g., an image of the patient's arm may be updated less frequently than an image of the patient's arm vasculature). Multiple images could be generated from a common camera or using different cameras. In some embodiments, the frequency at which one or more images is updated/generated may be selected/changed in any appropriate manner.

In various embodiments, the first light source may include a plurality of individually illuminable sections. Each ilEuminable section may contain at least one discrete light producing device. The discrete light producing device(s) may include Light Emitting Diodes (LEDs). The light producing devices may be arranged such that each individual light producing device is disposed within a separate recess. Light from each such light producing device may be coHimated in any appropriate manner. Alternatively, the light source may include a plurality of separate recesses, and each of the plurality of recesses may contain one or more individual light producing devices. The recesses may include walls disposed at an angle with respect to the first patient interface surface, where each of the walls is opaque to the light produced by the light producing devices. Each of the recesses may have an end portion that is transparent to the light produced by the light producing devices.

Some embodiments of the present aspect may include a second armrest interconnected to the chair. The second armrest may include a second patient interface surface operable to support the other arm of the patient. This second patient interface surface may be contoured to "cradle" a corresponding portion of the patient's arm. Moreover, a second light source may be disposed within the second armrest. The second light source may be arranged such that it is operable to project light from within the second armrest through the second patient interface surface. Furthermore, the various features and embodiments discussed above in relation to the first armrest and first light source may also apply to the second armrest and/or second light source. In addition, the camera may be operable to detect light from either the first light source or the second light source. Accordingly, the vasculature of either arm of the seated patient may be examined. A second aspect of the present invention is embodied by an apparatus for aiding in the visualization of the vasculature of a region of an arm of a patient. The apparatus may include a first armrest that includes a first patient interface surface. The apparatus may further include a first light source disposed within the first armrest, where the first light source is arranged to project light from within the armrest through the first patient interface surface. In some embodiments, the apparatus for aiding in the visualization of the vasculature of a region of an arm of a patient may include a camera and monitor. The camera and monitor may be configured similar to the camera and monitor discussed with reference to the first aspect.

Various refinements exist of the features noted in relation to the first and second aspects of the present invention. Further features may also be incorporated in the first and second aspects of the present invention as well. These refinements and additional features may exist individually or in any combination. Various features discussed above in relation to the first aspect of the present invention may be utilized by the second aspect of the present invention as well. A third aspect of the present invention is embodied by a method of visualizing the vasculature within an arm of a patient. The method may include seating a patient in a chair and selecting an arm of the patient for vasculature visualization. The method may further include positioning the selected arm so that it is in contact with an armrest of the chair. The method may also include projecting light from a light source within the armrest into the selected arm that is in contact with the armrest. The projected light may then be detected with a camera and displayed. The display may include visual information regarding the vasculature within the selected arm of the patient. In an embodiment of the present method, the display may be used to help guide access to the vasculature of the selected arm of the patient. Such access may, for example, include catheter insertion.

Various refinements exist of the features noted in relation to the first, second, and third aspects of the present invention. Further features may also be incorporated in the first, second, and third aspects of the present invention as well. These refinements and additional features may exist individually or in any combination. The various features discussed above in relation to the first, second, and third aspects of the present invention may be utilized by any of the aspects of the present invention as well. Additional aspects and corresponding advantages will be apparent to those skilled in the art upon consideration of the further description that follows. A fourth aspect of the present invention is embodied by what may be characterized as a patient assessment device. This patient assessment device includes a first armrest. At least one light source is disposed within the first armrest in any appropriate manner so as to project light at least generally toward a patient's arm when disposed on the first armrest.

The patient assessment device may be used for any appropriate application, such as to aid in the visualization of at least part of the vasculature of a patient's arm. In any case, each light source that is disposed within the first armrest may generate light at any appropriate wavelength or combination of wavelengths. Any appropriate number of light sources may be disposed in the first armrest. Multiple light sources may be presented in any appropriate arrangement. Each individual light source in the case of a multiple light source configuration may generate light of any appropriate wavelength or combination of wavelengths, and furthermore any appropriate timing may be used in relation to the activation of each such individual light source. One or more light sources may generate light at one wavelength or over one wavelength range, while one or more light sources may generate light at another wavelength or wavelength range.

In some embodiments, one or more light sources may be embedded within the first armrest. In any case, it may be desirable to dispose an appropriate barrier between each such light source and a patient's arm when disposed on the armrest, although such may not be required in alE instances. For instance, a transparent or translucent material may be disposed between each such light source and a patient's arm when disposed on the armrest. Such a transparent or translucent material may be integrated into an outer covering for the first armrest, although other implementations may be appropriate.

The patient assessment device may be in the form of a chair that includes the noted first armrest. Therefore, the various features discussed above in relation to the first aspect may be used in relation to this fourth aspect as well. For instance, such a chair may include a second armrest, and this second armrest may include one or more of the features addressed by this fourth aspect in relation to the first armrest. BRIEF DESCRIPTION OF THE FIGURES

Figure 1 is a block diagram illustrating functional components of an embodiment of a vasculature visualization and access station. Figure 2 is a perspective view of an embodiment of a vasculature visualization and access station in the form of a chair.

Figure 3 is a perspective view of an embodiment of an armrest used in a vasculature visualization and access station.

Figure 4 is a cross-sectional view of an alternative embodiment of an armrest used in a vasculature visualizatio n and access station .

Figure 5 is a flowchart directed to an embodiment of a method of visualizing vasculature within an arm of a patient.

DETAILED DESCRIPTION The apparatuses and methods disclosed and claimed herein can be made and executed without undue experimentation in light of the present disclosure. While the apparatuses and methods of this invention have been described in terms of preferred embodiments, it will be apparent to those of skill in the art that variations may be applied to the apparatuses and in the steps or in the sequence of steps of the methods described herein without departing from the concept, spirit and scope of the invention. More specifically, it will be apparent that certain dimensions and/or locations of the various components making embodiments of the invention may be varied to achieve the same or similar results. While configurations depicted in the figures indicate particular component and/or feature locations, the skilled artisan will recognize that the manner of operation of the embodiments of the invention does not require these locations be precisely as shown. The manner of operation of embodiments of the invention will not be significantly affected if these locations are not precisely observed. Thus, all similar substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit, scope and concept of the invention as defined by the appended claims.

Figure 1 is a block diagram illustrating functional components of an embodiment of a vasculature visualization and access station 100. The vasculature visualization and access station 100 may be operable to assist a practitioner (e.g., technologist, doctor, nurse, phlebotomist) by presenting an image of the vasculature structure within an arm of a patient. Again, the term "arm" includes at least a portion, and up to the entirety, of the anatomical structure that extends from the shoulder, and thereby includes without limitation the upper arm, the forearm, wrist, hand, and any combination thereof. The image may assist the practitioner in gaining access to a vein in order to, for example, insert a catheter, inject fluid, or draw a blood sample.

The vasculature visualization and access station 100 may include a chair 101. The chair 101 may be configured in a variety of ways known to those skilled in the art. In general, the chair 101 may contain an at least generally horizontal section on which the patient may sit and an at least generally vertical section to support the back of the patient while in a seated position. However, the seat and back sections may be disposed in any appropriate orientation.

The chair 101 may be portable and may include a portability device 102. The portability device 102 may be a set of wheels or casters interconnected to a support structure of the chair 101. Other devices and features known to those skilled in the art may be used to enable the chair 101 to be portable. The portability device 102 may include a locking feature. For example, in embodiments including casters, the portability device 102 may include a locking mechanism that when activated will prevent rotation of one or more of the casters, thereby selectively reducing the portability of the chair 101.

The vasculature visualization and access station 100 may include one or more armrests, such as a right armrest 103 and a left armrest 104. The armrests 103, 104 may be situated relative to the chair 101 to support the arms of the patient while the patient is seated in the chair 101. Again, "support the arms" includes supporting any portion of the arm in accordance with the foregoing, and does not require that the entirety of each arm be supported, although such could be the case. The armrests 103, 104 may be configured to support at least the forearms of the patient, at least the wrists/hands of the patient, or both. In some embodiments, the armrests 103, 104 each may be contoured to "cradle" an arm of the patient. The armrests 103, 104 may each include a light source 105, 106. The light sources 105, 106 may each contain one or more discrete light producing devices. For example, each light source 105, 106 may contain a single light bulb. In another example, each light source may contain a plurality of light bulbs.

The light sources 105, 106 may project infrared light. Other wavelengths of Sight outside of the infrared range may also be projected by the light sources 105, 106, either in addition to or in place of the aforementioned infrared light. The light sources 105, 106 may each project light at a plurality of different wavelengths within the infrared range. For example, the light sources 105, 106 may each include a plurality of discrete light producing devices, where a first portion of the discrete light producing devices are operable to produce infrared light at a first wavelength and a second portion of the discrete light producing devices are operable to produce infrared light at a second wavelength. Generally, each light source 105, 106 may produce light of any appropriate wavelength or combination of wavelengths, or light over any appropriate wavelength range or wavelength ranges.

The light sources 105, 106 may be configured such that light emitted from the light sources 105, 106 may be projected into an arm of the patient that is in proximity to one of the armrests 103, 104. For example, a patient may be seated in the chair 101 with his or her right arm resting on the right armrest 103. The light source 105 within the right armrest 103 may project light from within the right armrest 103 and into the right arm of the patient.

The armrests 103, 104 may be supported by adjustable armrest supports 107, 108 respectively. Briefly turning to Figure 2, a particular implementation of an embodiment of a vasculature visualization and access station

100 in the form of a vasculature visualization and access chair 200 is illustrated. As shown, the vasculature visualization and access chair 200 may have a front-to-back axis 219, a right-to-left axis 220 and a vertical axis 221. Returning to Figure 1, the adjustable armrest supports 107, 108 may be operable to allow for adjustment of the position of the armrests 103, 104 relative to a patient seated in the chair 101 along the front-to-back axis 219, the right-to-left axis 220, the vertical axis 221, or any combination thereof, wherein the axes are oriented similarly to the axes illustrated in Figure 2. Each of the armrests 103, 104 may be independently adjustable. The armrests 103, 104 may be rotatable about any one or more of the previously described axes. For example, the armrests 103, 104 may be rotatable about the right-to-left axis 220 resulting in the armrests 103, 104 being tiltable.

The adjustability of the armrests 103, 104 may enable the chair 101 to accommodate patients of varying sizes and in varying positions. For example, it may be desired for the patience to sit with his or her torso in an at least generally vertical position with the right armrest 103 adjusted such that the patient's right upper arm and forearm form a right angle, with the right forearm resting at least generally horizontally on the right armrest 103. In another example, it may be desired for the patient to sit with his or her torso in an at least generally vertical position with the right armrest 103 adjusted such that the patient's right arm is substantially straight and angled downward with the right forearm resting on the right armrest 103. In such a configuration, the right armrest 103 may be rotated about the right-to-left axis 220 such that the right armrest 103 is angled downward (e.g., the front of the right armrest 103 is lower than the rear of the right armrest 103),

The armrests 103, 104 may include optional straps that may be used to secure a patient's right or left forearm to the corresponding armrest, 103 or 104. In this regard, each armrest 103, 104 may function as an arm- board. Furthermore, the outer surfaces of the armrests 103, 104 may be constructed from nonporous materials.

Such nonporous materials may have the benefit of being easier to clean than porous materials such as cloth. Additionally, the armrests 103, 104 may have smooth surfaces, which may contribute to the cleanability of the armrests 103, 104.

The vasculature visualization and access station 100 may further include a camera 109. The camera 109 may be operable to detect the type of light emitted from the light sources 105, 106. Where the light source produces infrared light, the camera 109 may be operable to detect infrared light. For example, many standard black and white cameras are capable of detecting infrared light. The camera 109 may be interconnected to an adjustable camera support arm 111, which in turn may be interconnected to the chair 101. In this regard, by adjusting the adjustable camera support arm 111, the position of the camera 109 relative to the chair 101, and thereby relative to the patient seated in the chair 101, may be adjusted. For example, the position of the camera

109 may be adjusted so that, when the patient's right arm is positioned against the right armrest 103, the anterior of the forearm immediately below the elbow may be within the field of view of the camera 109.

The position of the camera 109 may be adjusted so that other areas of the patient's right arm (e.g., anterior wrist), positioned against the right armrest 103, may be within the field of view of the camera 109. The adjustable camera support arm 111 may allow for the camera 109 to be positioned so that similar portions of a patient's left arm may be within the field of view of the camera 109. Such adjustability may be achieved, for example, by having the adjustable camera support arm 111 include a swing arm interconnected to the back of the chair 101, and operable to swing the camera 109 to the left side or the right side of the patient. Articulating or telescoping members may be included in the adjustable camera support arm 111 to facilitate the above-described position adjustability of the camera 109.

The camera 109 may be operable to detect light, emitted from the light sources 105, 106, that has passed through an arm resting on one of the armrests 103, 104. As previously noted, the light emitted from the light sources 105, 106 may be infrared light. Infrared light may be used since blood within the vasculature structure within the patient's arm may absorb a greater amount of infrared light than the surrounding structure of the arm. Thusly, the vasculature structure may be seen as dark lines in an infrared image captured by the camera 109.

To display such an image, a monitor 110 may be interconnected to the camera 109. The monitor 110 may be interconnected to the chair 101 via the adjustable camera support arm 111 or in any other appropriate manner. The monitor 110 may be oriented to face toward a practitioner attempting to visualize the vasculature structure of the patient's arm. The monitor 110 position relative to the camera 109 may be adjustable.

The camera 109 may capture an infrared image of the vasculature structure of at least a portion of the arm of the patient. The camera 109 may capture real-time images of the vasculature structure. These infrared images may be displayed (using visible light) on the monitor 110. Images captured by the camera 109 may be sent directly to the monitor 110 for display. Alternatively, images captured by the camera 109 may pass through an image processor to modify and/or enhance the images prior to being displayed on the monitor 110. This image processing capability may be housed within the camera 109 and/or monitor 110, or this capability may be remotely located, such as, for example, within a system electronics module 113. A control interface 114 may also be present. The control interface 114 may allow an operator to adjust, enable and/or disable certain functions of the vasculature visualization and access station 100. For example, the control interface 114 may include a control for adjusting the contrast of the image displayed on the monitor 110. Other image capturing and displaying related parameters (e.g., image brightness, camera gain, focus parameters, zoom parameters) may also be controlled through the control interface 114, or they may be automatically controlled. System parameters, such as which portions of the light sources 105, 106 are to be active and light source 105, 106 power output level, may be controlled through the control interface 114. Optional accessories to the vasculature visualization and access station 100 may be controlled through the control interface 114. Optional accessories may include a visible light source interconnected to the camera 109 to shine visible light on the area of the patient's arm that is within the field of view of the camera 109. Such a visual light may assist the practitioner in accessing the vasculature structure of the patient. Other optional accessories may include the ability to capture and save images being displayed on the monitor 110. The control interface 114 may take the form of a plurality of buttons, switches and dials. The control interface 114 may be a touch screen interface contained within the monitor 110.

Images acquired by the camera 109 may be stored in any appropriate manner and at any appropriate location. Stored images may be retrieved and displayed on the monitor 110 or any other appropriate display as desired/required. For instance, this feature may be used to replay all or a portion of a procedure for any purpose.

Multiple images may be displayed on the monitor 110, and the signals that generate these images may be multiplexed in any appropriate manner. An image of the patient's vasculature may be presented, along with an image of the patient's arm. Multiple, static or still images may be presented. Multiple images may be presented in a video format as well (e.g., full motion video). Each image presented on the monitor 110 may be generated/updated at any appropriated frequency, for instance at the same or different frequencies. Functionality may be provided to independently select the frequency at which each image is generated/updated. In some embodiments, an image of the patient's arm vasculature is simultaneously presented with an image of the patient's arm (e.g., where the vasculature image is overlaid on the image of the arm, or stated another way where the patient's arm vasculature is presented in the context of the patient's arm (e.g., with the images being in proper registration)).

A power system 112 may be part of the vasculature visualization and access station 100. The power system 112 may be operable to provide power to run the light sources 105, 106, camera 109, monitor 110, control interface 114, and system electronics module 113, along with any other accessories that may be present. The power system 112 may include a rechargeable battery pack and a charging system. For example, the battery pack of the power system 112 may be operable to provide power for the vasculature visualization and access station 100 for a limited amount of time when the station 100 is unplugged. When plugged into an electrical outlet, the power system 112 may be operable to both recharge the battery pack, if needed, and power the vasculature visualization and access station 100 directly. !n this regard, the vasculature visualization and access station 100 may be completely self-contained and movable from location to location without the need for the station 100 to be plugged into a source of power.

As previously noted, the system electronics module 113 may include image-processing capabilities. The system electronics module 113 may, for example, also include subsystems capable of controlling or monitoring: the light sources 105, 106; the camera 109 operational parameters; the monitor 110 operational parameters; the control interface 114; and the power system 112. The system electronics module 113 may be capable of performing other functions such as data storage, wired or wireless communications with other systems, and diagnostic functions. The system electronics module 113 may be operable to monitor the temperature of the light sources 105, 106 and control optional cooling fans located in each armrest 103, 104 in response thereto. The system electronics module 113 may control the position of the armrests 103, 104 and/or camera 109 in embodiments where the adjustable armrest supports 107, 108 and/or adjustable camera support arm 111 are electronically positionable. The system electronics module 113 may include image data storage capabilities. Although in Figure 1 the system electronics module 113 is shown as a single functional block, the functions of the system electronics module 113 described herein may be performed by systems distributed throughout the vasculature visualization and access station 100. For example, image processing may be performed by a portion of the system electronics module 113 collocated with the camera 109 and/or monitor 110, and control of the light sources 105, 106 may be performed by a portion of the system electronics module 113 collocated with the respective armrests 103, 104. A storage apparatus 115 may be interconnected to the chair 101. The storage apparatus 115 may include a supplies storage component 116. The supplies storage component 116 may be configured to store various items associated with visualizing and accessing the vasculature structure of a patient. For example, the supplies stored in the supplies storage component 116 may include tourniquets, catheters, antiseptic pads, heparin locks, tape, Tegaderm (TM) brand dressings, disposable gloves, and other IV access supplies. Supplies related to the camera 109, monitor 110, or other components of the vasculature visualization and access station 100 may be stored in the supplies storage component 116. The storage apparatus 115 may include a waste container 117. The waste container 117 may be configured as a biohazard waste container. A sharps container 118 may be included as part of the storage apparatus 115.

The storage apparatus 115 may, for example, be interconnected to the back of the chair 101, although any appropriate integration may be utilized. The storage apparatus 115 may be a single unified apparatus that contains features operable to interconnect with the supplies storage component 116, the waste container 117, and the sharps container 118. Alternatively, the storage apparatus 115 may be comprised of discrete sections that are each operable to interconnect with the vasculature visualization and access station 100.

The vasculature visualization and access station 100 may also be configured to interconnect with other devices. Such devices may include those typically found in healthcare facilities. For example, the vasculature visualization and access station 100 may include an interconnection operable to interconnect the station 100 and an IV pole 119.

Figure 2 illustrates a particular implementation of an embodiment of the vasculature visualization and access station 100 described generally with reference to Figure 1. The vasculature visualization and access station of Figure 2 is in the form of a vasculature visualization and access chair 200. In the embodiment of Figure 2, the vasculature visualization and access chair 200 is configured similar to a typical office chair. The vasculature visualization and access chair 200 includes an at least generally horizontal section 201 on which the patient may be seated and an at least generally vertical section 205 to support the back of the seated patient. The horizontal section 201 and vertical section 205 each may be disposed in any appropriate orientation. The vasculature visualization and access chair 200 may include a support pedestal 202 interconnected to a support frame 203. In the embodiment of Figure 2, the portability device 102 of Figure 1 is in the form of a set of casters 204 interconnected to the support frame 203.

The vasculature visualization and access chair 200 includes two armrests: a left armrest 206 and a right armrest 207. However, the chair 201 could include a single armrest (not shown). In any case, the left armrest 206 is interconnected to the vasculature visualization and access chair 200 by a left armrest support member 208. Similarly, the right armrest 207 is interconnected to the vasculature visualization and access chair 200 by a right armrest support member 209. Each of the left armrest 206 and right armrest 207 may be contoured to "cradle" an arm of the patient. The left armrest 206 may include a light source (e.g., a single light producing device or a plurality of light producing devices) located therein and operable to project light from within the left armrest 206 and through a patient interface surface 222 along an upper surface of the left armrest 206. Such light may be projected through the patient's left arm that is adjacent to (e.g., resting on) the patient interface surface 222 of the left armrest 206. The right armrest 207 may be configured similarly to the left armrest 206.

Light projected from within the left armrest 206 and through the patient's left arm may be detected by a camera 210. The camera 210 may include a lens 211. The lens 211 may be an automatically and/or manually adjustable zoom lens. Similarly, the lens 211 may be capable of manual and/or automatic focusing. As illustrated in Figure 2, the camera 210 may be interconnected to a monitor 212 (e.g., the camera 210 and monitor 212 may be part of a common structure). The position of the monitor 212 may be adjustable relative to the camera 210 to provide an ergonomic configuration for a practitioner using the monitor 212 to visualize the vasculature structure of the patient. Alternatively, the monitor 212 may be in a fixed relationship with the camera 210. The camera 210 and the monitor 212 together may capture and present images of the vasculature structure of an arm of the patient. For example, in the position shown in Figure 2, the camera 210 and monitor 212 may be operable to display an image of the vasculature structure of the patient's forearm just below the elbow of the left arm when the patient's left arm is resting on the left armrest 206.

The position of the camera 210 relative to the patient's arm resting on the left armrest 206 may be adjustable in any appropriate manner. For example, the camera 210 may be mounted on a linkage 223 of any appropriate configuration, which may be interconnected to the back of the vasculature visualization and access chair 200. The linkage 223 of the illustrated embodiment may consist of a first arm 213 interconnected to the back of the vasculature visualization and access chair 200. In turn the first arm 213 may be interconnected to a second arm 214, which in turn may be interconnected to a third arm 215. The interconnections between the arms 213, 214 and 215 may be operable to allow the arms 213, 214 and 215 to move relative to each other. The camera 210 and monitor 212 may be rotatable relative to the third arm 215. Such a linkage 223 may be operable to allow the camera 210 position to be adjustable with respect to the patient's left arm resting on the left armrest 206. In this manner, the camera 210 may be positionable so that the field of view of the camera 210 may be positioned over any portion of the patient's left forearm positioned on the left armrest 206. For example, the linkage 223 may allow for the camera 210 to be positioned further forward (e.g., along front-to-back axis 219) so that a left wrist of the patient may be within the field of view of the camera 210. The range of motion of the linkage 223 may be selected so that any portion of the patient's arm positioned along the armrest 206 may be brought within the field of view of the camera 210 regardless of the position to which the left armrest 206 has been adjusted. The linkage 223 may be operable to allow the camera 210 and monitor 212 to swing around the back side of the vasculature visualization and access chair 200 and be positioned in a similar configuration with similar abilities over the right armrest 207 for visualization of the vasculature structure of the right arm of the patient. The linkage 223 may include electrical wiring connecting the camera 200 and monitor 212 with other components of the vasculature visualization and access chair 200. Other linkage 223 configurations than that shown in Figure 2 may be utilized.

For example, a linkage with fewer or more arms than that of Figure 2 may be utilized. The individual arms may be telescopic. Ball joints or other interconnection mechanisms may be used to allow for vertical movement of various components relative to other components. The linkage 223 may include counterbalancing and/or frictiona! members to assist in movement and positioning of the camera 210. The linkage 223 may be an electro- mechanical mechanism operable to reposition and/or stabilize the camera 210.

As illustrated in Figure 2, the camera 210 and monitor 212 are both interconnected to the linkage 223. In an alternate arrangement, the camera 210 and the monitor 212 may be each interconnected to the vasculature visualization and access chair 200 by separate linkages or other appropriate structure. In such an arrangement, the camera 210 position may be adjusted independently from the monitor 212 position. A housing 216 may be interconnected to the vasculature visualization and access chair 200. The housing

216 may contain components of the power system and system electronics of the vasculature visualization and access chair 200. The vasculature visualization and access chair 200 may include a contra! interface 217. The control interface 217 of the vasculature visualization and access chair 200 illustrated in Figure 2 is shown adjacent to the monitor 212. However, it will be appreciated that the control interface 217 may be configured as discussed with reference to the control interface 114 of Figure 1. For example, controls for turning on and off the light sources and or adjusting the power level of the light sources located within the armrests 206, 207 may be located on the armrests 206, 207.

The vasculature visualization and access chair 200 may include a storage apparatus 218 attached to the back of the vertical section 205 of the vasculature visualization and access chair 200. Although Figure 2 illustrates a specific embodiment of a vasculature visualization and access chair 200, it will be appreciated that any of the features or variations disclosed above with reference to Figure 1 may be applicable to the vasculature visualization and access chair 200 of Figure 2.

Figure 3 is a partial cross-sectional view of the left armrest 206 of Figure 2. The left armrest 206 of Figure 3 is oriented generally in the same orientation as the left armrest 206 of Figure 2. The left armrest 206 includes the patient interface surface 222 along a top portion of the left armrest 206. The left armrest 206 may be surrounded by a shell 307. The shell 307 may, for example, be comprised of a thin layer of material, such as plastic, surrounding the left armrest 206. The shell 307 may be comprised of one or more separate pieces that are interconnected during the assembly process for the left armrest 206. The shell 307 may include a Sens portion 305 that is transparent or translucent to the light emitted from the light source located within the left armrest 206. In an alternative arrangement, the entire shell 307 may be transparent or translucent to light emitted from the light source located within the left armrest 206 and therefore, in such an arrangement, a separate lens portion 305 may not be required. Returning to the illustrated embodiment of Figure 3, the shell 307, including the lens portion 305, may protect the light source located within the left armrest 206. In this sense, the lens portion 305 also functions as a barrier.

The outer surface of the shell 307 may be nonporous. Since the shell 307 may come into contact with several patients, the nonporous surface may enable the shell 307 to be easily cleaned and/or disinfected between uses by different patients. The outer surface of the shell 307 may have a coating and/or may be textured. The coating and/or texturing may be operable to enhance the propagation of light from the light source within the left armrest 206 and into the patient's arm in contact with the patient interface surface 222. Gels or similar substances may also be used to reduce light scattering at the patient arm-to-patient interface surface 222 interface. Such substances may be applied directly to the patient's arm and/or patient interface surface 222. Additionally, such substances may be contained within a member, such as a gel pack, that may be positioned between the patient's arm and the patient interface surface 222.

The light source within the left armrest 206 may, for example, be a single discrete light source such as a single light bulb. Alternatively, the light source within the left armrest 206 may include a plurality of discrete light sources. For example, as shown in Figure 3, the light source may include a plurality of LEDs 302 (e.g., infrared). Other types of light producing devices may also be utilized either in place of or in conjunction with the LEDs 302.

As illustrated, the LEDs 302 may be arranged in an array generally parallel to and offset from the patient interface surface 222. The array may be flat, as illustrated in Figure 3, or the array may be non-planar. For example, the array may be concave along the right-to-!eft axis 220 with respect to the patient interface surface 222. Such an arrangement may focus light emitted from the area toward a centerline along the patient's forearm. The individual LEDs 302 may be disposed in any appropriate arrangement. Light from the various LEDs 302 may be collimated in any appropriate manner. The array of LEDs 302 may be interconnected to a printed circuit board 303. Other methods known to those skilled in the art of locating and connecting to the LEDs 302 may be utilized. A heat sink 304 may be interconnected to the LEDs 302. The entire assembly, including the LEDs 302, printed circuit board 303, and heat sink 304, may be interconnected to an internal support structure 306. The internal support structure 306 may locate the assembly relative to the shell 307. In some embodiments, the LEDs 302 are positioned at or are only slightly recessed back from the lens portion 305. The left armrest 206 may include one such assembly or it may include a plurality of such assemblies arranged within the shell 307. The shell 307 may include one or more vents 308 operable to allow the exchange of air between the interior of the left armrest 206 and the surrounding environment. To further assist in the dissipation of heat, a cooling fan (not shown) may be included within the left armrest 206. The light source(s), such as the LEDs 302, within the left armrest 206 may be operable to project light through a light projection area or zone 310. The LEDs 302 may be commonly controlled. Alternatively, the LEDs 302 may be controlled individually or in any appropriate number of subgroups. Where the LEDs 302 are controlled in subgroups, each subgroup may include any number of LEDs 302. For example, the LEDs 302 may be grouped into three subgroups wherein a first subgroup consists of a group of LEDs 302 operable to project light through a first area or zone 312, a second subgroup consists of a group of LEDs 302 operable to project light through a second area or zone 313, and a third subgroup consists of a group of LEDs 302 operable to project light through a third area or zone 314. The projection of light through each of the areas 312, 313, and 314 may be individually controlled. The first area 312 may correspond to an area of the patient interface surface 222 that would typically be in contact with the wrist area of a patient. The third area 314 may correspond to an area of the patient interface surface 222 that would typically be in contact with the forearm of the patient in the area close to the elbow. The second area 313 may correspond to an area typically between the patient's wrist and eibow. Although the embodiment of the left armrest 206 of Figure 3 has been described with reference to LEDs 302 as the light source, other light sources, including infrared light sources, known to those skilled in the art could be used in place of the LEDs 302. The right armrest 207 may be configured similarly to the left armrest 206 described with reference to

Figure 3. Furthermore, the light sources located within the left armrest 206 may be controlled independently from the light sources located within the right armrest 207.

Figure 3 illustrates a configuration where the light producing devices (e.g., LEDs 302) are located within a common cavity 315 below the patient interface surface 222. Figure 4 illustrates an alternative light source configuration to that of Figure 3. Figure 4 illustrates a cutaway view of a portion of a patient interface surface 401.

In the embodiment illustrated in Figure 4, individual LEDs 402 are located within individual recessed areas 404. In an alternative arrangement, a plurality of LEDs or other light producing devices may be clustered together within a single recess. Returning to the configuration of Figure 4, the individual recessed areas 404 may be in the form of threaded holes. The individual recessed areas 404 may be capped by a lens 406 or another appropriate barrier, although such may not be required in ail instances. The lens 406 may form a portion of the patient interface surface 401 and may be transparent to light produced by the LEDs 402. The lens 406 may cover a plurality of individual recessed areas 404. Alternatively, each individual recessed area 404 may be capped by its own lens

406. The LEDs 402 may be interconnected to a printed circuit board 403. Portions of a shell 407 may form the individual recessed areas 404. The walls 405 of the individual recessed areas 404 may be configured (e.g., coated, colored, textured, placed at a particular angle with respect to the patient interface surface 401) to at least partially collimate light emitted by the LEDs 402. !n this regard, the walls 405 may be opaque to the light produced by the LEDs 402. Collimating the light, for instance so that it is projected primarily perpendicular to the patient interface surface 401, may result in a more efficient system in that scattering of the light may be reduced and therefore a greater percentage of the light emitted may be projected through the patient's arm as compared to a system that did not coltimate the emitted light. Any way of coflimating light from the LEDs 402 may be utilized as desired/required. Figure 5 is a flowchart of a method of visualizing the vasculature within an arm of a patient. The method will be described with reference to the steps illustrated in Figure 5 and the particular embodiment illustrated in Figures 2 and 3. The first step may be to seat 501 the patient in the vasculature visualization and access chair 200. Using the vasculature visualization and access chair 200 and having the patient in a seated position may have several advantages over other potential devices and patient positions. For example, in comparison to having the patient in a gurney or bed, the vasculature visualization and access chair 200 may take up significantly less floor space. Furthermore, the patient may be required to move after a practitioner has visualized and accessed the vasculature of the patient. This may be the case where the vasculature was accessed to insert a catheter for the delivery of contrast media and the patient must subsequently be moved to a CT scanner. It may be significantly easier for the patient to egress from the vasculature visualization and access chair 200 as compared to a bed. Moreover, during the vasculature visualization and accessing procedure, a patient may become lightheaded and/or faint. Accordingly, having a patient seated in the vasculature visualization and access chair 200 and supported by the vertical section 205 and armrests 206, 207 during the procedure, may reduce the risk of injury to the patient. The vasculature visualization and access chair 200 may also place the patient in a safe and comfortable position, thereby reducing the overall stress associated with the visualization and access of the vasculature. The next step may be to select 502 an arm of the patient for visualization. This selection may be based on standard practices known to those skilled in the art. For exemplary purposes, the remainder of the current method will be described with reference to a procedure where the left arm of the patient has been selected for visualization and access. The next step may be to position the left arm of the patient so that it is in contact with the left armrest 206 of the vasculature visualization and access chair 200. The left aim may be positioned so that the posterior of the patient's left arm is in direct contact with the patient interface surface 222 of the left armrest 206. In this regard, the left elbow of the patient may be positioned toward the back end of the left armrest 206 (e.g., the end of the left armrest 206 proximate to the vertical section 205). Accordingly, the left wrist of the patient may be positioned toward the front of the left armrest 206. The left armrest 206 may be positioned as shown in Figure 2 such that the forearm of the patient is substantially parallel to the floor and at a right angle with the patient's upper arm. Alternatively, the left armrest 206 may be positioned to place the patient's arm in another position. For example, the left armrest 206 may be rotated about the right-to-left axis 220 such that the forward part of the armrest 206 is pointed downward. Such a position may result in the patient's arm being substantially straight and angled downward while maintaining contact with the patient interface surface 222.

Following positioning 503 of the patient's left arm, the practitioner may engage in well-known techniques used when accessing the vasculature of the patient. For example, the practitioner may apply a tourniquet to plump the vein prior to visualization and access. The tourniquet may be obtained from the storage apparatus 218. The next step may be to project 504 light from a light source within the left armrest 206 and into the left arm of the patient. This step may include activating the appropriate portions of the light source corresponding to the portion of the patient's vasculature that is to be visualized and accessed. For example, where the patient's vasculature is to be visualized and accessed at the antecubital bifurcation of the venous structure of the upper forearm, only portions of the light source, such as the third area 314, may be illuminated. The practitioner may then position the camera 210 so that the camera 210 may detect 505 Sight projected from the light source within the left armrest 206 that has passed through the patient's left arm. The monitor 212 may then display 506 the detected light. The display of the monitor 212 may include information regarding the position, size and configuration of the vasculature of the patient. For example, where the light source is an infrared light source, blood within the vasculature of the patient will absorb the infrared light at a higher level than surrounding tissue. Accordingly, the monitor 212 may display this absorption differential in a manner that will communicate the vasculature structure to the practitioner. In this regard, the image on the monitor 212 may be produced directly from the output of the camera 210. Alternatively, the image may go through image processing to further assist in the visualization of the vasculature. For example, the image may be color enhanced to further highlight the vasculature. The image may be real-time. If the image is unsatisfactory to the practitioner, the practitioner may make one or more adjustments to increase the utility of the image. The practitioner may alter the light source. For example, in attempting to visualize the vasculature of the upper forearm, the practitioner may have initially only illuminated the portion of the light source within the third area 314 proximate to the antecubital bifurcation. If this illumination proved unsatisfactory, the practitioner may activate the portion of the light source within the second area 313 to supplement the portion of the light source within the third area 314, Alternatively, the practitioner may turn off the portion of the light source in the third area 314 and only use the portion of the light source in the second area 313. Similarly, the practitioner may reposition the camera 210 and/or change the focus and/or zoom settings of the camera 210 to improve the image. Other parameters, such as camera gain, image contrast, and image brightness may also be adjusted. The practitioner may then attempt to access the vasculature of the patient, for example, by attempting to insert a catheter into the venous structure of the patient. To assist in this process, the practitioner may turn on a light interconnected to the camera 210 that projects visible light into the field of view of the camera 210, thereby illuminating the area where the catheter is to be inserted. The supplies necessary for venous access (e.g., catheter, alcohol wipes) may be obtained from the storage apparatus 218. During insertion of the catheter, the needle portion of the catheter may be visible on the monitor 212. This may further assist the practitioner in positioning the catheter during the access procedure. Accordingly, the practitioner may look at the image displayed on the monitor 212 to locate the targeted vein and the needle relative to that vein. The practitioner may continue to view the vein and the needle relative to the vein on the monitor 212 as the needle is advanced into the vein.

One particular reason for accessing the vasculature of the patient may be to provide an access point to inject a contrast medium into the patient. The contrast medium may be used for subsequent imaging processes such as CT scanning or MRI. In such situations, if the catheter is not correctly situated within the vasculature, contrast media may extravasate into tissue surrounding the catheter. Such an event may be capable of being detected using the vasculature visualization and access chair 200, For example, as contrast media flows into the tissue surrounding the catheter, an area of increased brightness surrounding the catheter may be visible on the monitor 212. The foregoing description of embodiments of the present invention has been presented for purposes of illustration and description. Furthermore, the description is not intended to limit the present invention to the forms disclosed herein. Consequently, variations and modifications commensurate with the above teachings, and skill and knowledge of the relevant art, are within the scope of the present invention. The embodiments described hereinabove are further intended to explain best modes known of practicing the present invention. The embodiments described hereinabove are further intended to enable others skilled in the art to utilize the present invention in such or other embodiments and with various modifications required by the particular application(s) or use{s). It is intended that the appended claims be construed to include alternative embodiments to the extent permitted by the prior art.

Claims

What is claimed is:

1. An apparatus for aiding in visualization of vasculature of an arm of a patient, the apparatus comprising: a first armrest that comprises a first patient interface surface operable to support a first arm of a patient; and a first light source at least partially disposed within the first armrest, wherein the first light source is arranged to project light from the first armrest through the first patient interface surface.

2. The apparatus of Claim 1 , wherein the first light source is operable to produce infrared light.

3. The apparatus of any of Claims 1-2, wherein the first armrest comprises a heat sink thermally interconnected to the first light source.

4. The apparatus of any of Claims 1-3, wherein the first patient interface surface is textured.

5. The apparatus of any of Claims 1-4, wherein the first patient interface surface is coated.

6. The device of any of Claims 1-5, wherein the first light source emits light of single wavelength.

7. The device of any of Claims 1 -5, wherein the first light source emits light of a plurality of wavelengths.

8. The apparatus of any of Claims 1-7, wherein the first light source comprises a plurality of individually illuminable sections.

9. The apparatus of any of Claims 1 -8, wherein the first light source comprises a plurality of discrete light producing devices.

10. The apparatus of Claim 9, wherein the plurality of discrete light producing devices comprise light emitting diodes.

11. The apparatus of any of Claims 9-10, wherein each of the plurality of discrete light producing devices is disposed within a separate recess.

12. The apparatus of Claim 11, wherein each of the recesses comprises a wall disposed at an angle with respect to the first patient interface surface, wherein each of the walls is opaque to light produced by the plurality of light producing devices.

13. The apparatus of any of Claims 1-12, further comprising: a second armrest that comprises a second patient interface surface operable to support a second arm of the patient; and a second light source at least partially disposed within the second armrest, wherein the second light source is arranged to project light from the second armrest through the second patient interface surface.

14. The apparatus of Claim 13, wherein the second light source is operable to produce infrared light.

15. The apparatus of any of Claims 13-14, wherein the second armrest comprises a second heat sink thermally interconnected to the second light source.

16. The apparatus of any of Claims 13-15, wherein the second patient interface surface is textured.

17. The apparatus of any of Claims 13-16, wherein the second patient interface surface is coated.

18. The device of any of Claims 13-17, wherein the second light source emits iight of single wavelength.

19. The device of any of Claims 13-17, wherein the second light source emits light of a plurality of wavelengths.

20. The apparatus of any of Claims 13-16, wherein the second Sight source comprises a plurality of individually illuminabie sections.

21. The apparatus of any of Claims 13-20, wherein the second light source comprises a plurality of discrete lig producing devices.

22. The apparatus of Claim 21, wherein the plurality of discrete light producing devices comprise iight emitting diodes.

23. The apparatus of any of Claims 21-22, wherein each of the plurality of discrete light producing devices is disposed within a separate recess.

24. The apparatus of Claim 23, wherein each of the recesses within the second armrest comprises a wall disposed at an angle with respect to the second patient interface surface, and wherein each of the walls is opaque to light produced by the plurality of light producing devices.

25. The apparatus of any of Claims 11-12 and 23-24, wherein each of the recesses comprises an end member transparent to light produced by the plurality of light producing devices.

26. The apparatus of any of Claims 1-12, further comprising: a chair, wherein the first armrest is interconnected to the chair.

27. The apparatus of any of Claims 13-24, further comprising: a chair, wherein the first and second armrests are interconnected to the chair.

28. The apparatus of any of Claims 26-27, further comprising: a rechargeable power supply interconnected to the chair.

29. The apparatus of any of Claims 26-28, wherein the chair is portable.

30. The apparatus of any of Claims 26-29, further comprising: a storage apparatus for storing medical supplies, wherein the storage apparatus is interconnected to the chair.

31. The apparatus of any of Claims 26-30, further comprising: a sharps container interconnected to the chair.

32. The apparatus of any of Claims 1-31 , further comprising: a camera operable to detect light from a light source (e.g., the first and/or second light source) of the apparatus.

33. The apparatus of Claim 32, wherein the camera comprises a visible light source operable to project visible light in the direction of a field of view of the camera.

34. The apparatus of any of Claims 32-33, wherein the camera comprises a zoom lens.

35. The apparatus of any of Claims 32-34, further comprising: an image processing module operable to process an image signal from the camera.

36. The apparatus of any of Claims 32-35, wherein the camera is interconnected to a support arm and is selectively positionable with respect to a patient interface surface {e.g., the first and/or second patient interface surface) of the apparatus.

37. The apparatus of any of Claims 32-36, further comprising: a monitor operable to display visual information based, at least in part, on light detected by the camera.

38. The apparatus of Claim 37, wherein the monitor is interconnected to a support arm and is selectively positionable with respect to a patient interface surface (e.g., the first and/or second patient interface surface) of the apparatus.

39. A method of visualizing vasculature within an arm of a patient, the method comprising: seating a patient in a chair; selecting an arm of the patient for visualization of vasculature of the arm; positioning the arm in contact with an armrest of the chair; projecting light from the armrest into the arm that is in contact with the armrest; detecting the projected light with a camera; and displaying visual information regarding the vasculature of the arm based, at least in part, on the detecting.

40. The method of Claim 39, further comprising: using the displayed visual information to help guide access to the vasculature within the arm of the patient.

41. The method of any of Claims 39-40, wherein the arm of the patient is disposed between the armrest and the camera during the projecting and the detecting.