Automatic Detection of Needle Puncture in a Simulated Cannulation Task

Cannulation for hemodialysis is the process of inserting a tube into the body for removal or delivery of fluids. The cannulation process can cause several problems if the bottom of the arteriovenous fistula (AVF) or graft vessel wall is punctured by the dialysis needle. One of the main reasons for improper cannulation is the lack of skill in performing the various steps of cannulation: palpation to diagnose fistula health, needle entry, obtaining blood into cannula (termed “flashback”), and threading the needle. In this paper, we introduce a method for automatic detection of needle insertion in a simulated fistula that can be used for assessment and training of cannulation skills. Initial validation studies suggest that the algorithm is successful in detecting puncture within 0.1s on average and within 0.5s in the worst case. In the future, we will incorporate needle insertion detection into a simulator for objectively examining assessment and training of hemodialysis cannulation skills.