Model | BIX-HS13 — Advanced Elderly Venipuncture Training Arm (Geriatric Vein Injection Trainer) |
Summary | Elderly venipuncture training arm: Asian elderly male right arm with thin skin, low subcutaneous fat, tortuous veins, and replaceable skin and vessels. |
Simulation | Thin wrinkled skin, less subcutaneous fat, vessel tortuosity with poor elasticity; built to increase puncture difficulty |
Puncturable Vessels | Cephalic, basilic and median cubital veins; partly hidden for palpation-based location |
Procedures | Puncture, infusion and blood-drawing; loss-of-resistance with simulated blood return |
Consumables | Skin and blood vessels are replaceable |
Stated Purpose | Practising a difficult elderly arm also cultivates care for elderly patients and clinical patience |
Certification / Price | ISO 9001 / 14001 / 45001 & CE (page-stated); price on request |
Audience | Nursing schools, in-service and IV-team training, geriatric/emergency units |
Educational-use note: educational equipment, not a medical device for patient use. Request the spec sheet for spare skin and vessel sets.
Most venipuncture teaching arms are designed to be succeedable. Real geriatric arms are not: skin is thinner and tears easily, reduced subcutaneous fat lets veins roll, and vessels are tortuous and less elastic. Students trained only on smooth, well-padded arms meet the hard arm for the first time on a patient.
The difficulty is quantified. Among 472 older emergency department patients, independent factors for first-attempt failure included a non-palpable vein after tourniquet (OR 2.21), a non-upper-extremity site (OR 4.72), a history of difficult access (OR 3.02) and — critically for educators — a nurse with under two years of experience (OR 3.45, p < 0.001) (Yalçınlı et al., 2019).
Difficulty compounds: in the SPECTRA control analysis, A-DIVA high-risk patients needed four attempts in 57% of cases versus 16%, with success of 48.5% vs 88% (Prates et al., 2026). Repeated attempts are what a training arm exists to prevent — and training works. A randomized nurse trial of simulation training improved PIVC knowledge by 31% and skills by 24%, in a context where most nurses get little formal training in the procedure (Keleekai et al., 2016). And in 260 nursing students, mannequin IV arms matched peer practice (48.3% vs 51.7%) while removing the risk of learning on a human (Jones et al., 2014).
Skin is the third variable: skin tears are common in older people and risk becoming chronic wounds through age-related skin change and trauma (Benbow, 2017). Training on thin, wrinkly, replaceable skin teaches the handling that avoids them.
Evidence | Finding | Relevance |
Yalçınlı et al., 2019 | 472 older patients: non-palpable veins OR 2.21; nurse <2 years OR 3.45 for first-attempt failure | Experience is modifiable |
Prates et al., 2026 | High-risk (A-DIVA): 57% needed four punctures vs 16%; success 48.5% vs 88% | Train difficulty, don't discover it |
Keleekai et al., 2016 | RCT, nurses: simulation training improved knowledge 31%, skills 24% | Simulated practice closes a real gap |
Jones et al., 2014 | RCT, 260 students: mannequin arms matched peer practice (48.3% vs 51.7%) | Mannequins work, without learner risk |
Godfrey & Gallipoli, 2024 | PIVC failure "unacceptably high"; workshop + phantom practice gave 95.0% success | Model practice is part of the fix |
Benbow, 2017 | Skin tears are common in older people and risk becoming chronic wounds | Thin, replaceable skin is necessary |
The cephalic, basilic and median cubital veins are all cannulable — enough variety for a full session without rotating models.
Vessels are partly hidden and partly visible, so students combine sight with palpation — decisive when veins are impalpable after tourniquet (Yalçınlı et al., 2019).
The student feels the loss of resistance and sees simulated blood return — cues that separate a genuine puncture from a superficial needle that produces nothing.
Thin, wrinkled skin with less subcutaneous fat makes the arm realistically unforgiving: over-angulation, excessive traction and careless tape application have visible consequences (Benbow, 2017).
All vessels support infusion and blood-drawing practice, covering the encounter from first puncture to sampling — and because skin and vessels are replaceable, an intentionally fragile arm stays sustainable.
Model | Target | Best for |
HS13 | Elderly male right arm — thin skin, tortuous veins | Geriatric access, difficult-vein technique |
HS10 | Adult elbow venipuncture | Standard venous access |
HS3 / HS3S | Full functional arm venipuncture (HS3S with pump) | Infusion, flow simulation |
HS5 | Arm artery puncture | Arterial sampling |
HS4 | Electronic IV training hand | Hand-vein cannulation |
HS12 / HL | Intramuscular injection pads | Portable IM practice |
Buying logic: choose the HS13 when the curriculum must prepare students for difficult, fragile veins rather than textbook anatomy. Pair it with a standard adult arm (HS3/HS10): easy case first, hard case before it is met clinically.
Station | Time | Activity |
A. Assess | 10 min | Inspect and palpate; map the three veins; choose the site |
B. Standard access | 20 min | Cannulate the median cubital vein; feel resistance loss, confirm blood return |
C. Hard mode | 20 min | Repeat on basilic and cephalic veins with the vein rolled or hidden |
D. Skin-safe handling | 15 min | Anchoring, angulation, securement without traction damage |
E. Communication | 10 min | Explain the procedure; verbalise gentleness and consent |
● Site selected after palpation, with justification recorded
● Skin anchored without pinching or tearing
● Needle angle and depth suited to thin skin and reduced fat
● Loss of resistance felt and blood return obtained
● Line secured without tension on fragile skin
● Procedure explained and verbal consent gained
Item | Frequency | Notes |
Skin surface | Each session | Mild disinfectant; dry before storage |
Skin and vessels | Per cycle | Replace when leaks, tears or wall damage appear |
Fluid system | Each session | Flush and refill per manual |
Storage | Daily | Flat, dry, out of sun; no sharp objects |
Q1: What is the BIX-HS13? A: An advanced elderly venipuncture training arm — an Asian elderly male right arm with thin wrinkled skin, less subcutaneous fat and tortuous low-elasticity vessels, built to increase puncture difficulty.
Q2: Which veins can be punctured? A: The cephalic, basilic and median cubital veins all support puncture, infusion and blood-drawing. Vessels are partly hidden, so palpation is part of the exercise.
Q3: How does the model confirm a successful puncture? A: The student feels the loss of resistance and sees simulated blood return — the same cues used clinically.
Q4: What happens when the skin or veins wear out? A: Both skin and blood vessels are replaceable, so the arm is maintained rather than replaced. Request spare sets at adanursing@adaanatomy.com..
Q5: Is it suitable for beginners? A: Best used after basic technique is established: teach standard access first, then bring students here before they meet fragile veins.
Q6: What is the price, MOQ and certification? A: Price on request; MOQ 1 unit. The product page states ISO 9001 / 14001 / 45001 & CE. Email adanursing@adaanatomy.com. for the quotation and spare parts.
First-Attempt Cannulation Failure Factors (Yalçınlı et al., 2019)
Difficult Access and Repeated Punctures (Prates et al., 2026)
Simulation Training for PIVC Insertion (Keleekai et al., 2016)
Rubber IV Training Arms vs Peer Practice (Jones et al., 2014)
Ultrasound Pathway with Phantom Practice (Godfrey & Gallipoli, 2024)
Skin Tears in Older People (Benbow, 2017)