Patent Publication Number: US-2023148872-A1

Title: Temperature Monitoring for Vessel Detection

Description:
PRIORITY 
     This application claims the benefit of priority to U.S. Patent Application No. 63/280,043, filed Nov. 16, 2021, which is incorporated by reference in its entirety into this application. 
    
    
     BACKGROUND 
     Intravascular medical procedures are very common. Most every patient in a hospital experiences some intravascular procedure ranging from simple intravenous drug delivery to stent installation. As such, accessing the vasculature of the patient is a routine procedure performed by various care providers, primarily nurses. Cannulating the proper blood vessel for a defined procedure may be straight forward in some instances and complicated in others. Neonatal patients at one end of the patient spectrum and geriatric patients at the other have blood vessels that in some instances are difficult to find, identify, and cannulize. Accordingly, patient care facilities and patients could benefit by lowering error rate associated with cannulating the proper blood vessels. 
     Medical technologies, such as ultrasound imaging, cannula tracking, and the like have helped reduce the error rate. However, these technologies require setup time and additional equipment that cost. 
     Disclosed herein are systems and methods that utilize temperature scanning to identify and locate blood vessels and determine other vascular conditions. 
     SUMMARY 
     Disclosed herein is a medical system in accordance with some embodiments. The medical system generally includes a temperature scanning device configured to provide temperature data based on temperature variations of a skin surface extending across a subcutaneous target area of a patient body. The system further includes a console configured to communicate with the temperature scanning device, where the console includes one or more processors and a non-transitory computer-readable medium having stored thereon logic that, when executed by the one or more processors, causes system operations. The operations include obtaining temperature data across the target area, the target area including a subcutaneous blood vessel, wherein a cause of the temperature variations across the target area include a temperature difference of a blood temperature within the blood vessel with respect to a body tissue temperature adjacent the blood vessel. 
     In some embodiments, the operations further include providing an indication to the clinician based on the temperature data. In further embodiments, the operations include converting the temperature data into thermal image data, and providing a thermal image to the clinician based on the thermal image data. The thermal image may include a mapping of the blood vessels within the target area. Providing the thermal image may include includes providing a live thermal image and/or thermal image snapshots. 
     In some embodiments, the system further includes a temperature source configured to alter the blood temperature within the blood vessel. In some embodiments, the blood temperature is altered by placing the temperature source in contact with a target contact area of the patient, where the target contact area is located upstream with respect to a blood flow within the blood vessel. In some embodiments, the temperature source may be one of a hot pack or a cold pack, and in other embodiments, the temperature source may be a thermal contact pad of a targeted temperature management system. In some embodiments, the temperature source is an infusate delivered to the blood vessel. 
     The temperature variations may be the result of a temperature gradient extending along the blood vessel. In other embodiments, the temperature variations may be caused by a temperature of blood outside of the blood vessel with respect to the body tissue temperature adjacent the blood vessel. In some embodiments, the blood temperature is lower than the temperature of the body tissue. In some embodiments, the temperature variations may be caused by an infusate temperature outside of the blood vessel with respect to the body tissue temperature adjacent the blood vessel. 
     In some embodiments, the console is included within a housing of the temperature scanning device. In further embodiments, the display of the system is included within the housing of the temperature scanning device. 
     In some embodiments, the system includes a camera for providing an image of the target area and the camera may be included within the housing of the temperature scanning device. The operations may further include obtaining a camera image of the target area, and providing the thermal image superimposed atop the camera image. 
     In some embodiments, the system may include an ultrasound probe coupled with the console, the ultrasound probe configured to obtain an ultrasound image of the target area and the operations may further include obtaining an ultrasound image of the target area, and providing the thermal image superimposed atop the ultrasound image. In some embodiments, the temperature source is integrated into the ultrasound probe. 
     In some embodiments, the temperature scanning device is a hand-held device. In some embodiments, the system includes an augmented reality device, where the temperature scanning device is coupled with the augmented reality device, and an augmented reality image of the target area includes the mapping of the blood vessels overlayed onto a view of the target area. 
     Also disclosed herein is a method of determining a vascular condition of a patient. According to some embodiments, the method includes causing a temperature difference within a subcutaneous target area of the patient, obtaining a thermal image of a skin surface adjacent the subcutaneous target area, and determining the vascular condition based on the thermal image. 
     In some embodiments of the method, causing a temperature difference includes placing a temperature source in contact with the patient to alter the temperature of blood flowing through one or more blood vessels within the target area and determining the vascular condition includes identifying each of one or more blood vessels as a vein or as artery based on the location of the temperature source with respect to the target area. 
     In some embodiments of the method, determining the vascular condition includes determining a blood flow direction within at least one of the one or more blood vessels, and in further embodiments, determining the vascular condition includes determining a location of at least one of one or more blood vessels within the target area. 
     In some embodiments of the method, causing a temperature difference includes placing a temperature source in contact with the patient upstream with respect to veinous blood flow within the target area and determining the vascular condition includes identifying at least one vein within the target area. 
     In some embodiments of the method, causing a temperature difference includes placing a temperature source in contact with the patient upstream with respect to blood flow within one or more blood vessels passing through the target area and determining the vascular condition includes determining an extravasation within the target area, the extravasation emanating from any of the one or more blood vessels. 
     In some embodiments of the method, causing a temperature difference includes delivering an infusate to the patient within the target area and determining the vascular condition includes determining an infiltration of the infusate within the target area. 
     In some embodiments of the method, causing a temperature difference includes applying a thermal contact pad of a targeted temperature management system to the patient. In further embodiments, causing a temperature difference includes lowering the temperature of a portion of the subcutaneous target area. 
     These and other features of the concepts provided herein will become more apparent to those of skill in the art in view of the accompanying drawings and following description, which describe particular embodiments of such concepts in greater detail. 
    
    
     
       DRAWINGS 
         FIG.  1 A  illustrates a medical system including temperature scanning in use with a patient in accordance with some embodiments. 
         FIG.  1 B  is an exemplary thermal image depicting an extravasation instance in accordance with some embodiments. 
         FIG.  2    illustrates a block diagram of a console of the medical system of  FIG.  1 A  in accordance with some embodiments. 
         FIG.  3 A  illustrates a temperature source applied to a hand of a patient in accordance with some embodiments. 
         FIG.  3 B  illustrates a temperature source in the form of a thermal contact pad coupled with a targeted temperature management system in accordance with some embodiments. 
         FIG.  4 A  illustrates an implementation of the system of  FIG.  1 A  including the delivery of an infusate in accordance with some embodiments. 
         FIG.  4 B  illustrates a thermal image showing the infusate of  FIG.  4 A  flowing within a blood vessel in accordance with some embodiments. 
         FIG.  4 C  illustrates a thermal image showing the infusate of  FIG.  4 A  infiltrating body tissue in accordance with some embodiments. 
         FIG.  5    illustrates a second embodiment of the medical system including an ultrasound probe in accordance with some embodiments. 
         FIG.  6    illustrates a third embodiment of the medical system including an augmented reality device in accordance with some embodiments. 
     
    
    
     DESCRIPTION 
     Before some particular embodiments are disclosed in greater detail, it should be understood that the particular embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that a particular embodiment disclosed herein can have features that can be readily separated from the particular embodiment and optionally combined with or substituted for features of any of a number of other embodiments disclosed herein. 
     Regarding terms used herein, it should also be understood the terms are for the purpose of describing some particular embodiments, and the terms do not limit the scope of the concepts provided herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps in a group of features or steps, and do not supply a serial or numerical limitation. For example, “first,” “second,” and “third” features or steps need not necessarily appear in that order, and the particular embodiments including such features or steps need not necessarily be limited to the three features or steps. Labels such as “left,” “right,” “top,” “bottom,” “front,” “back,” and the like are used for convenience and are not intended to imply, for example, any particular fixed location, orientation, or direction. Instead, such labels are used to reflect, for example, relative location, orientation, or directions. Singular forms of “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. 
     With respect to “proximal,” a “proximal portion” or a “proximal-end portion” of, for example, a catheter disclosed herein includes a portion of the catheter intended to be near a clinician when the catheter is used on a patient. Likewise, a “proximal length” of, for example, the catheter includes a length of the catheter intended to be near the clinician when the catheter is used on the patient. A “proximal end” of, for example, the catheter includes an end of the catheter intended to be near the clinician when the catheter is used on the patient. The proximal portion, the proximal-end portion, or the proximal length of the catheter can include the proximal end of the catheter; however, the proximal portion, the proximal-end portion, or the proximal length of the catheter need not include the proximal end of the catheter. That is, unless context suggests otherwise, the proximal portion, the proximal-end portion, or the proximal length of the catheter is not a terminal portion or terminal length of the catheter. 
     With respect to “distal,” a “distal portion” or a “distal-end portion” of, for example, a catheter disclosed herein includes a portion of the catheter intended to be near or in a patient when the catheter is used on the patient. Likewise, a “distal length” of, for example, the catheter includes a length of the catheter intended to be near or in the patient when the catheter is used on the patient. A “distal end” of, for example, the catheter includes an end of the catheter intended to be near or in the patient when the catheter is used on the patient. The distal portion, the distal-end portion, or the distal length of the catheter can include the distal end of the catheter; however, the distal portion, the distal-end portion, or the distal length of the catheter need not include the distal end of the catheter. That is, unless context suggests otherwise, the distal portion, the distal-end portion, or the distal length of the catheter is not a terminal portion or terminal length of the catheter. 
     Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by those of ordinary skill in the art. 
     Any methods disclosed herein comprise one or more steps or actions for performing the described method. The method steps and/or actions may be interchanged with one another. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order and/or use of specific steps and/or actions may be modified. 
       FIG.  1 A  illustrates a medical system configured to detect and identify blood subcutaneous blood vessels within a patient body. The medical system  100  generally includes a temperature scanning device  101  operatively coupled with a console  130 , in accordance with some embodiments. The temperature scanning device  101  is configured for obtaining temperature data across a skin surface of a target area  20  of a patient  10 . The temperature scanning device  101  includes a housing  104 . In some embodiments, the housing  104  may facilitate grasping and holding by the hand of the clinician during use of the system  100 . In some embodiments, the console  130  may be enclosed within the housing  104  of the temperature scanning device  101 . 
     The console  130  is configured to receive the temperature data from the temperature scanning device  101  and process the temperature data in reference to blood vessels within the target area  20  as further described below. In some embodiments, the console  130  may process the temperature data to provide an indication to a medical practitioner (e.g., a clinician) regarding the location of one or more blood vessels within the target area  20 . In further embodiments, the indication may include a thermal image  110  illustrating the locations. I still further embodiments, the thermal image  110  may illustrate a mapping of the blood vessels with the target area  20 . In some embodiments, the console  130  includes a display  131  for portraying the thermal image  110 , and in further embodiments, the display  104  may include a graphical user interface (GUI) configured for receiving input from the clinician. 
     The system  100  may include or be utilized in conjunction with a temperature source  150 . The temperature source  150  is configured to generate a subcutaneous temperature difference within the target area  20  of the patient  10 , where the subcutaneous temperature difference causes the temperature differences/variations across the skin surface. The temperature source  150  may take several forms as further described below. 
     According to one implementation of the system  100 , the temperature source  150  causes a lowering of a blood temperature within one or more blood vessels  30 . By way of one example, as illustrated in  FIG.  1 A , the temperature source  150  is held by the patient&#39;s hand causing a lowering of the blood temperature within the capillaries of the hand. The blood, having the lowered temperature, flows via blood vessels  30  (e.g., veins) through the target area  20 . The lowered blood temperature within the blood vessels  30  results in a temperature difference between the blood vessels  30  and the surrounding body tissue  31  which is translated (i.e., migrates) to the skin surface for detection by the temperature scanning device  101 . In some embodiments, the resulting temperature data is converted into the thermal image  110  that may be portrayed on the display  131 . Note that the term “thermal image” as used herein includes any visual indication based on temperature data (e.g., a visual indication of the blood vessels based on the temperature data). Note that, in the illustrated implementation, the blood flowing within adjacent arterial blood vessels (not shown) is not affected by the temperature source  150  and therefore, the temperature of the arterial blood vessels is essentially the same as the temperature of the surround tissue  31 . Hence, the arterial blood vessels are not detected by the temperature scanning device  101  and thus, are not portrayed in the thermal image  110 . 
     In some implementations, the target area  20  may extend beyond the patient  10 . As such, the thermal image  110  may include an environment  15  extending beyond the patient  10  where the environment  15  has a temperature that differs from the temperature of skin surface of the patient  10 . Therefore, the thermal image  110 , when portrayed, may include the transition between the patient  10  and the environment  15 . 
     The thermal image  110  may help facilitate the clinician in performing a medical procedure, such as an intravascular procedure, for example. More specially, the thermal image  110  may help the clinician to identify a target blood vessel for cannulation thereby reducing the propensity of making an error when cannulizing the patient  10 . The medical system  100  is useful for imaging a target blood vessel prior to a percutaneous puncture with a needle and for inserting the needle or another medical device into the target blood vessel. Indeed, the medical system  100  is shown in  FIG.  1 A  in a general relationship to the patient P during a medical procedure. It should be appreciated that the system  100  can be useful in a variety of medical procedures other than cannulation. 
     It is to be noted that, while the temperature source  150  provides a cooling effect in the illustrated example, the temperature source  150  is not limited to providing a cooling effect. As such, this disclosure is broad enough to include a temperature source  150  having a temperature greater than the patient  10 , the surrounding tissue  31 , and/or the blood  33  flowing within the blood vessels  30 . 
     In some embodiments, the thermal image  110  may portray a temperature gradient extending along the blood vessel  30 . In other words, the thermal image  110  may depict a first temperature difference  114  and a second temperature difference  115  located downstream of the first temperature difference  114 . In some instances, the first temperature difference  114  may be greater than the second temperature difference  115 . 
     In some embodiments, although not required, the system  100  may include a camera  107 . The camera  107  may be included within the housing  104  of the temperature scanning device  101  or the camera  107  may be physically separate the temperature scanning device  101 . The camera  107  is communicatively coupled with the console  130  via a wired or wireless connection. The camera  107  may be configured to obtain a camera image  111  of the target area  20 . In some embodiments, the camera image  111  may be portrayed in combination with the thermal image  110 . In further embodiments, the camera image  111  may be superimposed atop the thermal image  110  or vice versa. 
     The temperature scanning device  101  may include one or more input devices  105  (e.g., control buttons) for defining operating modes of the temperature scanning device  101  or the system as a whole. In some embodiments, the input devices  105  may include a trigger for obtaining snapshots of the thermal image  110  and/or the camera image  111 . 
       FIG.  1 B  illustrates another exemplary implementation of the system  100 . More specifically,  FIG.  1 B  is a thermal image  120  of an extravasation condition of the patient, i.e., a condition where blood  33  is leaking from the blood vessel  30 . In such an instance, the blood  33 , as cooled by the temperature source  150 , is leaking into the surrounding tissue  31  through a hole  36  in the blood vessel wall causing an accumulation  35  of the blood  33  within the surrounding tissue  31 . The accumulation  35  of the blood  33  causes a temperature difference between the accumulation  35  of the blood  33  and the surrounding tissue  31  that translates to the skin surface to be detected by the temperature scanning device  101 . 
       FIG.  2    illustrates a block diagram of the medical system  100  in accordance with some embodiments. As shown, the medical system  100  includes a console  130 , the display  131 , and the temperature scanning device  101 . The console  130  includes a variety of components of the medical system  100 , and it is appreciated that the console  130  can take any of a variety of forms. One or more processors  261  and memory  262  such as random-access memory (“RAM”) or non-volatile memory (e.g., electrically erasable programmable read-only memory [“EEPROM”]) is included in the console  130  for controlling functions of the medical system  100 , as well as executing various logic operations or algorithms during operation of the medical system  100  in accordance with executable logic  263  therefor stored in the memory  262  for execution by the processors  261 . 
     The medical system  100  further includes ports  124  for connection with additional components. Although not shown, additional optional components may include a printer, storage media, keyboard, etc. The ports  264  can be universal serial bus (“USB”) ports, though other types of ports can be used for this connection or any other connections shown or described herein. A power connection  265  is included with the console  130  to enable operable connection to an external power supply  267 . An internal power supply  266  (e.g., a battery) can also be employed either with or exclusive of the external power supply  267 . Power management circuitry  268  is included with the digital controller/analog interface  270  of the console  130  to regulate power use and distribution. 
     A temperature scanning device interface  271  and control buttons  105  (see  FIG.  1 A ) included on the temperature scanning device  101  can be used to immediately call up a desired mode to the display  131  by the clinician for assistance in a medical procedure. In some embodiments, the display screen  131  is an LCD device. 
     Optionally, a stand-alone ultrasound probe  280  can be communicatively coupled with the console  130  by way of one of the ports  264 . The ultrasound probe  280  may be employed in connection with ultrasound-based visualization of the target area as further described below. 
     In some embodiments, the console  130  may be a general computing device, such as a personal computer or a server, for example. The general computing device may be configured to communicatively couple with the temperature scanning device, and the optional ultrasound probe via a wired or wireless connection. In such embodiments, the logic  263  may be stored in memory of the general computing device and cause one or more processors of the general computing device to perform operations of the system  100 . 
     As discussed above the temperature source  150  may take several forms. In  FIG.  1 A , the temperature source is illustrated an object grasped by the patient&#39;s hand. Such an object may be water bottle, an ice pack, a metal bar, or the like. As the hand comprises a large amount of capillary blood vessels, grasping the temperature source  150  may be effective in exchanging thermal energy with the blood flowing within the hand. 
       FIGS.  3 A- 3 B  illustrate additional embodiments of the temperate source  150 .  FIG.  3 A  illustrates a pad  305  wrapped around the hand thereby effecting the temperature of the palm and backside of the hand as well as the wrist. As such, the pad  305  may affect the temperature of the blood within the hand a greater rate than temperature source simply grasped by the hand. The pad  305  may be a cooling pad or a heating pad. 
       FIG.  3 B  illustrates a thermal contact pad  311  of a targeted temperature management system  310 . The targeted temperature management system  310  includes a module  313  that circulates water having a defined temperature through the thermal contact pad  311  to affect the temperature of the thermal contact pad  311  and thereby, facilitate thermal energy exchange with the hand including the blood flowing through the hand. The targeted temperature management system  310  provides an advantage of setting the temperature of the temperature source  150  and adjusting the temperature as needed during the procedure. 
     Although the various embodiments of the temperature source  150  are shown and described as applied to the hand of the patient. Other embodiments may be configured to engage the patient  10  at other locations in accordance with various medical procedures. Similarly, the temperature source  150  embodiments are illustrated in accordance with affecting the temperature of venous blood flow. Other embodiments may be configured to affect the temperature of arterial blood flow. 
       FIG.  4 C  illustrates a second implementation of the medical system  100 . In this implementation, an infusate  405  is being delivered to the patient  10  via a syringe  401 . The infusate  405  has a temperature that is lower than the temperature of the tissue  31 . Infiltration (i.e., the delivery of an infusate into the patient outside of the blood vessel) is common error that occurs during cannulation which sometimes ay result in a hazard to the patient. As a mitigation during cannulation, the clinician may seek to verify that a distal tip of the catheter  406  is inserted into the blood vessel  30 . A common practice is to draw back a syringe plunger (not shown) to draw fluid back into the syringe (not shown), at which point the clinician can verify that blood is drawn back into the syringe indicating that the distal tip is located within the blood vessel. During delivery of the infusate, the distal tip of a catheter may become dislodged from the blood vessel resulting in infiltration. The system  100  facilitates a method of verifying the lack of infiltration or detecting the presence infiltration while infusate is being delivered. 
     In the illustrated exemplary implementation, an infusate  405  is delivered to the patient  10  via a catheter  406 . The infusate  405  has a temperature (e.g., room temperature) that is lower than the temperature of the tissue  31  and the blood  33 . The catheter  406  passes through the skin at an insertion site  409 . 
       FIG.  4 B  illustrates a thermal image  401  in accordance with a first instance where the distal tip  410  of the catheter  406  is located within the blood vessel  30 . The infusate  405  flowing through the catheter  406  joins the blood  33  flowing within the blood vessel  30  at the distal tip  410 . When the infusate  406  joins the blood  33 , the lower temperature of the infusate  405  causes a lowering of the temperature of the blood  33  downstream of the distal tip  410 . As shown, the infusate  405 , due to its temperature difference in relation to the tissue  31 , is visible in the thermal image  401 . Similarly, the blood  33  downstream of the distal tip  410  is also visible in the thermal image  401  due to its temperature difference in relation to the body tissue  31 . As such, the clinician may verify via the thermal image  401  that the infusate  405  is flowing into the blood vessel  30 , i.e., infiltration is not occurring. 
       FIG.  4 C  illustrates a thermal image  411  in accordance with an alternative second instance where the distal tip  410  of the catheter  406  is dislodged from or otherwise not located within the blood vessel  30 . The infusate  406  flowing through the catheter  406  flows into the tissue  31  causing an accumulation of infusate  406  adjacent the distal tip  410 . The accumulation of the infusate  406  has a temperature that is lower than the temperature of the tissue  31 . As shown, the accumulation of the infusate  405 , due to its temperature difference in relation to the tissue  31 , is visible in the thermal image  401 . As such, the clinician may detect that infusate  405  is accumulating within the tissue  31  and not flowing into the blood vessel, i.e., that infiltration is occurring. By way of summary, the clinician can quickly and easily detect infiltration or verify the absence of infiltration, by observing a thermal image of the target area  20  obtained by the system  100 . 
       FIG.  5    illustrates a second embodiment of the medical system. The medical system can, in certain respects, resemble components of the medical system  100  described in connection with  FIGS.  1 A- 4   . It will be appreciated that all the illustrated embodiments may have analogous features. As such, relevant disclosure set forth above regarding similarly identified features thus may not be repeated hereafter. Moreover, specific features of the medical system  100  and related components shown in  FIGS.  1 A- 4    may not be shown or identified by a reference numeral in the drawings or specifically discussed in the written description that follows. However, such features may clearly be the same, or substantially the same, as features depicted in other embodiments and/or described with respect to such embodiments. Accordingly, the relevant descriptions of such features apply equally to the features of the medical system of  FIG.  5   . Any suitable combination of the features, and variations of the same, described with respect to the medical system  100  and components illustrated in  FIGS.  1 A- 4    can be employed with the medical system and components of  FIG.  5   , and vice versa. 
     The medical system  500  generally includes the temperature scanning device  101  and the console  130  having logic  563  stored in memory of the console  130 . The medical system  500  further includes the ultrasound probe  280  (see  FIG.  2   ) coupled with the console  130 . The ultrasound probe  280  is configured to obtain an ultrasound image of the target area  520  of the patient  10 .  FIG.  5    illustrates the system  500  obtaining a thermal image  510  of the target area  520  and further obtaining an ultrasound image  540  of the target area  520 . The target area  520  includes a blood vessel  530  through which blood  533  is flowing in the direction indicated by the arrow  534 . 
     In some embodiments, the ultrasound probe  280  includes a temperature source  550  integrated into the housing  581  of the ultrasound probe  280 . The ultrasound probe  280  is configured such that the temperature source  550  is spaced laterally away from the ultrasound imaging plane  541 . In use the ultrasound probe  280  may be placed in contact with the patient so that the imaging plane  541  and the temperature source  550  are aligned with the vasculature of the patient  10 . In the illustrated implementation, the imaging plane  541  intersects the blood vessel  530  so that the ultrasound image  540  includes the blood vessel  530 . 
     Similarly, the temperature source  550  is in contact with the patient  10  adjacent the blood vessel  530  so the temperature source  550  affects the temperature of the blood  530 . In the illustrated instance, the temperature source  550  is also located upstream with respect to the blood flow direction so that blood  533  affected by the temperature source  550  flows through the target area  520  and more specifically the image plane  541 . 
     The temperature source  550  may be configured to warm or cool the blood  533  or both. In some embodiments, the temperature source  550  may include a thermo-electric device (TED)  551  that defines a temperature of the bottom surface  555  of the housing  581 . The TED  551  may be configured to define a temperature of the bottom surface  555  based on a DC voltage applied to the TED  551 . Furthermore, the TED  551  may be configured to cool the blood  533  in accordance with a first polarity of the DC voltage and warm the blood in accordance with an opposite second polarity of the DC voltage. 
     According to exemplary use case, the temperature source  550  cools the blood  533  flowing within the blood vessel  530  to establish a temperature difference between the blood  533  and the surrounding tissue  531  within the target area  520 . The temperature scanning device  101  detects the temperature difference and provides thermal imaging data to the console  130  accordingly where the logic  563  processes the thermal imaging data into a thermal image  510  to be portrayed on the display  131 . At the same time, the ultrasound probe  280  provides ultrasound imaging data to the console where the logic  563  processes the ultrasound imaging data into an ultrasound image  540  to be portrayed on the display  131 . The logic  563  may then superimpose the thermal image  510  atop the ultrasound image  540  (or vice versa) so that the clinician may view the blood flow image  530 A as portrayed in the thermal damage  510  in combination with the blood vessel image  530 B portrayed within the ultrasound image  540 . By simultaneously observing the blood flow image  530 A along with the blood vessel image  530 B, the clinician may gain confidence that the blood vessel image  530 B is consistent with a target blood vessel for a given medical procedure thereby avoiding a cannulation error, for example. 
     In some embodiments, the logic  563  may perform a spatial positioning assess of the blood flow image  530 A with respect to the blood vessel image  530 B thereby determine confidence that the blood flow image  530 A is in assignment with the blood vessel image  530 B. 
       FIG.  6    illustrates a third embodiment of the medical system. The medical system  600  can, in certain respects, resemble components of the medical systems  100 ,  500  described in connection with  FIGS.  1 A- 5   . It will be appreciated that all the illustrated embodiments may have analogous features. As such, relevant disclosure set forth above regarding similarly identified features thus may not be repeated hereafter. Moreover, specific features of the medical systems  100 ,  500  and related components shown in  FIGS.  1 A- 5    may not be shown or identified by a reference numeral in the drawings or specifically discussed in the written description that follows. However, such features may clearly be the same, or substantially the same, as features depicted in other embodiments and/or described with respect to such embodiments. Accordingly, the relevant descriptions of such features apply equally to the features of the medical system of  FIG.  6   . Any suitable combination of the features, and variations of the same, described with respect to the medical systems  100 ,  500  and components illustrated in  FIGS.  1 A- 5    can be employed with the medical system and components of  FIG.  6   , and vice versa. 
     The medical system  600  generally includes the temperature scanning device  101 , a console  630 , and a display  631  enclosed with a headset housing  604 . The system  600  may include one or more input devices  605  (e.g., control buttons) located on the hosing  604  for defining operating modes of the medical system  600 . In some embodiments, the input devices  605  may include a button for obtaining snapshots of the augmented reality view. 
     The display  631  may be a single display within the housing a pair of displays (e.g., one for each eye). The logic  663  may cause the thermal image  610  to be portrayed on the display  631 . As such, the clinician may identify and locate the blood vessels  30  within the target area  20  of the patient  10  as described above in relation to the systems  100 ,  500 . 
     In a similar fashion to the system  100 , although not required, the system  600  may include the camera  107  according to some embodiments. The camera  107  may be included within the housing  604 . The camera  107  may is configured to obtain a camera image  611  of the target area  20 . In some embodiments, the camera image  611  may be portrayed in combination with the thermal image  610 , such as superimposed atop the thermal image  610  or vice versa. As such, the system  600  may operate similar to a virtual reality device. 
     According to alternative embodiment, the system  600  may operate as an augmented reality device. In such an embodiment, the system  600  includes lenses (e.g., glasses not shown) included in the housing  604  through which the clinician may be directly view the target area  20 . The display  631  projects the thermal image  610  onto the lenses (or otherwise makes the thermal image  610  visible) so that the clinician may view the thermal image  610  in combination with the direct view of the target area. As such, the clinician may identify and locate the blood vessels  30  within the target area  20  of the patient  10 . 
     Methods of the foregoing medical systems include methods implemented in the medical systems. For example, a method of the medical system (e.g., systems  100 ,  500 , or  600 ) includes a non-transitory CRM (e.g., EEPROM) having the logic stored thereon that causes the medical system to perform a set of operations for thermal imaging when the logic is executed by the processors of the console. 
     The logic may obtain temperature data pertaining to subcutaneous blood vessels within a target area when the temperature of the blood within the blood vessels is altered via a temperature source. The logic may process the temperature data to determine the location of the blood vessels. The logic may further provide an indication pertaining to the location of the blood vessels to the clinician. The logic may then generate an image or mapping of the blood vessels for portrayal on the display so that the clinician may visualize the blood vessels within the target area. 
     In some embodiments, the logic may obtain a camera image of the target area of the patient along with obtaining the thermal image of subcutaneous blood vessels. The logic may then portray the thermal image in combination with camera image on the display of the system. 
     In some embodiments, the logic may obtain an ultrasound image of the target area via an ultrasound probe. The logic may then portray the thermal image in combination with the ultrasound image on the display. 
     Use of the system (e.g., systems  100 ,  500 , or  600 ) also includes operations performed by the clinician to facilitate the locating a desired subcutaneous blood vessel in preparation for performing an intravascular medical procedure. 
     In general, the clinician may determine a vascular condition of a patient by causing a temperature difference within a subcutaneous target area of the patient, obtaining a thermal image of a skin surface adjacent the subcutaneous target area via the system, and then by observation of the thermal image, the clinician may determine the vascular condition based on the thermal image. 
     The clinician may apply a temperature source to the patient at a location that is upstream of an intended insertion site for a cannula to be inserted into a predefined blood vessel. In so doing, the clinician may lower the temperature of the blood flowing within the predefined blood vessel. The lowered temperature of the blood migrates to the skin surface causing variations in the temperature of the skin surface where they are detected by the temperature scanning device so that the location of the blood vessels are made visible. 
     Based on the location of the temperature source on the patient, the clinician may identify the blood vessel as a vein or an artery based on the position of the temperature source. In other words, as the temperature source affects only the blood temperature upstream the target area, the clinician may determine that the any blood vessels that are portrayed in the thermal image have a blood flow direction from the temperature source toward the target area. 
     As the thermal image portrays the blood vessel and the outer limits of the patient within the target area (i.e., the transition in temperature between the skin surface the local environment), the clinician may determine by observation of the thermal image, the location of the blood vessel within the target area. 
     Methods may also include identifying a vein directly by placing the temperature source upstream of the target area with respect to venous flow generally. Similarly, the clinician may directly identify an artery by placing the temperature source upstream of the target area with respect to arterial flow generally. 
     In some instances, the blood may exit the blood vessel via an opening in the vessel wall causing. By placing the temperature source upstream with respect to the blood flow within a blood vessel of concern, the clinician may observe any occurring extravasation emanating from the blood vessel within the thermal image and thereby determine any extravasation. 
     An infusate may generally be delivered at room temperature (i.e., lower than blood or body tissue temperature). As such, the clinician may view the infusate within the blood vessel during delivery. Similarly, in an instance of infiltration of the infusate, the clinician may observe the infiltration within the thermal image. 
     While some particular embodiments have been disclosed herein, and while the particular embodiments have been disclosed in some detail, it is not the intention for the particular embodiments to limit the scope of the concepts provided herein. Additional adaptations and/or modifications can appear to those of ordinary skill in the art, and, in broader aspects, these adaptations and/or modifications are encompassed as well. Accordingly, departures may be made from the particular embodiments disclosed herein without departing from the scope of the concepts provided herein.