Peripheral Venous Cannulation

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  • 1. INTRA VENOUSCANNULATION
  • 2. EQUIPMENT
    Tourniquet
    Gloves
    Hazardous material container
    Alcohol swab
    Gauze or cotton
    5-ml syringe with saline
    Cannula
    Vecafix™ (or similar approved IV dressing
  • 3. METHOD
    Tell the patient who you are and what you are going to do.
    Attach the tourniquet to the upper arm.
    Examine and palpate the arm for a vein. Look at– the back of the hand – common site but can be fragile and mobile in elderly– the ante cubitalfossa will always have a vein but might be uncomfortable for the patient– the anatomical snuffbox at wrist
  • 4. Swab the selected vein.
    Anchor the vein and insert the cannula at a 30° angle to the skin (Fig. 2). Advance until you feel give in the vein wall.
    Watch for flashback at the base of the cannula.
    Pull back the needle part of the cannula (the stylet) 1–2 mm and watch blood flow into the plastic tubing.
  • 5. Slide the needle back while advancing the cannula into the vein.
    Remove the needle completely and place the cap on the end of the cannula.
    Dispose of the needle immediately. Tape down using Vecafix™.
    Flush with 5 ml normal saline.
  • 6. Fig. 2 Cannulation of a vein. Ensure that the stylet and cannula have entered the vein (A) before withdrawing the stylet and advancing the cannula (B).
  • 7. HINTS AND TIPS
    After putting on the tourniquet, ask the patient to drop the hand by the side and to clench and unclench the fist. Do something else in the meantime (e.g., draw-up your saline, open up the cannula).
    If you cannot feel a vein in one arm, do not attempt to go in blind – stop and review the other arm
  • 8. If you still have no luck, ask the patient to put both hands in some warm water to help vasodilation
    If you become really desperate, try sticking GTN patches to the antecubital fossa veins
    Foot veins are sometimes used, but this can be painful for the patient and should only be used as a last resort
  • 9. Cannula sizes
  • 10. THANK YOU