2. Objectives
By the end of this session learner will be able to
• Define IV cannulation
• Explain the indication of IV cannulation
• Explain the advantages of IV cannulation
• Enlist the equipment's that are used for IV
• List the sites for iv placement
• Explain the IV cannulation procedure
• Explain the complication of IV cannulation
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3. Cannula
A cannula (/ˈkænjʊlə/; from Latin "little reed"; plural
cannulae or cannulas)[1] is a tube that can be inserted
into the body, often for the delivery or removal of fluid
or for the gathering of data.
Origion of cannula
1675–85; < New Latin, Latin: small reed, equivalent to
cann(a) cane + -ula -ule
a metal tube for insertion into the body to draw off
fluid or to introduce medication
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4. Cannulation
“The aim of intravenous management is safe, effective
delivery of treatment without discomfort or tissue
damage and without compromising venous access,
especially if long term therapy is proposed”
The Royal Marsden
NHS Trust Manual of Clinical Nursing Procedures
Fourth Addition
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5. Anatomy and physiology
• Approximately 2/3 of the total blood volumeis in the
vein which is transport deoxygenated blood to the heart
from the tissues
• Veins are thin valled ,fibrous ,have large lumen and low
pressure
• Superificial and deep veins
• Some veins have valves to regulate the one way flow to
the heart especially lower limbs
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6. Blood vessel walls have three layers
• Tunic Intima innermost, epithelial lining
• Tunic Media Elastic and Smooth muscle fibers
• Tunic Externa Outer coat
Major veins of the arm
• Dorsal • Cephalic • Basilic • Cubital Fossa
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8. • Fluid and electrolyte replacement
• Administration of medicines
• Administration of blood/blood products
• Administration of Total Parenteral Nutrition
• Haemodynamic monitoring
• Blood sampling
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Indications
9. Advantages
• Immediate effect
• Control over the rate of administration
• Patient cannot tolerate drugs / fluids orally
• Some drugs cannot be absorbed by any other route
• Pain and irritation is avoided compared to some
substances when given SC/IM
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14. What equipment do you need
• Dressing Tray - ANTT
• Non Sterile Gloves / Apron
• Cleaning Wipes
• Gauze swab
• IV cannula (separate slide)
• Tourniquet
• Dressing to secure cannula
• Alcohol wipes
• Saline flush and sterile syringe or fluid to be
administered
• Sharps bin
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15. Procedure
• Wash hands prepare equipment ANTT
• Remove the cannula from the packaging and check
all parts are operational
• Loosen the white cap and gently replace it
• Apply tourniquet
• Identify vein
• Clean the site over the vein with alcohol wipe, allow
to dry
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16. • Insert the needle (bevel side up) at an angle of 10-
30o to the skin (this will depend on vein depth.)
• Observe for blood in the flashback chamber
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17. • Apply gentle pressure over the vein (beyond the
cannula tip) remove the white cap from the needle
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18. • Remove the needle from the cannula and dispose of
it into a sharps container
• Attach the white lock cap
• Secure the cannula with an appropriate dressing
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19. • Flush the cannula with 2-5 mls 0.9% Sodium
Chloride or attach an IV giving set and fluid
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20. Document the procedure including:
• Date and time
• Site and size of cannula ,any problems
encountered
• Review date (cannula should be in situ no longer
than 72 hours without appropriate risk assessment.)
• Thanks to the patient
• Clean up, dispose of rubbish
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21. Possible Complications:
The intravenous (IV) cannula offers direct access to a
patient's vascular system and provides a potential route
for entry of micro organisms into that system. These
organisms can cause serious infection if they are
allowed to enter and proliferate in the IV cannula,
insertion site, or IV fluid.
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22. IV-Site Infection:
Does not produce much (if any) pus or inflammation at
the IV site. This is the most common cannula-related
infection, may be the most difficult to identify
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23. Cellulites:
Warm, red and often tender skin surrounding the site
of cannula insertion; pus is rarely detectable.
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24. Infiltration
• Infiltration or tissuing occurs when the infusion (fluid) leaks
into the surrounding tissue. It is important to detect early as
tissue necrosis could occur – re-site cannula immediately
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25. Bruising
Bruising commonly results from failed IV placement -
particularly in the elderly and those on anticoagulant
therapy.
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26. Haematoma:
Haematoma occurs when blood leaks out of the infusion
site. The common cause of this is using cannula that are
not tapered at the distal end. It will also occur if on
insertion the cannula has penetrated through the other
side of the vessel wall – apply pressure to the site for
approximately 4 minutes and elevate the limb
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27. Phlebitis:
Phlebitiss is common in IV therapy and can be cause in many
ways. It is inflammation of a vein (redness and pain at the
infusion site) – prevention can be using aseptic insertion
techniques, choosing the smallest gauge cannula possible for the
prescribed treatment, secure the cannula properly to prevent
movement and carry out regular checks of the infusion site.
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28. References:
• Clinical Skills Education Centre
http://www.qub.ac.uk/cskills/index.htm
• Standards for Infusion Therapy RCN
http://www.rcn.org.uk/publications/pdf/standardsi
nfusiontherapy.pdf
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