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IV CANNULATION.pdf
IV cannulation involves inserting a cannula into a vein to provide venous access for purposes like drug administration, hydration therapy, blood transfusion, and patient monitoring. Veins have three layers and are unlike arteries in that they are superficial, display dark red blood, and have no pulsation. The ideal vein for cannulation is bouncy, soft, visible, straight, and easily palpable. Complications can include infection, infiltration where fluid leaks into surrounding tissue, and phlebitis which is inflammation of the vein. Proper technique and regular inspection of the site are important to prevent complications.
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IV CANNULATION.pdf
- 1. IV CANNULATION Intravenous (IV)cannulation is a technique in which a cannula is placed inside a vein to provide venous access. Anatomy of Veins: Veins are unlike arteries in that they are 1) Superficial 2) Display dark red blood at skin surface 3) No pulsation Veins have 3 Layers Purpose: PROCEDURE: PRE PROCEDURE: ♣ Preparation of patient and environment: ♣ Check and verify the physician’s orders ♣ Assemble articles ♣ Explain the procedure to the patient ♣ Position the patient Drug administration Hydration therapy Blood transfusion Parentral nutrition Patient monitoring Blood sampling Tunica Media ♣ Contains nerve endings and muscle fibers ♣ Vasoconstrictive response occurs at this layer Tunica Adventitia ♣ Connective tissue ♣ Consists arteries and veins that supply blood to blood Tunica Intima ♣ Inner most layer ♣ No nerve endings ♣ Phlebitis begins Valve ♣ Prevent backflow and pooling
- 2. Equipment required A TrayContaining ♣ Torniquet ♣ Examination gloves ♣ Plastic Sheet ♣ Easy fix ♣ Alcohol Swabs ♣ Gauze pieces ♣ I.V Cannula ♣ 3 way extension Cannula Sizes : Characterisitcs of Ideal vein: ♣ Bouncy ♣ Soft ♣ Visible ♣ Straight ♣ Easily palpable Veins to Avoid: ♣ Thrombosed/Sclerosed/Fibrosed ♣ Inflammed/bruised ♣ Thin/Fragile ♣ Mobile ♣ Areas or sites of ♣ Near bony prominences ♦ Infection ♦ Oedema ♦ Phlebitis ♦ Side of mastectomy ♦ Fractured extremity Site Selection Common veins Gauze Indications 14 G Trauma Surgical Procedures 16 G Trauma Surgical Procedures 18 G Trauma Blood Transfusion 20 G IV fluids Blood Transfusion 22 G Children Older Adults 24 G Neonates Children Old elderly 26 G Neonates
- 3. Encourage Venous filling/dilationby: ♣ Tourniquet application - 3 to 4 inches above the site of insertion. ♣ Opening and closing the fist. ♣ Lowering the limb below the heart. INTRA PROCEDURE ♣ Wash Hands and Don Gloves ♣ Apply Tourniquet 3-4 inches above the site of insertion ♣ Clean the site with Alcohol swab from centre to periphery in circular motion ♣ Maintain traction on the skin to anchor the vein. ♣ Hold the catheter with thumb (behind the thumb rest) with the 2nd and the 3rd finger in front of the side port or catheter wings. ♣ Insert the stylet through the skin and into the vein at an angle of 15° to 30 ° ♣ Placement of the needle tip into the vein is confirmed by blood in the flashback chamber. ♣ Upon visualisation of flashback decrease the catheter to skin angle virtually parallel to the skin ♣ Advance the entire catheter. ♣ Remove tourniquet ♣ Remove the stylet while applying digital pressure to the vein just beyond the catheter tip (to prevent excessive bleeding) ♣ While applying digital pressure,Remove the white cap from the needle and place it to the cannula. ♣ Secure the cannula with Adhesive tape. ♣ Fix the Cannula: Fixation technique Purpose of dressing IV cannula ♦ Protect the puncture site ♦ Secure the catheter . ♦Prevent catheter movement which could damage the vessel ♣ Flush the line with Distilled water and Normal saline. ♣ If Infusion is ordered, prime the line and connect to the IV cannula. POST PROCEDURE ♣ Documentation ♣ Poper disposal of Biomedical Waste Site Inspection: ♣ Every shift, before & after any intermittent injection of drugs ♣ Look for signs of phlebitis (redness, tenderness, swelling, pain), infiltration & extravasation. Dressing Change: ♣ Wet or soiled dressings should be changed. ♣ Remove carefully to preserve line. Connection check ♣ All connections should be checked for tightness(Leurlock). ♣ Ensure the injection port cap is closed at all times. COMPLICATIONS : ♣ IV site Infection ♣ Cellulitis ♣ Infiltration ♣ Extravasation ♣ Phlebitis ♣ Thrombophlebitis ♣ Emboli Chevron Butterfly H shaped
- 4. VIP (VISULA INFUSIONPHLEBITIS) SCALE FLUSH PROTOCOL S - Saline A - Administration of Drug S - Saline Administration H - Hep lock (In ICU - Central line Nurses Alerts: ♣ Select site on Dominant arm ♣ Remove the hair with clippers if necessary. ♣ Always Catheterize distal veins first (Metacarpals). ♣ Donot Repalpate the vein after cleaning the site. ♣ Angle of Insertion 150 to 300. ♣ Provide good source of light. ♣ Ensure cannula is in bevel up position during insertion. ♣ Use a well padded splint if necessary (especially for paediatric clients). ♣ Avoid blood sampling above the cannula site. Golden rules for preventing phlebitis Wash and/or disinfect your hands thoroughly Prepare the Venipuncture site carefully Use flexible catheters Select the smallest catheter gauge possible Always check the physiochemical properties of the infusate or drug Infiltration Extravasation Infiltration occurs when the infusion cannula moves out of a vein, and the medication or fluid seeps into the surrounding tissue. Extravasation,occurs when a vesicant (that is irritating to human tissue) drug is administered into the surrounding tissue instead of into the intended vein.