IV Cannulation

IV Cannulation

·        Superficial veins of the arm: metacarpal, dorsal venous arch, cephalic (radial – thumb side), basilic (ulnar), median antebrachial, antecubital

·        Parts of a cannula: bevel, stylet, catheter, hub of catheter, flash back chamber, air vent

·        Cannulation procedure: blood return, level off, advance catheter, release tourniquet, pressure upstream remove stylet

·        ¯Haematoma by ¯angle of insertion, ¯force

·        Keeping it going: if infusion stopped, blood can track back through cannula and clot. Intermittent flushing with saline helps

·        If hemiplegia, or mastectomy, insert in good arm

·        Infiltration/tissuing is leakage into surrounding tissues. Will be pale, cold, boggy, painful. If red and warm then infection

·        Phlebitis = inflammation of the vein.  Caused by

o   Infection

o   Chemical irritation (eg antibiotics, especially erythromycin)

o   Mechanical

·        Consequences of infection: inflammation of skin, cellulites or bacteraemia

·        Minimising infection: hand washing, sterile equipment, site care and regular inspection

·        Always record in notes: date and time of insertion, what gauge, what vein

·        Replace every 72 hours, unless inserted in emergency in which case replace in 6 – 8 hours 

·        Consent: check armband, explain reasons for iv therapy, duration, what‟s being infused, possible complications. Obtain verbal consent

·        Choice of gauge: age, flow required, what‟s being infused.