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11/13/24, 7\:20 PM Guide | IV cannulation

IV cannulation

Table of contents
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Gather equipment

Collect the equipment required for the procedure and place it within reach on a tray or trolley, ensuring that all the items are
clearly visible\:
Clean procedure tray
Non-sterile gloves
Disposable apron (optional)
Tourniquet
Cannula (size appropriate to the indication for cannulation)
Sterile dressing pack (to provide a sterile
Cannula dressing
Luer lock cannula cap or extension set
Gauze swabs
Normal saline 0.9% (10 ml)
Syringe (10ml)
Alcohol swab (2% chlorhexidine gluconate in 70% isopropyl)
Sharps container
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Gather equipment

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Brie
i n v o l v e s i n s e r t i n g a s m a l l p l a s t i c t u b e i n t o y o u r v e i n u s i n g a n e e d l e . T h i s w i l l a l l o w u s t o a d m i n i s t e r
t h e c a n n u l a . Y o u m a y b r i e
"
Gain consent to proceed with intravenous cannulation.
Check if the patient has any allergies (e.g. latex).
Adequately expose the patient's arms for the procedure.
Position the patient so that they are sitting comfortably. If a bed is available, the patient can lay down for the procedure (this is
sometimes preferable, particularly if the patient is prone to vasovagal syncope).
Ask the patient if they have any pain before continuing with the clinical procedure.

Preparation

1. Don gloves (if not already wearing some).
2. Open the dressing pack and place the cannula, cannula dressing and other items onto the
3. Prepare the normal saline
4. If you are planning on using an extension set, you should attach this to the
5. Choose an arm to cannulate\:
You should ask the patient if they have a preference. It is preferable to use the patient's non-dominant arm in most cases.
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Pre-existing medical conditions may prevent particular limbs from being used (e.g. arterio-venous
6. Place a pillow under the arm to be cannulated to make the procedure more comfortable for the patient.
7. Place a
Don gloves (prior to setting up saline

Choosing a vein

1. Inspect the patient's arm for an appropriate cannulation site\:
You should select a site that is the least restrictive for the patient such as the posterior forearm or dorsum of the hand. In an
emergency situation, any large peripheral vein may be used.
Avoid areas near the elbow and wrist joints (to reduce the likelihood of dislodgement as a result of the patient's movement).
Areas of broken, bruised or erythematous skin should be avoided.
Areas in which two veins join should be avoided where possible, as valves are often present.
2. Position the patient's arm in a comfortable extended position that provides adequate access to the planned cannulation site.
3. Apply the tourniquet approximately 4-5
4. Palpate the vein you have identi
Tapping the vein and asking the patient to repeatedly clench their
An ideal vein feels 'springy'
. A vein that feels hard is likely sclerosed, thrombosed or phlebitic (in
avoided.
5. Once you have identi
more than 1-2 minutes at a time.
6. Clean the site with an alcohol swab for 30 seconds and then allow to dry completely for 30 seconds\:
You should start cleaning from the centre of the cannulation site and work outwards to cover an area of 5cm or more.
DO NOT touch the cleaned site afterwards at any point, otherwise, the cleaning procedure will need to be repeated prior to
cannulation.
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Inspect for a suitable vein

Inserting the cannula

1. Wash your hands again, removing gloves if these were worn for setting up the saline
2. Don a new pair of non-sterile gloves.
3. Re-apply the tourniquet if removed previously.
4. Remove the cannula sheath.
5. Prepare the cannula\:
Open the cannula wings if present.
Slightly withdraw and replace the needle (this will allow it to glide easier during cannulation).
Unscrew the cap at the back of the cannula and place upright in the tray (if the cannula is ported).
6. Anchor the vein with your non-dominant hand from below by gently pulling on the skin distal to the insertion site.
7. Warn the patient that they will experience a sharp scratch.
8. Insert the cannula directly above the vein, through the skin at an angle of 10-30º with the bevel facing upwards.
9. Observe for a
10. Lower the cannula and then advance the needle a further 2mm after
lumen.
11. Partially withdraw the introducer needle, ensuring the needle end is within the plastic tubing of the cannula (you should
observe blood entering the plastic tubing of the cannula as you do this).
12. Carefully advance the cannula into the vein as you simultaneously withdraw the introducer needle until the cannula is fully
inserted and the needle is almost removed.
13. Release the tourniquet.
14. Place some sterile gauze directly underneath the cannula hub.
15. Apply pressure to the proximal vein close to the tip of the cannula to reduce bleeding.
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16. Gently pull the introducer needle backwards whilst holding the cannula in position until it is completely removed.
17. Connect a Luer lock cap or primed extension set to the cannula hub.
18. Dispose of the introducer needle immediately into a sharps container.
19. Apply adhesive strips to secure the cannula wings to the skin. Do not obscure the insertion site with the strips, as this needs
to remain visible to allow early identi
There is signi
medical school or hospital guidelines.
Wash hands again

Flushing the cannula

1. Inject the normal saline into the cannula using the
The
Observe for signs of swelling around the site or pain during administration and stop if this occurs.
2. Close the cannula port (if ported).
3. Secure the cannula with a dressing if the cannula
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Flush the cannula

To complete the procedure...

Explain to the patient that the procedure is now complete and that they should seek review if the cannulation site becomes
painful or in
Thank the patient for their time.
Dispose of your PPE and other clinical waste into an appropriate clinical waste bin.
Wash your hands.
Document the details of the procedure on a cannulation chart or in the patient's notes including\:
The patient's details\: full name, date of birth and unique identi
The date and time that cannulation was performed.
The indication for cannulation.
The type of cannula used (e.g. 20 gauge).
Source\: geekymedics.com
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