Intravenous Cannulation
It involves connecting a tube into a patient’s vein to insert infusions directly into their bloodstream. IV cannulation is a procedure that has risks such as infection at the entry site. Cannulation is therefore achieved only for specific indications which include fluid management, blood sampling, medicine administration and haemodynamic monitoring. (1)
Equipment required for performing IV cannulation is a clean tray, non-sterile gloves, cannula, sharps container, alcohol swab, syringe, tourniquet, sterile dressing pack, cannula dressing, Luer lock cannula cap, gauze swabs and normal saline. (2)
Begin by explaining the procedure to the patient and gain their consent to proceed. Confirm the patient’s identification then prepare the equipment. Decontaminate your hands using soap and water then put on an apron and gloves. Identify a suitable vein then clean the site of entry using a chloraprep wipe and allow it to air dry then apply the tourniquet without palpating the cleaned skin. Place traction on the skin below the intended entry site and insert the cannula directly above the vein with the bevel facing upwards at an angle of 30º. (3) Observe for flashback in the cannula chamber then decrease the angle between the needle and the skin. Proceed by advancing the needle a further 2mm after flashback to ensure it is within the vein’s lumen. Withdraw the introducer needle partially while ensuring the needle end remains within the cannula’s plastic tubing. Carefully advance the cannula fully into the vein then release the tourniquet. Place some sterile gauze directly underneath the cannula hub then apply pressure to the proximal vein close to the tip of the cannula to reduce bleeding. Connect the bionector to the cannula and hold the cannula in place using the sterile dressing. Take care not to cover the puncture site with the tape when holding the cannula in place to prevent covering any possible phlebitis that may develop. Flush the bionector and cannula with 5ml of saline before checking for any signs of extravasation around the cannula site. Remove cannula if there is suspected tissuing. Get rid of all waste into the correct disposal bins and confirm that the patient is comfortable. (1)
Complications may arise during the procedure such as phlebitis whereby the tunica media of the vein gets damaged and becomes inflamed. There are various types of phlebitis. Mechanical phlebitis is caused by a cannula catheter, moving within the vein, which causes irritation and inflammation. This occurs when the cannula is too big for the vein, causing increased friction within the vein which makes the patient uncomfortable. Chemical phlebitis is caused by the concentration and PH of the substance being administered. Other complications that may arise include Haematoma.(2)
There are five different sizes of cannula. The size of cannula to use is determined by the flow rate of the fluid passing through the cannula. Using a smaller cannula increases the comfort of the patient and reduces the trauma to the vein and enables better blood flow.
In summary, IV cannulation is a crucial clinical skill that is beneficial to patient care. It makes it possible to administer drugs and fluids directly into the vascular system for a quick release, increasing the patients care.(1)
- https://www.essaysauce.com/health-essays/intravenous-cannulation-in-pre-hospital-care/
- https://teachmesurgery.com/skills/clinical/cannulation/
- https://medcaretips.com/intravenous-cannulation/