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Intravenous Cannulation

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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)

 

  1. https://www.essaysauce.com/health-essays/intravenous-cannulation-in-pre-hospital-care/
  2. https://teachmesurgery.com/skills/clinical/cannulation/
  3. https://medcaretips.com/intravenous-cannulation/

  Remember! This is just a sample.

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