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IV Cannulation

Oten tested in OSCEs using plastic arms. You get marks for all the little things like washing your hands and putting on gloves. Nevertheless technique is very important as in some patients cannulation is extremely difficult.

Venous Cannulation

Indications 

Fluid, drugs, emergency situations, feeding.

Need

Method

  1. Prepare the equipment. Remove the cap of the cannula and leave in your tray,
  2. Introduce & explain. Say that no needle is left in arm only a bit of plastic, and that the patient needs to be careful.
  3. Set up drip stand with a bag of fluid (checked by nurse)
  4. Put some tissues underneath the arm
  5. Palpate a vein. The most convenient site fot the patient is usually the back of the hand.
  6. Apply the tourniquet about 20cm above the site of insertion.
  7. Wipe with steret
  8. Slowly insert the cannula through the skin at an angle of about 30 degrees until you get a flashback of blood. When you see this flashback, gently flatten the cannula so it is at 0 degrees to the skin and advance another minimally 0.5 cm. Loosen the tourniquet. Now start to slide the plastic cannula whilst withdrawing the trocar (so effectively the metal trocar does not move relative to the skin) until it is fully in the vein.
  9. Remove the trocar, blood should start to exit the cannula. Apply the plastic cap to the cannula.
  10. Flush cannula with 5-10ml of 0.9% saline 
  11. Secure the cannula with a VacuFix/Tagaderm.
  12. Connect fluid tube. 
  13. Bandage a loop of the tube to the arm. 
  14. Write up the cannula care chart if available

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