Demonstration video thanks to Geeky Medics
Equipment
- Gloves
- Hand sanitiser
- Tourniquet
- Appropriate size cannulaÂ
- Alcohol swab
- Gauze
- SyringeÂ
- 0.9% sodium chloride vial
- Vacutainer/additional syringe if taking bloods too
- Cannula port/bung/octopus
- Cannula dressing
- Stickers to label cannulaÂ
- Access to a sharps bin
Procedure
- Introductions, handwashing, consent, check patient identifiers
- Apply tourniquet
- Identify suitable vein (as straight as possible & bounces when you palpate)
- Clean with an alcohol swab and let dry
- Insert the needle of the cannula until a flash is seen, carefully insert a 1 mm further (be patient). This is because the plastic catheter is slightly shorter than the needle and you want to make sure both are in the vein
- Advance the cannula over the needle, ensure you anchor the vein while you do thisÂ
- Once fully advanced, apply pressure to the vein proximally to the cannula and remove the needle
- If bloods are required attach syringe or vacutainer
- Attach the bung/octopus port
- Clean any blood from around the area
- Flush the cannula with 0.9% sodium chloride. This should be painless and cause no swelling, otherwise, it suggests the cannula has “tissued” (which means it is now in the tissue rather than the vein)
- Fix the cannula using the dressingsÂ
- Label the cannula with the date
- Document the cannula size and area inserted i.e. Left ACF
Tips
- Always question whether a cannula is necessary before placing one
- Larger cannulas are better for giving a lot of fluids quickly. Radiographic contrast usually requires a cannula that’s pink or larger
- Try to go distally to allow more attempts to be had at the same vein proximally if unsuccessful
- Tapping the vein, gravity, submerging the hand in lukewarm water can all help improve your success rate
- Ensure you anchor the vein (particularly in the elderly) as it will otherwise roll away from the needlepoint
- Once you pierce the skin advance slowly until you get flashback, this stops you advancing through the vein. Once you achieve this, shallow your angle as you advance further by 1mm
Written By Zana Martin (FY2)
