Procedure of IV cannulation for reference
- 1. 08/28/2024 Dr Shamshad 1 Intravenous Cannulation (IV) Dr. Shamshad Majmaah university KSA
- 2. 08/28/2024 Dr Shamshad 2 Objectives 1. Identify the common sites of IV cannula insertion (peripheral & central). 2. Identify the different sizes and shapes of IV cannulae. 3. Insert an IV cannula (peripheral), in a manikin in a professional way.
- 3. • Intravenous (IV) cannulation: A technique in which a cannula is placed inside a vein to provide venous access. Venous access allows sampling of blood, as well as administration of fluids, medications, parenteral nutrition, chemotherapy, and blood products. 08/28/2024 Dr Shamshad 3
- 4. Patient and Site selection Depends on : Duration of IV therapy, patient’s activity level, condition of the extremities. Avoid Veins: Not resilient , feel hard or cordlike (often thrombosed). Avoid arms : Patients who have undergone radical mastectomy, same side as the surgery (circulation may be impaired , edema and complications like thrombosis) . Pediatric patients: Lower extremities veins used Neonates patients : Scalp veins sets are commonly. . 08/28/2024 Dr Shamshad 4
- 5. 08/28/2024 Dr Shamshad 5 Ease of access: • Use of the non-dominant extremity • Avoiding joint areas • Avoiding use of the lower extremities Contraindications: • Pre-existing Vascular Compromise Lymphatic or venous drainage has been compromised, i.e. lymph node dissection accompanying mastectomy, A-V fistulas, injured extremities, thrombosis. • Regional Infections - overlying cellulitis or infection
- 6. 08/28/2024 Dr Shamshad 6 Common sites: Peripheral IV cannula insertion Head Upper limb Lower limb External jugular vein Cephalic vein Greater saphenous vein Basilic vein Dorsal digital vein Median vein Metacarpal vein
- 7. 08/28/2024 Dr Shamshad 7 Common sites: Central IV cannula insertion Neck Internal jugular vein Chest & upper limb subclavian vein & axillary vein Lower limb: Groin Femoral vein
- 8. 08/28/2024 Dr Shamshad 8 Different types of iv cannulation Scalp vein set
- 9. 08/28/2024 Dr Shamshad 10 Color Gauge Size Recommended Uses 14G Trauma, Rapid blood transfusion, Surgery. 16G Rapid fluid replacement, Trauma, Rapid blood transfusion 18G Rapid fluid replacement, Trauma, Rapid blood transfusion 20G Most infusions, Rapid fluid replacement, Trauma, Routine blood transfusion 22G Most infusions, Neonate, Pediatric, Older adults, Routine blood transfusion 24G Most infusions, Neonate, Pediatric, Older adults, Routine blood transfusion, Neonate or Pediatric blood transfusion 26G Pediatrics, Neonate Orange Grey Green Pink Blue Yellow Purple
- 10. 08/28/2024 Dr Shamshad 11 Different parts of iv cannula 1 2 3
- 11. 08/28/2024 Dr Shamshad 12 Adhesive plaster Disposable bin for needle
- 12. 08/28/2024 Dr Shamshad 13 1. Introduce yourself to the patient and clarify the patient’s identity. 2. Explain the procedure to the patient and gain informed consent to continue. 3. Explain that cannulation may cause some discomfort but for short period of time. Procedure
- 13. 08/28/2024 Dr Shamshad 14 4. Sanitize our hands using alcohol cleanser.
- 14. 08/28/2024 Dr Shamshad 15 5. Put on your gloves, clean the patient’s skin with the alcohol wipe and let it dry 6. Position the arm so that it is comfortable for the patient and identify a vein. 7. Apply the tourniquet and re-check the vein.
- 15. 08/28/2024 Dr Shamshad 16 8. Remove the cannula from its packaging and remove the needle cover ensuring not to touch the needle.
- 16. 08/28/2024 Dr Shamshad 17 9. Stretch the skin distally and tell the patient to expect a sharp scratch. 10. Insert the needle, bevel upwards at about 30 degrees. 11. Advance the needle until a flashback of blood is seen in the hub at the back of the cannula
- 17. 08/28/2024 Dr Shamshad 18 12. Once this is seen, progress the entire cannula a further 2mm, then fix the needle, advancing the rest of the cannula into the vein.
- 18. 08/28/2024 Dr Shamshad 19 13. Release the tourniquet, apply pressure to the vein at the tip of the cannula and remove the needle fully. Remove the cap from the needle and put this on the end of the cannula.
- 19. 08/28/2024 Dr Shamshad 20 14. Carefully dispose of the needle into the sharps box. 15. Apply the dressing to the cannula to fix it in place and ensure that the date sticker has been completed and applied.
- 20. 08/28/2024 Dr Shamshad 21 16. Check that the use-by date on the saline has not passed. If the date is ok, fill the syringe with saline and flush it through the cannula to check for patency. 17. If there is any resistance, if it causes any pain, or you notice any localized tissue swelling; immediately stop flushing, remove the cannula and start again.
- 21. 08/28/2024 Dr Shamshad 22 18. Dispose of your gloves and equipment in the clinical waste bin, ensure the patient is comfortable and thank them
- 22. 08/28/2024 Dr Shamshad 23 Complications :Peripheral IV cannulation Infection Phlebitis Infiltration Artery / nerve damage Dislocation Stenosis
- 23. 08/28/2024 Dr Shamshad 24 Complications :Central IV cannulation Pneumothorax Hemothorax Air embolism Venous thrombosis “Pinch off” syndrome Infection Artery / nerve damage
- 24. 08/28/2024 Dr Shamshad 25 Ultrasound guided venipuncture • An established technique for both peripherally inserted central catheters & central venous cannulation. • With the increasing availability of portable ultrasound facilities, this may become an option in the future for difficult peripheral venous cannulations. • A hand held Doppler probe has been used to identify accurately forearm veins of more than 2 mm diameter in patients with invisible and impalpable veins.
- 25. 08/28/2024 Dr Shamshad 26 Ultrasound guided venipuncture
- 26. 08/28/2024 Dr Shamshad 27 Vein Finders: Optical devices use the behavior of Infrared light to create an image & superimpose project it onto the viewing area. Infrared light is projected onto the viewing area and is absorbed at the locations where blood (veins) reside. Where light is absorbed there is less light reflected.