Table of Contents
- Indications for An intravenous (IV) cannulation
- Intravenous (IV) cannula Gauge size, Color Code, and Uses
- Equipments needed for the procedure
- Preparing for the procedure
- Choosing an appropriate vein for the procedure
- Steps for inserting the cannula
- Conclusion
1. Indications for An intravenous (IV) cannulation
An intravenous (IV) cannula is inserted into a patient's vein so that iv Medications, infusions (e.g colloid, crystalloid), and blood products can be injected directly into the patient's bloodstream. Cannulas also known as venflons come in a variety of colors that correspond to the size of the tube. The size to use may be determined by the patient's veins.
2. Intravenous (IV) cannula Gauge size, Color Code, and Uses
| Gauge | Color Code | Uses |
|---|---|---|
| Orage | 14G | Blood transfusions, surgery, and major trauma |
| Gray | 16G | Surgery, trauma, and large-volume infusions |
| Green | 18G | large-volume infusions, Blood transfusion |
| Pink | 20G | Routine treatments, fluid replacement, and medications |
| Blue | 22G | Neonate, eldery, and pediatric |
| Yellow | 24G | Neonate, eldery, and pediatric |
3. Equipments needed for the procedure
Collect all the equipment needed for the procedure and place it on a tray or trolley so that it is easily accessible.
- Cannula (appropriate size for the indication)
- Gauze swabs
- Alcohol swab
- Tourniquet
- Syringe
- Sharps container
- Non sterile gloves
- Sterile dressing pack
- Extension set
- Normal saline 0.9%
- Tray
4. Preparing for the procedure
- Sanitized your hands with alcohol gel or wash them with soap under running water if they are soiled.
- Wear your protective equipment as necessary.
- Verify the patient's name and birthdate.
- Explain procedure to patient by using terminology that will be understandable to patients to succinctly describe what the procedure entails. (e.g "I need to do cannulation, it entails putting a thin plastic tube into your vein with the use of a needle we will be, As a result, we will be able to provide fluids and drugs through the cannula. As the needle is placed, you may feel a harsh scratch for a split second")
- Obtain patient consent before starting the procedure
- Exposed patient's arms for the procedure
- Place the patient in a comfortable sitting position or lying down if there is a bed
- Wear your gloves (Non sterile)
- Place the cannula, cannula dressing etc on the field of the dressing pack
- Draw saline into the syringe to prepre the standard saline flush
- Connect the flush to an extension set and prime the line
- Choose the arm you want to use for the procedure. It is recommended to use the patient's non-dominant arm. The patient's preference should also be considered
5. Choosing an appropriate vein for the procedure
- Choose a location such as the posterior forearm or the dorsum of the hand. Use any large peripheral vein in an emergency
- To reduce the possibility of dislodgement, avoid areas near the elbow and wrist joints
- Do not choose a location where two veins meet because valves are frequently present
- Areas of broken or bruised skin should not be used
- Extend the patient's arm in a relaxed manner that allows for easy access to the intended cannulation site
- Place the tourniquet 4 - 5 fingerwidths above the intended cannulation location
- To make the vein easier to see and palpable, tap the vein and have patient to clench their fist repeatedly. Avoid using a vein that feels hard because is most likely to sclerosed, inflamed or thrombosed
- After finding a suitable vein (A vein that feels "springy"), you may need to briefly remove the tourniquet, as it shouldn't be worn for more than 1-2 minutes at a time
- Use an alcohol swab to clean the area for 30 seconds, then allow it to dry completely for 30 seconds
6. Steps for inserting the cannula
- Wash your hands and put on a fresh set of non- sterile gloves
- Place the tourniquet 4 - 5 fingerwidths above the intended cannulation location
- Take off the cannula sheath
- If there are cannula wings, open them
- Replace the needle after a slight withdrawal to allow it to glide easier during cannulation
- Remove the cannula's cap and place it upright in the tray
- Gently pull on the skin distal to the insertion site with your non-dominant hand to anchor the vein from below
- Inform the patient that they will be a sharp scratched
- Directly above the vein, insert the cannula into the skin at an angle of 10 to 30 degrees with the bevel facing up
- Check for a blood flashback into the cannula chamber, which indicates that the needle has penetrated the vein
- After observing flashback, lower the cannula and move the needle another 2mm to verify it is within the vein's lumen
- Withdraw the introducer needle partially while making sure the needle's tip is within the cannula's plastic tubing
- Until the cannula is fully implanted and the introducer needle is almost completely removed, carefully insert the cannula into the vein while simultaneously withdrawing the needle
- Take the tourniquet off
- Place a peice of sterile gauze right beneath the cannula hub
- To decrease bleeding, apply pressure to the proximal vein near the tip of the cannula
- Hold the cannula in place while gradually removing the introducer needle from the introducer needle
- Attach a luer lock cap or a primed extension set to the cannula hub
- Immediately dispose of the introducer needle in a sharps container
- Use adhesive strips to adhere the cannula wings to the skin. The insertion site must stay visible to enable for early detection of swelling
- Use the prepred standard saline flush you prepared to inject into the cannula. There should be no resistance when administering the flush. Keep an eye out for any signs of pain or swelling at the injection site, and stop the medication if these things happen
7. Conclusion
The method of cannulation varies widely, thus you should always check the policies of your local hospital or medical school
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