IV cannulation

Question 1

Rules of cannulation

Answer 1

-person using sharps is responsible to dispose of it
-avoid recapping sharps
-get rid of sharps ASAP

Question 2

Indications of cannulation

Answer 2

-immediate administration of drugs or fluids
-prophylactic- clinically unstable patients where drugs or fluids are likely to be required imminently

Question 3

Contraindications of IV

Answer 3

-patients unlikely to require IV drugs or fluids
-not in an AV fistula (vein and artery fused together, for dialysis patients)
-not in areas where lymphatic drainage has been affected or in the presence of injury

Question 4

Steps of inserting IV

Answer 4

1. consent and explanation
2. hand hygiene and PPE
3. identify appropriate sight, starting distally
4. apply tourniquet
5. choose appropriately sized cannula
6. prepare rest of equipment (wipe, cannula, syringe, gauze, vecafix, flush- drug check flush)
7. wipe the skin (don’t palpate the site after wiped)
8. remove cannula from packet apply skin tension with non dominant hand to prevent vein moving
9. insert cannula at an initial low angle looking for primary flashback in flashback chamber
10. once you have flashback, flatten cannula so nearly level with skin and advance 3-5mm
11. release non dominant hand and grip body of cannula, then use dominant hand to pull the needle back slightly
12. advance the plastic cannula forwards while holding the needle until all the plastic cannula is in the vein
13. remove tourniquet
14. anchor cannula to the skin with non dominant hand whilst occluding the vein
15. remove sharp, place cap on back of cannula, dispose sharp
16. secure cannula wings with strips
17. flush
18. no fix cannula with vecafix, label date and time
19. document procedure

Question 5

What a good vein looks like

Answer 5

-bouncy
-straight
-refills
-stable

Question 6

Things to help distend veins

Answer 6

-light tapping the site
-arm below level of heart
-open and closing fist

Question 7

Common IV sites

Answer 7

-ACF- anticubital fossa (inside of elbow)
-back of hand
-foot- rarely

Question 8

Anatomy of cannula

Answer 8

-needle surrounded by catheter (plastic bit stays inside the vein)
-wings held by vecafix
-flashback chamber
-luer lock plug at the back

Question 9

Cannula sizes

Answer 9

24G- yellow (smallest) (paeds)
22G- blue (analgesia, majority drugs)
20G- pink (analgesia, majority drugs)
18G- green (fluids)
16G- grey
14G- orange (largest) (major trauma)