IV cannulation

Question 1

What do you do first?

Answer 1

Wash your hands

Question 2

3 I’s

Answer 2

Introduction, identification, informed consent

Question 3

Contraindications

Answer 3

AV fistula
Lymphodema
Surgery to chest and armpit
Broken, bruised or infected skin

Question 4

Risks

Answer 4

Pain
Bleeding
Bruising
Infection

Question 5

Explaining procedure: Why are you cannulating?

Answer 5

To allow us to give you fluids and medications straight into your circulation

Question 6

Equipment required

Answer 6

Gloves and apron
Kidney dish and sharps bin
Tourniquet, wipes, gauze and swabs
Cannula, cap and cannula dressing
Saline and syringe

Question 7

Preparation of equipment

4 steps

Answer 7

1) Prepare saline flush (checking date on saline)
2) Ask which arm the patient would prefer
3) Place patients arm in a comfortable position
4) Place gauze below the patients arm

Question 8

Identifying and preparing a vein

4 steps

Answer 8

1) Inspect arm for visible vein
2) Apply tourniquet
3) Palpate vein
4) Clean area of puncture

Question 9

Preparing to insert cannula (vein has been identified and cleaned)
(4 steps)

Answer 9

1) wash hands
2) Don gloves and apron
3) Open cannula wings
4) Remove cannula sheath

Question 10

Inserting cannula

8 steps

Answer 10

1) Secure vein DISTALLY with other hand
2) “sharp scratch”
3) Push canulla in until flashback is seen
4) Withdraw needle and push cannula in simultaneously (not all the way yet)
5) Remove tourniquet
6) Apply gentle pressure to proximal vein
7) Remove needle
8) Dispose into sharps bin

Question 11

Cannula is in the vein (blood is still coming out), now what? (2 steps)

Answer 11

1) Connect cap to cannula
2) Ensure tourniquet is removed
Note: don’t tape it down yet

Question 12

Flushing the cannula

3 steps

Answer 12

1) Wipe the surface of the cap
2) Push in and hold syringe
3) Depress plunger

Question 13

While flushing, what should you look for?

Answer 13

1) Resistance
2) Swelling
3) Pain
If any of these happen, you stop immediately

Question 14

Once the cannula has been successfully flushed you would…

Answer 14

1) Tape it down

2) Record on the cannula when it was inserted

Question 15

To conclude you would?

4 things

Answer 15

1) Correctly dispose of all waste
2) Wash hands
3) Thank patient
4) Document correctly

Question 16

What would you document?

Answer 16

Patient details
Date and time of cannulation
Date and time cannula will need replacing
Type of cannula used
Site of the cannula
Your details