All you need to know about Intravenous Cannulation

When a small plastic tube, known as a Cannula, is inserted into a peripheral vein (thereby making it intravenous), it is known as Intravenous (IV) Cannulation. Through this IV Cannula, fluids, medicines and nutrients can be administered directly into the bloodstream. In some instances, one can also obtain blood samples through it.

There are three main steps to know in the process: Preparation, Method and Aftercare.

At the Preparation stage, the person-in-charge should undertake the following steps:

• Disinfect your hands
• Clean trolleys and trays with an aseptic agent
• Validate expiry date of saline solution
• Wipe top of saline vial with chlorhexidine
• Draw saline into injection syringe and discard its needle
• Gather all other necessary equipment such as cannula pack, saline-filled syringe, two chlorhexidine wipes, pre-primed bionector, tourniquet, inco pad, and sharps bin
• The contents of the cannula pack should be cannula, gauze, sterile dressing, absorbent pad, and cannula assessment record

At the Method stage, the person-in-charge should undertake the following steps:

• Wear your safety PPE such as gloves and apron
• Clean puncture site with wipe
• Apply tourniquet
• Insert the cannula with the bevel up at an angle of 30 degrees
• Advance cannula and monitor for flashback
• When advancing the cannula forward over the needle and into the vein, hold the needle introducer still
• Release the tourniquet
• Discard needle in the sharps bin
• Connect bionector to cannula
• Use sterile dressing to secure the cannula in its place
• Ensure the puncture site is not covered with tape to allow future monitoring for developing phlebitis
• Using 5 ml saline, flush the bionector and the cannula
• Ensure that resistance is not felt
• Remain ready to remove cannula if any signs of tissuing are suspected around the cannula site
• Dispose of all the waste in appropriate bins
• Remove your gloves and apron
• Decontaminate your hands again

As part of the Aftercare stage, the following steps are mandatory from the patient’s side:

• The patient should inform nurses present in case there is redness or swelling observed at the site of cannula insertion
• If the area around the cannula feels wet or the dressing comes undone, the patient must inform the nurses
• The patient must also advise if the cannula is interfering with their ability to self-care

In the Aftercare stage, the medical staff’s responsibilities are:

• Fill the correct cannula insertion documentation and place it in patient’s notes
• Check and flush cannula three times a day and remove after 72 hours