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Intravenous (IV) Cannulation Intravenous (IV) cannulation is 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. Cannulae • Parts of a cannula: • Types of cannulae: Colour Gauge Estimates Uses flow rate (ml/min) 24 20 Paediatrics, neonates 22 36 •Paediatrics, elderly, chemotherapy patients • Suitable for slow speed infusions 20 60 •The Most commonly used cannula •Suitable for IV analgesia and non-emergent blood transfusions 18 125 Used in trauma, surgery, blood transfu- sions and administration of dyes in con- trast studies 16 180 Trauma patients rapid transfusion of whole blood or blood components 14 240 Trauma patients ,rapid Large volume replacement Sites for intravenous cannulation (figure A - below) • Veins of the fore arms: Basilic vein Cephalic vein Median cubital vein : (figure B - below) • Veins of the hands Metacarpal veins Dorsal venous arch • General rules in selecting an IV site: Start in the most distal area before going proximally Use the upper extremities rather than the lower extremities Avoid areas of flexion Use the largest , longest ,straightest palpable vein Indications for IV cannulation • Repeated blood sampling • Administration of drugs • Administration of intravenous fluids • Administration of blood and blood products • Administration of intravenous nutritional support Contraindications to IV cannulation • Injured, infected, swelled or burned extremity • Extremity that have an arteriovenous fistula • The arm on the side of a mastectomy Complications of IV cannulation Complication Causes Sigs& symptoms Intervention Haematoma • Blood leaking • Swelling, tender- • Apply appro- (localised out of the vein ness and discol- priate pressure collection of into the tissue ouration bandage, moni- extravasated due to puncture tor the site blood, usually or trauma Prevention: clotted in an • Proper device organ or tissue) insertion • Pressure over site on removal of cannula Phlebitis • Poor aseptic • Tenderness, red- • Remove can- (Inflammation of technique ness, heat and nula the vein) • High osmolarity oedema • Apply warm I.V. infusions or •Advanced-indurati compression drugs on, palpable ve- • Observe for • Trauma to the nous cord signs of infection vein during inser- • If phlebitis is tion/incorrect advanced antibi- cannula gauge otics may be re- • Prolonged use quired of the same site Thrombo- • Injury to the vein • Tender- • Remove can- phlebitis • Infection ness/redness nula (Formation of a • Chemical irrita- • Heat/oedema • Observe for thrombus and tion • Cordlike appear- signs of infection inflammation in • Prolonged use ance of the vein • Change can- the vein, usually of the same vein • Slowing of the IV nula frequently occurs after infusion (48-72hrs) phlebitis) Infection • Lack of asepsis • Tenderness and • Remove can- (Pathogen in • Prolonged use swelling nula the surrounding of the same site • Erythema/purulent • Antibiotics may tissue of the I.V. drainage be required site) • Documentation
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