Cannulation:
1. Introduction:
- Begin with washing hands
- Introduce yourself
- Check the patients name and DOB and what they would like to be called.
- Check details against wristband if patient is wearing one
- Explain procedure and gain consent
o State that it shouldn’t be too painful but might be uncomfortable
o See if they have any needle phobias (e.g. if they would prefer lying down in bed)
- Check for allergies
- Ask the patient which arm they would like to be used
- Position patient appropriately
2. Gather equipment
- Clean tray
- Wash hands again
Gather equipment:
o 2x gloves – check with trust whether 2x non-sterile or 1x sterile, 1x non-sterile is used
o Tourniquet
o Cannula
o Cannula extension set
o Saline flush (usually pre-prepared)
§ Check expiry date
o Alcohol swabs for disinfecting skin
o Sharps bin
o Gauze
o Cannula dressing
- Wash hands again and place equipment in the tray
3. Prepping the cannula:
- Wash hands, apply apron and put on 1st pair of gloves (non-sterile)
- Prepare saline flush by inserting saline into extension and flushing both lumens of the cannula
4. Return to patient
- Wash hands
- Inspect arms to look for any suitable veins
- Apply tourniquet
- Palpate veins and identify suitable vein
Take your time with doing this and remember that sometimes you can feel veins that you cannot necessarily see
- Remove tourniquet
5. Insertion of cannula
- Wash hands
- Put on sterile gloves
- Wipe the site with alcohol swab for 30 seconds and leave to dry for 30 seconds
- Put tourniquet back on
- Remove sheath from canula
- Anchor the vein with non-dominant hand
- Warn patient of sharp scratch and insert cannula at 10-30 degrees
- Observe for flashback
- Insert the advancing cannula into the vein whilst holding/withdrawing needle
- Remove tourniquet
- Remove the needle and dispose in sharps bin
- Attach extension set
- Secure cannula using tape
- Flush the cannula with the saline and ask patient if there is any pain
o Lock the cannula
- Secure cannula with dressing and label with date of insertion
6. To Complete
- Remove gloves and dispose of equipment appropriately
- Wash hands
- Thank patient and check they are feeling ok
VIP SCORE:
The Visual Infusion Phlebitis (VIP) score is used at least once a day to check for phlebitis and monitoring infusion sites. The score is useful to monitor infusion sites and when cannulas need to be removed.
Questions:
1. What does the V.I.P Score stand for and what is it used for?
The Visual Infusion Phlebitis (VIP) score is used at least once a day to check for phlebitis and monitoring infusion sites.
2. The I.V site on a patient has swelling and pain near the I.V site. What score does this get on the V.I.P and what action needs to be taken?
The score is 2 (early phlebitis) and the cannula needs to be removed and inserted at a different site.
3. What are some of the complications of cannulation?
- Infection
- Phlebitis
- Thrombophlebitis
- Embolus
- Pain
- Haematoma
- Haemorrhage
- Extravasation
- Arterial cannulation
- Needlestick injury
4. Label the veins of the arm:
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