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Anatomy and Site
- Antecubital fossa (this is the most commonly used site and contains the basilic, cephalic and median cubital veins).
- Forearm, hand and digital veins
- Administration of intravenous medicines.
- Transfusions of blood or blood components.
- Maintenance or correction of hydration levels if unable to tolerate oral fluids.
- Infection at the site of access, e.g. cellulitis.
- Bleeding tendencies (relative contraindication), e.g. on warfarin
- The presence of injury or damage (e.g. fracture, Stroke, edema, lymphadenopathy)
- Arteriovenous (AV) fi stula in arm of proposed cannula site.
- Previous mastectomy with axillary node surgery or lymphoedema
- Infection at the puncture site- Minimised by cleaning the skin with an antiseptic wipe
- Hematoma – Minimised by apply gentle pressure for 1–2 minutes after the procedure
- Phlebitis-All cannulae should be removed after 72 hours, regardless of whether or not they look infected
- Pain- when inserting larger cannulae pain can be reduced by using a subcutaneous or topical local anesthetic.
- Failure-If the flashback does not occur, the vein has probably not been punctured. Re-palpate the vein and withdraw the cannula before re-advancing again.