Peripheral venous cannulation

Last Updated on February 17, 2019 by frcemuser

Anatomy and Site

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
Thrombophlebitis.
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.