Peripheral venous cannulation

Last Updated on 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

Indications

  • Administration of intravenous medicines.
  • Transfusions of blood or blood components.
  • Maintenance or correction of hydration levels if unable to tolerate oral fluids.

Contraindications

  • 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

Complications

  • 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.

Cannula size and flow rate

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