Iv cannula technique

An easy way to get an IV access

1. Technique of iv access Presentation by Dr. Vishal Kr. Kandhway

2. introduction IV cannulation is the second most invasive procedure for patients in hospital. Today -85% - 95% of all hospitalised patients receive IV’s in one form or another

3. indications Administration of anaesthesia. Administration of fluids. Administration of medications. Administration of blood or blood products. Radiological imaging using IV contrast

4. contraindication Sites close to infection Veins of fractured limbs Where there is an AV fistula present Oedema Affected side of CVA Side of Mastectomy Extra care to be taken on patients with bleeding, clotting disorders & on warfarin.

5. site VEIN SELECTION Where: - Back of hand - Forearm - Antecubital fossa What : - Patent - Palpable - Distal - Straight - Avoid bifurcations

6. areas to be avoided Areas of joint flexion Hardened/sclerosed veins Major veins near arteries Veins in lower extremities Areas of surgery Small veins Previously cannulated veins

7. LOCATION OF VEINS IN ARM & FOREARM Veins of the Hand 1. Digital Dorsal veins 2. Dorsal Metacarpal veins 3. Dorsal venous network 4. Cephalic vein 5. Basilic vein Veins of the Forearm 1. Cephalic vein 2. Basilic vein 3. Median Cubital

8. Cannula types Size Colour Coding Flow Rate Uses 14G Orange 240ml/min Trauma Patients. Rapid, Large-volume replacement 16G Grey 180ml/min Trauma Patients, Major Surgery, Intra partum/Post partum, GI bleeds, Multiple blood transfers, High volume of fluids 17 G White 125ml/min Newly added 18G Green 90ml/min Blood products, delivery of irritant medications, major surgery, contrast study 20G Pink 60ml/min General use,IV maintenance, IV antibiotics, IV analgesia 22G Blue 36ml/min Small or Fragile veins, Cytotoxic therapy 24G Yellow 20ml/min For paediatric usage 26G Violet 13ml/min Newly added

9. SUGGESTED EQUIPMENT FOR PIVC INSERTION Cleaned procedural trolley. Sterile dressing pack or IV starter pack. Tourniquet: either a single use disposable or single patient use. Gloves Alcohol swab Appropriate sterile adhesive butterfly strips 10mL syringe or commercially available prefilled syringe for flush 2ml hep-lock syringe Sterile gauze squares Sharps disposal bin. It is the responsibility of the clinician inserting the PIVC to ensure items have not passed their expiry dates and that the integrity of the packaging has been maintained.

10. procedure Explain procedure to the patient. Wear personal protection equipments, i.e. gloves, apron (if required) Select the location according to the procedure Apply tourniquet Make the selected vein prominent & clean the area with betadine solution. Clean the area with alcohol swab Stretch the skin and fix the vein Insert the cannula at 45 degree to the vein. Once cannula is inserted check the patency by using an IV flush. Fix the cannula by using Tagaderm/ butterfly sticking. Dispose the biological and plastic waste

11. New methods AccuVein’s Illumination is the new infra-red device used for venipuncture in the patients with difficult venous access that include Elderly, Dark-skinned and Obese individuals.

12. complications Hematoma Haemorrhage Infection Phlebitis Thrombophlebitis Puncturing an artery Puncturing a nerve Infiltration Extravasation

13. A Video guide