welcome to the clinical skills video for peripheral venous cannulation prior to
performing any procedure on a patient you must ensure that you have got the
correct patient and that the patient is fully aware and informed of the
procedure about to perform must ensure that you then wash your hands thoroughly
using the 11 stage approach
you must now assemble your equipment prior to opening
the packs and assembly new equipment you must clean the procedure tray with the
appropriate wipe and allow it to dry thoroughly the equipment required for
this procedure is the appropriate sized venous cannula torniquet non sterile gloves
skin preparation wipes
an octopus or extension sets and a syringe with saline
in this example we are using the Nottingham University Hospitals cannulation packs
these contain a non ported cannula
but ported cannulas may be used
within the pack you will find a tourniquet an appropriate sized cannula skin
preparation wipe a label for putting in the patient's notes and address in
in this example the way we were not using pre-prepared 10 ml syringes with saline
already in situ so will require a drawing up needle a 10 mil vial
0.9% normal saline and a 10ml syringe
when preparing all the equipment and drawing up the saline I must ensure an
aseptic non-touch technique is maintained at all times
must also ensure that the octopus bung or extension set that is being used is
pre-primed prior to the procedure this is to ensure that no air is left in situ
and the patient receives no air emboli and you also require gauze which
doesn't come within the cannulation part if a cannulation pack is not available
within your clinical area that other disposable items can be obtained
once the equipment is all prepared you must gel your hands before applying and apron
and non sterile gloves
on the label you must right the date and time the cannula has been inserted
position exposed the arm and identify a suitable vein ideally this should be a
large forearm vein apply the tourniquet and once the tourniquet has been applied
recheck the vein ensure your patient is ready to proceed
and then clean the chosen site for 30seconds
and allow it to dry for 30 seconds
remove the cannula from its pack used in a no touch technique stretch the
skin then insert the needle with the bevel upwards in line with the vein at
an angle of approximately 30 degrees advance the needle observe him for the
first flashback in the hub of the cannula partially withdraw the styler
and observe for the second flashback along the cannula length level off the
cannula and then slowly advance the needle into the vein once the needle is
fully in the technique will vary depending on whether you are using a
ported or non ported cannula the non ported cannulas will give flashback but
won't bleed from the hub of the cannula once the need is removed here we
demonstrate what to do if you were using any potted cannula place the gauze
underneath the cannula release the torniquet apply pressure to the vein
above where the cannula is in and remove the needle and dispose of it
appropriately within a sharps bin if using a non ported cannula
you will not need to place the gauze underneath the cannula and apply
pressure to the vein due to the fact that the cannula won't bleed attach the
appropriate connection device or extension set if you're not taking blood
samples at this point flush the cannula whilst holding and
securing the cannula in place with your other hand
remembering to clamp off the extension set remove the syringe
remove the gauze and then apply the dressing to secure the cannula in place
most dressings have two single strips that you place either side of the
cannula remove the middle square of the dress in and then the back this just
makes it a bit easier
finally remove the last out a piece of dress in ensure the sticker with the
date and time has struck down to the patient
secure the cannula appropriately ensure that you complete the appropriate
documentation to go into the patient's notes and ensure that the patient is
okay and explained any complications that they may encounter
in summary
ensure that you have prepared the patient and confirm their identity
assemble and prepare all equipment ensuring an aseptic non-touch technique
identify the appropriate vein insert the needle at approximately 30 degrees
withdraw the needle slightly to observe for any flashback and then advance to
cannula once cannula is fully and prior to removing the needle ensure that you
have put in place gauze remove the tourniquet and apply pressure to the vein
the needle can then be safely removed disposable sharps safely attach an
extension set flush the cannula ensure the cannula is secured provide any
aftercare advice to the patient and ensure that the correct documentation is
filled out