What are the steps of IV cannulation?

The steps of IV cannulation involve a series of procedures to successfully insert a catheter into a peripheral vein for intravenous access.

Steps for IV Cannulation

Here's a breakdown of the steps involved in IV cannulation, incorporating aseptic technique:

1. Gather Supplies: Assemble all necessary equipment, including:

   • IV catheter of appropriate gauge
   • Tourniquet
   • Antiseptic solution (e.g., chlorhexidine, alcohol)
   • Sterile gloves
   • Transparent dressing
   • Gauze
   • Tape
   • IV extension set or saline lock
   • Saline flush

2. Prepare the Patient:

   • Explain the procedure to the patient and obtain informed consent.
   • Position the patient comfortably.
   • Select an appropriate insertion site, ideally on a non-dominant arm. Avoid areas of injury, infection, or compromised circulation.

3. Apply Tourniquet:

   • Place the tourniquet 4-6 inches above the selected insertion site to distend the veins. Palpate for a suitable vein that is straight, easily palpable, and resilient.

4. Hand Hygiene and Don Gloves:

   • Perform thorough hand hygiene with soap and water or an alcohol-based hand rub.
   • Don sterile gloves.

5. Clean Insertion Site:

   • Clean the insertion site thoroughly with the antiseptic solution using a back-and-forth motion for at least 30 seconds, allowing it to air dry completely. Do not touch the site after cleaning.

6. Stabilize the Vein:

   • Using your non-dominant hand, stabilize the vein by gently pulling the skin taut below the insertion site. This helps to prevent the vein from rolling.

7. Insert the Cannula:

   • Remove the protective cap from the IV cannula.
   • Insert the IV cannula through the skin at a shallow angle (approximately 10-30 degrees) with the bevel facing up, directly over the selected vein.

8. Advance the Cannula and Observe for Flashback:

   • Advance the cannula until you see a flashback of blood in the catheter hub.

9. Thread the Catheter:

   • Lower the angle of the cannula slightly and advance the catheter fully into the vein while holding the needle stationary.

10. Release the Tourniquet:

    • Carefully release the tourniquet.

11. Stabilize and Secure the Catheter:

    • Apply pressure above the insertion site to prevent bleeding.
    • Remove the needle and engage the safety mechanism.
    • Immediately connect the IV extension set or saline lock to the catheter hub.

12. Flush the Catheter:

    • Gently flush the catheter with normal saline to ensure patency and check for any signs of infiltration or occlusion.

13. Dress the Insertion Site:

    • Apply a transparent dressing over the insertion site, ensuring the catheter hub and connection are visible.

14. Secure the Catheter:

    • Secure the catheter and tubing with tape to prevent accidental dislodgement.

15. Document the Procedure:

    • Document the date, time, location of insertion, catheter gauge, number of attempts, and patient's response to the procedure.

Successful IV cannulation requires proper technique, adherence to aseptic principles, and careful observation throughout the procedure.