Equipment
Equipment used for intravenous (IV) cannulation includes the following (see the images below):
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Nonsterile gloves
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Tourniquet
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Antiseptic solution (2% chlorhexidine in 70% isopropyl alcohol)
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Local anesthetic solution
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1-mL syringe with a 30-gauge needle
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2 × 2 in. gauze
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Venous access device
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Vacuum collection tubes and adaptor
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Saline or heparin lock
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Saline or heparin solution
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Transparent dressing
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Paper tape
Patient Preparation
Anesthesia
Both intradermal injection of a topical anesthetic agent just prior to IV insertion [5] and topical application of a local anesthetic cream [6] about 30 minutes prior to IV insertion have been shown to achieve significant reduction of the pain associated with the procedure. Both should be used unless the situation is an emergency. [7]
Positioning
Make sure that there is adequate light and that the room is warm enough to encourage vasodilation. Adjust the height or position of the bed or chair to make sure you are comfortable and to prevent unnecessary bending. Make sure the patient is in a comfortable position, and place a pillow or a rolled towel under the patient’s extended arm.
The patient’s skin should be washed with soap and water if it is visibly dirty.
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Partial selection of equipment required for IV cannulation.
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Partial selection of equipment required for IV cannulation.
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Various sizes of over-the-needle IV catheters.
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Over-the-needle IV catheter.
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Vacuum collection tubes and adaptor for IV cannulation.
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Vein palpation for IV cannulation.
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Insertion sites for IV cannulation.
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Insertion site for IV cannulation.
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Application of antiseptic solution for IV cannulation.
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Flushing of tubing with normal saline for IV cannulation.
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Subcutaneous injection of local anesthetic for IV cannulation.
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Applying traction with nondominant thumb to stabilize vein for IV cannulation.
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Angle of insertion with bevel up for IV cannulation.
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Flashback of blood into venous access device for IV cannulation.
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Sliding hub of catheter over needle and into vein for IV cannulation.
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Using nondominant hand to secure venous access device in vein while using dominant hand to remove and secure needle for IV cannulation.
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Using blood sampling adapter for IV cannulation.
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Securing saline lock with transparent dressing for IV cannulation.
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Flushing and locking venous access device for IV cannulation.
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In same patient, flushing and locking venous access device for IV cannulation.
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Again in same patient, flushing and locking venous access device for IV cannulation.
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Labeling for IV cannulation.
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Removal of IV catheter.
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IV cannulation. Video courtesy of Gil Z Shlamovitz, MD.
