Intravenous Cannulation (OSCE)

 

Introduction 

  1. Greet patient and introduce yourself πŸ‘‹
  2. Confirm patient details βœ 
  3. Briefly explain the procedure in a patient friendly manner 
  4. Get patient consent 
  5. Check for any relevant allergies 
  6. Ensure the patient is sitting with their arms exposed 
  7. Check the patient is not in any pain 
  8. Wash hands βœ‹ 

 

Equipment 

 Disposable gloves βœ‹ 

 Disposable apron 

 Sharps bin πŸ—‘

 Tourniquet 

 2% chlorhexidine gluconate in 70% isopropyl alcohol swab 

 Cannula 

 Cannula dressing 

 Luer lock cannula cap/extension set 

 Gauze 

 Sterile dressing pack 

 10ml Syringe πŸ’‰

 0.9% 10ml saline 

 Clean procedure tray 

 


Preparation  

  1. Put gloves on βœ‹ 
  2. Place all unpackaged equipment on procedure tray 
  3. Draw saline into syringe πŸ’‰
  4. Attach extension set to the flush if using 
  5. Identify the arm more suitable for cannulation (patient preference/pre-existing medical conditions should be considered) 
  6. Place a field and pillow beneath the chosen arm 



 

Choosing a vein 

 

  1. Inspect arm for suitable cannulation site (should be unrestrictive and skin should be intact, not at the joining of 2 veins) πŸ’‰
  2. Lay the arm in a comfortable position, giving you sufficient space for cannulation 
  3. Tap the chosen vein as the patient clenches and unclenches their fist to visualise it more easily βœŠ 
  4. Apply tourniquet 4 to 5 finger widths above your chosen cannulation site
  5. Palpate the vein to assess whether it is suitable (feels springy not hard) 
  6. Release tourniquet 
  7. Clean site with alcohol swab for 30 seconds βŒ›
  8. Allow site to dry 

 

Insertion of cannula 

  1. Wash hands βœ‹ 
  2. Put on clean gloves βœ‹ 
  3. Reapply tourniquet  
  4. Uncover cannula and prepare it (open wings if present, withdraw then replace the needle slightly, unscrew the cap at the back) 
  5. Pull the skin beside the chosen cannulation site tight with your non-dominant hand βœ‹ 
  6. Inform patient you are ready to insert the cannula and they should expect to feel a sharp scratch
  7. Insert cannula above vein, at a 10 to 30Β° angle πŸ“
  8. Flashback confirms you have punctured the vein successfully 
  9. Lower the cannula and insert the needle approximately 2mm further to reach the vein’s lumen πŸ“
  10. Withdraw the introducer needle slightly and observe blood filling the cannula tubing 
  11. Continue to withdraw the needle and simultaneously insert the cannula into the vein  
  12. When the cannula is inserted fully and the needle is almost removed, release the tourniquet
  13. Place a sterile gauze near cannula tip 
  14. Hold cannula still while you remove introducer needle completely 
  15. Apply pressure on sterile gauze 
  16. Connect Luer lock cap/extension hub to cannula hub 
  17. Appropriately dispose of sharps and waste πŸ—‘
  18. Tape cannula wings to skin, ensuring insertion site remains visible 

 

Flushing the cannula 

  1. Inject saline flush into cannula (stop if pain or swelling) 
  2. Close cannula port 
  3. If flushed successfully, secure the cannula using a dressing βœ… 

 

Completion 

  1. Tell the patient to procedure is complete βœ… 
  2. Thank patient 
  3. Wash hands βœ‹ 
  4. Document cannulation details where appropriate βœ 


Summary:

  1. Greet the patient and explain the procedure
  2. Prepare by collecting equipment, putting on PPE and washing your hands
  3. Identify the arm more suitable for cannulation and place a pillow underneath it
  4. Identify suitable cannulation site and apply tourniquet 4-5 finger widths above it
  5. Insert cannula into lumen of vein
  6. When cannula is fully inserted and the introducer needle is almost fully removed, release tourniquet 
  7. Apply pressure and attach Luer lock cap to cannula hub before taping wings to skin
  8. Complete procedure by thanking patient and appropriately disposing of waste

 

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