Intravenous Cannulation (OSCE)
Introduction
- Greet patient and introduce yourself π
- Confirm patient details β
- Briefly explain the procedure in a patient friendly manner
- Get patient consent
- Check for any relevant allergies
- Ensure the patient is sitting with their arms exposed
- Check the patient is not in any pain
- Wash hands β
Equipment
Disposable gloves β
Disposable apron
Sharps bin π
Tourniquet
2% chlorhexidine gluconate in 70% isopropyl alcohol swab
Cannula
Cannula dressing
Luer lock cannula cap/extension set
Gauze
Sterile dressing pack
10ml Syringe π
0.9% 10ml saline
Clean procedure tray
Preparation
- Put gloves on β
- Place all unpackaged equipment on procedure tray
- Draw saline into syringe π
- Attach extension set to the flush if using
- Identify the arm more suitable for cannulation (patient preference/pre-existing medical conditions should be considered)
- Place a field and pillow beneath the chosen arm
Choosing a vein
- Inspect arm for suitable cannulation site (should be unrestrictive and skin should be intact, not at the joining of 2 veins) π
- Lay the arm in a comfortable position, giving you sufficient space for cannulation
- Tap the chosen vein as the patient clenches and unclenches their fist to visualise it more easily β
- Apply tourniquet 4 to 5 finger widths above your chosen cannulation site
- Palpate the vein to assess whether it is suitable (feels springy not hard)
- Release tourniquet
- Clean site with alcohol swab for 30 seconds β
- Allow site to dry
Insertion of cannula
- Wash hands β
- Put on clean gloves β
- Reapply tourniquet
- Uncover cannula and prepare it (open wings if present, withdraw then replace the needle slightly, unscrew the cap at the back)
- Pull the skin beside the chosen cannulation site tight with your non-dominant hand β
- Inform patient you are ready to insert the cannula and they should expect to feel a sharp scratch
- Insert cannula above vein, at a 10 to 30Β° angle π
- Flashback confirms you have punctured the vein successfully
- Lower the cannula and insert the needle approximately 2mm further to reach the veinβs lumen π
- Withdraw the introducer needle slightly and observe blood filling the cannula tubing
- Continue to withdraw the needle and simultaneously insert the cannula into the vein
- When the cannula is inserted fully and the needle is almost removed, release the tourniquet
- Place a sterile gauze near cannula tip
- Hold cannula still while you remove introducer needle completely
- Apply pressure on sterile gauze
- Connect Luer lock cap/extension hub to cannula hub
- Appropriately dispose of sharps and waste π
- Tape cannula wings to skin, ensuring insertion site remains visible
Flushing the cannula
- Inject saline flush into cannula (stop if pain or swelling)
- Close cannula port
- If flushed successfully, secure the cannula using a dressing β
Completion
- Tell the patient to procedure is complete β
- Thank patient
- Wash hands β
- Document cannulation details where appropriate β
Summary:
- Greet the patient and explain the procedure
- Prepare by collecting equipment, putting on PPE and washing your hands
- Identify the arm more suitable for cannulation and place a pillow underneath it
- Identify suitable cannulation site and apply tourniquet 4-5 finger widths above it
- Insert cannula into lumen of vein
- When cannula is fully inserted and the introducer needle is almost fully removed, release tourniquet
- Apply pressure and attach Luer lock cap to cannula hub before taping wings to skin
- Complete procedure by thanking patient and appropriately disposing of waste
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