1. Prepare and assemble all equipment.
2. Explain the procedure and gain consent. Consent can be given orally or by
co-operation (RCN 2010).
3. Check patient’s identification (Hospital number on wristband, Name &
DOB).
4. Wash and dry hands as per trust policy prior to commencement of
procedure.
5. Non sterile gloves and a disposable apron should be worn.
6. Use the cannula selection guide to select a suitable cannula pack based on
vein type and treatment to be administered. Always select smallest gauge
possible (Macklin & Chernecky 2004)
Cannula Gauge Colour Flow rate mls/min Flow rate litres/hr
22 Blue 42 2.5
20 Pink 67 4
18 Green 103 6.2
16 Gray 236 14.2
14 Orange 270 16.2
7. Assess both upper limbs and choose a suitable vein. Veins in the lower
extremities (feet, legs) should not be used routinely due to risk of
thrombus (INS 2006).
8. Wash and dry hands as per trust policy.
9. Open the cannula pack using Aseptic Non Touch Technique.
10. Apply disposable tourniquet to the selected arm (tight enough to impede
venous flow but not too tight as to affect arterial flow) and palpate for an
appropriate vein. N.B. The use of a rubber glove or hands as a tourniquet
is strictly prohibited.
11. Clean the skin at the intended insertion site with 2% Chlorhexidine in 70%
alcohol for 30 seconds and allow to dry. Do not touch or re-palpate the
vein after skin cleansing.
12. Insert the cannula with the bevel up and observe for flashback. If
successful, advance the cannula keeping the stylet still.
13. Release the tourniquet before removing the needle to avoid bruising
14. Apply digital pressure to the vein above the cannula tip and remove the
stylet and place in sharps bin immediately
15. ATTACH PRIMED NEEDLE FREE DEVICE TO CANNULA – do not connect plain
white cap!!
OR
16. Secure the cannula with a sterile, permeable, semi-transparent cannula
dressing which enables clear observation of the insertion site. The ‘tram
lines’ secure each wing horizontally and should not obstruct the view of the
insertion site.
17. Write the date of insertion on the cannula.
18. A competently trained practitioner in IV therapy must then flush the
cannula using a 10ml syringe and 5mls of 0.9% Normal saline (ENSURE THIS
IS PRESCRIBED).
19. The flush must be drawn up using a blunt fill needle. Flush via the needle
free device.
20. Dispose of all sharps in accordance with trust policy
21. Disposal of waste in accordance with trust policy using yellow bag in the
pack
22. Decontaminate hands according to trust policy
23. NB Should you fail to cannulate after two attempts you must escalate to a
more experienced colleague or doctor.
24. Complete the brightly coloured sticker from the cannula pack and put
into the medical notes immediately. You MUST inform the Nurse of the
insertion so they can document on the VitalPac.
CANNULA AUDITS ARE CONDUCTED MONTHLY. EVERY CANNULA MUST
ADHERE TO THE ABOVE PROCESSES INCLUDING NEEDLE FREE DEVICE
ATTACHMENT, DRESSING PLACEMENT AND DOCUMENTATION.