Intravenous Cannulation (Internal Medicine)

• Infusion of IV fluids

• Abnormalities of the overlying skin (cellulitis, burns, etc.)
• Abnormalities of the extremity (trauma, ipsilateral radical mastectomy, presence of an arteriovenous fistula)

• Gloves, antiseptic solution
• Rubber elastic tourniquet
• Local anesthetic solution, 25-gauge needle, and small syringe (optional)
• Intravenous catheter
• If phlebotomy is required, 5- to 10-mL syringe or vacuum bottles and vacuum bottle holder to collect the sample and specimen bottles
• Appropriate IV fluid or saline “lock” setup and IV tubing
• Sterile saline for the flush or IV fluids
• Cotton balls or gauze for bleeding and sterile dressing

• Upper extremity veins are preferable.
• Commonly used veins include the dorsal metacarpal veins, the basilic vein, and the cephalic vein.

Figure 3 :  Equipment.

View Larger Image

Figure 4 :  Intravenous catheter.

View Larger Image

The full content of this section includes:

• Step-by-step text instructions for performing the procedure
  
• Clinical pearls providing practical clinical tips from medical experts
• Patient safety guidelines consistent with Joint Commission and OHSA standards
• Links to medical evidence and related procedures

Figure 16 :  Apply traction with your non-dominant hand. Hold the intravenous catheter at the level of the flash chamber, with your thumb and middle finger.

View Larger Image

Figure 17 :  Observe for a flash of blood.

View Larger Image

• Frequently reassess the IV line.
• Flush the line at least every 8 hours.
• Change peripheral lines every 3 to 4 days.

• Infiltration and extravasation of IV fluids
• Arterial placement
• Air embolism
• Catheter fracture and embolism
• Infection
• Thrombophlebitis