The veins in the antecubital fossa should be avoided, as insertion here will limit the movement of the patient's arm and the cannula would be at a high risk of extravasating.
Select a suitable vein before selecting the device. The veins of choice are the cephalic or basilic. Avoid using the antecubital veins as this will restrict the patient's movement and increase the risk of complications such as phlebitis and infiltration (Dougherty & Watson, 2011; RCN, 2010).
Avoid the palm side of the wrist and the cephalic vein at the wrist because of the risk of nerve damage.
Complications include infection, phlebitis and thrombophlebitis, emboli, pain, haematoma or haemorrhage, extravasation, arterial cannulation and needlestick injuries. Careful adherence to guidelines and procedures can minimise these risks.
It is best to avoid cannulating at the site of valves because, as highlighted by Dougherty (2008), they can prevent advancement of a cannula and the use of force can cause pain and vessel rupture. Valves can be palpated or seen as a small bulge in the vein. They tend to occur where veins branch or join together.
Ensure that the blood pressure cuff is deflated during venous cannulation so as to not miss out the accidental arterial puncture. Signs of suspected arterial puncture include noting bright red blood with pulsatile flow, blood column moving upwards in the tubing of an infusion set, intense pain and distal ischaemia.
Complications of gaining I.V. may include infiltration, hematoma, an air embolism, phlebitis, extravascular drug administration, and intraarterial injection. Intraarterial injection is more rare, but as threatening.
However, at times, complications arise including the fracture of the cannula inside the vein, which is a rare but potentially serious complication with the possibility of pulmonary embolism.
One of the most common complications that can occur for catheter users is catheter blockage. Catheter blockages often form from a buildup of minerals, salts, and crystalline deposits which can block the eye holes of the catheter and prevent urine from draining from the bladder.
Cannulation of the cephalic, basilic, or other unnamed veins of the forearm is preferrable. The three main veins of the antecubital fossa (the cephalic, basilic, and median cubital) are frequently used. These veins are usually large, easy to find, and accomodating of larger IV catheters.
Accessory Cephalic Vein: this vein comes off the cephalic vein (hence its name) and is easy to stabilize. It is relatively large so this vein can hold an 18 gauge and easily a 20 or 22 gauge IV. Tip: when going for this vein for an IV go below the bend of the arm rather than in the bend.
Each clinician should have a maximum of 2 attempts before escalating.
Arterial cannulation has become increasingly significant in the appropriate monitoring and stabilization of the critically ill patient. It allows for continuous monitoring of the patients hemodynamic status by revealing an accurate blood pressure reading as well as a mean arterial pressure.
A blown vein is a vein that's mildly injured during a blood draw or IV placement. Symptoms include bruising, swelling and discomfort around your vein. While a blown vein isn't serious, it needs about 10 to 12 days to heal before your provider can use it again.
An extravasation injury is the inadvertent leakage of a solution that is vesicant. This means any medicine or fluid with a potential to cause blisters, severe tissue injury (skin, tendons or muscle) or tissue death if it escapes away from the intended venous pathway.
The following is a case report of a patient who had an intravenous (i.v.) catheter inserted into her cephalic vein and thereafter sustained an injury to the superficial branch of the radial nerve. When an i.v. catheter penetrates a nerve, it can cause temporary or permanent damage.
Despite its benefits and frequent use, intravenous cannulation has complications that can seriously threaten patient safety such as clotting, occlusion, leakage, infiltration, extravasation, phlebitis, and infection [4]. Furthermore, it is the main source of procedure-related pain in hospitalized patients [5].
The superficial veins of the upper extremities are preferred to those of the lower extremities for peripheral venous access because cannulation of upper-extremity veins interferes less with patient mobility and poses a lower risk for phlebitis.
One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra-arterially, which can potentially lead to life altering consequences.
If an artery is pierced, the blood pressure will be great enough to force blood into the syringe. This may not be the case with a smaller artery. Whether it spurts or needs to be drawn in, the arterial blood will be bright red.
Arteries have a pulse, and the blood in them is bright red and frothy. Arteries are located deeper in the body than veins and so are not visible as many of your veins are. You'll know you hit an artery if: The plunger of your syringe is forced back by the pressure of the blood.
It is not recommended that blood be drawn from the feet . The Providers permission is required to draw from this site. Specimens should not be obtained from the arm on the same side as a mastectomy. Avoid areas of hematoma.