Cannulation

MRCS Part B OSCE Revision

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Cannulation and IVI Fluid

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Introduction

  • Begin by washing your hands
  • Introduce yourself, explain that you need to take some blood and gain verbal consent
  • Check the patient's name and date of birth against her wrist band and notes
  • Ask if she has any significant past medical history, clotting disorders or transmissible blood diseases

  • Ensure you have kit including tourniquet, green venflon, syringe with 5ml saline, cannula dressing, alcohol wipe, sharps bin
  • Wash your hands
  • Wear an apron, eye protection and gloves
  • Firmly tie the tourniquet around the arm (if a mannequin stating this may suffice)
  • Palpate the antecubital fossa or given area for a vein
  • Clean the area with an alcohol wipe and allow time to dry
  • Open the “wings” of the cannula
  • Ensure that the bevel (the eye) of the needle is pointing upwards
  • Hand position: middle finger on the right wing, index finger on the injection port, thumb at the end of the cannula
  • Insert cannula directly into the vein at approximately 30 - 40 degrees
  • Advance the cannula slowly until a flashback is seen at the base of the cannula
  • Holding the needle still, gently advance the plastic cannula into the vein, not the needle
  • Position a swab beneath the cannula to prevent any blood spilling not the patient
  • Remove the tourniquet prior to removing the needle
  • Press over the end of the cannula (within the vein) to minimise blood loss, whilst removing the needle
  • Remove the cap and dispose of the needle into a sharps bin
  • Attach the cap
  • Apply a cannula dressing
  • Flush the cannula via the top port with 5ml of saline watching for extravasation or discomfort
  • Thank patient
  • Dispose of protective clothing in orange bag
  • Wash hands
  • If you are setting up an IVI infusion:
  • Check the solution is correct and in date
  • Ensure the fluid is documented on the drug chart
  • Insert the giving tube into the end of the saline bag
  • Carefully run the fluid through with the end cap on to avoid spillage
  • Clamp the giving tube
  • Remove the end cap and fasten to the top port of the cannula
  • Release the clamp so that fluid begins to drip

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Attach Tourniquet and Clean Area
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Open Venflon
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Palpate a vein and advance Venflon
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Watch for flashback
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Remove the needle and tourniquet
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Attach cap
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Apply dressing
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Flush with 5ml N. Saline
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Dispose of sharps

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