Cannula Care and Removal Procedure ,, the equipment ,, the objective ,, Indications of cannula care and removal:

Cannula Care and Removal Procedure

Introduction:

Intravenous (IV) cannulation is a technique in which a cannula placed inside a vein to provide venous access as introducing intravenous medication, infusion, or parental nutrition. Caring of cannula is routine care but most important to health care associated infection (HAIs).

Intravenous (IV) cannulation: is indicated for short-term use in many clinical situations.

Objective:

To prevent infection

To prevent further risk of complications

To monitor the patency of the IV cannula

Indications of cannula care and removal:

Indications of care	Indications of removal
1. When dressing becomes wet, blood        stained or is not well secured 2. Inspect insertion site & patency of cannula.	1. According to hospital policy (recommended 48-72 hours). 2. When IV therapy is completed as ordered. 3. In case of complications (infection, phlebitis or extravasation). 4. When the cannula became unpatented (accidentally dislodged, occluded, kinked). 5. At the time of patient's discharge.

 

Equipment:

Clean gloves                                      Normal saline( 2cc)

Band-Aid                                            Disposable pad.

3cc syringe                                         Adhesive tap

Betadine or alcohol swab           

                                             

Remember to:

Cannula care performed every shift or as needed

PThe site of insertion should be assessed every 2 hours if a transparent semi-permeable dressing is used, otherwise with every dressing change.

The cannula site should be changed at the first signs of inflammation or discomfort, or at least every 48-72 hours to reduce the risk of phlebitis developing.

Support cannula carefully during care to avoid dislocation

Remove cannula after 48-72 hours  or if necessary

The cannula, which not routinely in use for intravenous infusion should be flushed every 12 hours with 5 to 10 ml. normal saline 0. 9%injection.

Never flush the cannula before withdrawal from it  (to ensure that there is no blood clots occluded it).

If the patient has sensitivity to the dressing or tape material, skin protecting ointment is applied at the site.

Don't obscure area above I.V site with tape to prevent extravasation.

If the IV infusion continued, stop it before cannula care or removal.

 

Reference:

Lynn,P.,(2015).Taylor’s clinical nursing skills,4^th ed.,Philadelphia: Wolters Kluwer

Mosby.,(2009).Nursing video skills,sv3.0.,Elsevier

Cannula Care and Removal Procedure with Rational

Steps	Rational
Pre procedure:
1.Check physicion prescription	To ensure safety
2.Wash hands	To reduce infection
3.Prepare well function, adequat equipment	To save time
4.Introduce youreslf to patient	To build trust
5. Identfiy the patient	To ensure that is the right patient
6.Explain procedure to the patient	To facilitate cooperation
7.Keep patient privacy	To minimize embarrassment
8.Place patient in comfortable position	To maintain comfort
9.Put Disposable pad under the arm with venous      Access	To reduce infection
10.Disinfectant your hands with alchol hand gel	To reduce infection
11.Wear clean gloves	To reduce infection
During procedure :
12.  Check if cannula is function or not by: - Fill syring with 2cc normal saline then connect tip of syringe into cannula & aspirate  amount of saline slowly. - If blood not appear in the syringe, inject the normal saline slowly,if there is resistance DONOT inject (NOT patent). - If no reisitance, inject saline slowly, observe the insertion site, (swelling during inject STOP if no swelling inject slowely, pain).	To maintain patient safety
13. Support the cannula with nondominant hand and          carefully  remove old dressing by use gauze with          water or saline.	To avoid dislocate
14. Observe skin condition ( if there is any inflamation,       redness, swelling, pain)signs of phlibitis.	To determine early signs of infection
15.Change gloves	To prevent infection
16. Disinfect insertion site with alcohol swab or           betadine in one direction,start from insertion site           outward.(repeat by new swab if needed)	To reduce infection
17. Leave Alcohol to evaporate.or betadine	To be effective
18. Fix cannula by adhesive tap	To avoid dislocate
19.Lable dressing with data,time of change,date of       insertion,nurse name.	To provide further information
Post procedure:
20.Dispose any used material	To reduce infection
21. Remove gloves	To reduce infection
22.Wash hands	To reduce infection
23. Record the procedure (patancy, skin around insertion site, date of insertion, date of care)	Documentation provides ongoing data
24.Report any abnormalitis	To ensure patient safety
Cannula Removal
Pre procedure:
1-Follow steps 1 to 11
During procedure:
12-Observe skin condition ( if there is any inflamation,          redness , swelling ,pain.)	To determine early signs of infection
13- Remove cannula (after 48-72 hours from insertion        or if necessary)	To reduce infection
14- Use gauze with water or saline over old tape.	To facilitate removal
15.Remove old tape which attached to cannula gently        (support the cannula) .	To facilitate removal
16. Remove IV cannula &quickly press with dry cotton over puncture site until bleeding is stopped.	To avoid blood loss
17. Assess vein puncture site (for redness, swelling or formation of hematoma) press on the site of removal for 5 minutes at least.	To determine early signs of infection
18.Put band aid over puncture site	To reduce infection
Post procedure:
19.Dispose any used material	To reduce infection
20.Remove gloves.	To reduce infection
21. Wash hands.	To reduce infection
22.Record the procedure (skin color, ant redness, hematoma)	Documentation provides ongoing data
23 Report any abnormalities	To ensure patient safety