Page updated 30 April 2007
Peripheral Intravenous Cannulae
Insertion
- Choose a site where patient's movement will not cause movement of device at the entry site. The forearm provides an ideal site where veins tend to be straight and where the arm provides a natural splint. Avoid the antecubital fossa and the hand unless there are no other options.
- Do not shave the site.
- Clean the skin with alcoholic chlorhexidine or alcoholic povidone iodine (check patient is not allergic to iodine), twice, allowing the solution to evaporate to dryness on each occasion.
- Clean hands or put on sterile gloves after preparation of the materials and the skin before inserting the device. Only repalpate the vein if wearing uncontaminated sterile gloves.
Insertion sites should be reviewed for symptoms of inflammation and inspected:
- at least every shift
- every time IV infusion is commenced or IV drugs are given
- if there is any discomfort
- if established infusion ceases to function fully
- if the dressing comes adrift
Fixings and Dressings
- The catheter must be secured properly to ensure minimal movement of the cannula.
- Always anchor the flexible end of any administration set to the skin so that tension and movement is not applied to the entry site.
Suggestions for Dressings for Peripheral Lines
| Suitable for | Anchor/Dressing |
|---|---|
Peripheral IV cannulae remaining in place for a few hours only Where the patient is able to keep their arm still. Continuous inspection required |
Non-sterile tape* only to anchor the cannula |
| Peripheral IV cannulae remaining in place for days where patient needs to carry on with other activities | PREFERRED IV-dedicated transparent occlusive dressing OR Non-sterile tape* to anchor cannula plus IV-dedicated transparent occlusive dressing to cover exit site (plus bandage and splint if desired) OR Non-sterile tape* to anchor cannula plus sterile gauze-type dressing to cover insertion site (plus bandage and splint if desired) |
*Notes: Non-sterile tape must not come into contact with exit site. Bandages must be applied so as to allow inspection of site. Sterile gauze should be replaced at each inspection of the insertion site.
On-going Management
- Lines should be assessed for signs of inflammation each nursing shift. A line dressing may be left if the patient has no discomfort and the drip is flowing freely. If there are any problems, the insertion site must be inspected.
- A peripheral IV cannula used for TPN must be changed every 24 hours.
- A peripheral IV cannula used for other drugs and infusions should normally be changed routinely every 72 hours or immediately if any of the following occur:
- Pain on administration of fluids
- Inflammation at insertion site
- Phlebitis
- Leakage of infusion fluids / drugs from exit site
- Extravasation of fluids / drugs inot tissues
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