Risks of IV Cannulation

  • Bruising/haematoma: relatively common, particularly after failed or vigorous cannulation attempts
  • Infection of the cannulation site: cellulitis may arise around the insertion site, which in some cases may progress to systemic sepsis
  • Displacement (tissuing): the cannula may become dislodged from the vein; in which case you must remove it and site a new cannula
  • Extravasation: if the cannula has not been properly sited injected fluids or drugs may pool under the skin, which may be irritating to the patient and in some cases cause tissue necrosis
  • Thrombophlebitis: irritation and clotting of the vein at the cannula site requires removal of the cannula
  • Blockage: clots or collections of infusion products may occlude the cannula. In some cases, you can resolve this by flushing the cannula with normal saline, but it may be necessary to remove the cannula
  • Arterial puncture: detected by pulsatile blood flow into the cannula chamber and from the end of the cannula after the needle is removed. Arterial puncture may be intensely painful and lead to distal limb ischaemia. If this occurs you should remove the cannula immediately, remove the tourniquet and apply firm pressure to the site
  • Peripheral nerve injury: this is rare. Remove the cannula immediately if the patient develops paraesthesia or numbness near the cannula site.

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