Important tips and tricks for IV cannulation!

[@swood07413]

Dude the "blunt portion of upper canula" pearl regarding flattening your needle blew my mind. Makes so much more sense, especially with the visual. Thanks!

[@ABCsofAnaesthesia]

I know right! Someone taught me that back in 2005 as a medical student and revolutionized my ‘cannulation career’ 😂

[@swood07413]

@@ABCsofAnaesthesia For sure! I'm an EM resident and we're fortunate to have great nurses at our shop for most IV's, but I definitely need these skills if I'm ever in the jungle or something... I look forward to watching the rest of your videos, and thanks for all your help and teaching!

[@angelidez13]

YES!!! I'm so glad I came across this video, we're doing IV insertions in class and I feel like this will help me so so much

[@tutatehaja1777]

I have had a few unsuccessful IV cannulations and my confidence has taken a bit of a hit. But after watching your video I'm feeling much better and will be using your tips. Thank you again. From New Zealand 🇳🇿

[@johnzaleski5182]

Was successful in initiating an IV on each of my last 6 patients. I had your instruction playing in my head on each patient. Have really built my confidence. Half of these were medium to hard sticks, too.

[@mkdau01]

I used to work post-op surgery and switched to intra-op (sedation) then back to pre/post-op, meaning that I have switched from being quite rusty in my IV skills to needing them basically 24/7.... I have to say, THIS video is the ONLY one I have found to be the most helpful and accurate. He literally includes every tip/trick a practitioner needs to refresh their IV skills rapidly. Thank you! Literally the BEST.

[@kayn9109]

So helpful, your explanation of "flattening cannula" by using empty cannula plastic bag is just spot-on! Now I got it! The best IV cannulation teaching video. Thank you so much :)

[@ABCsofAnaesthesia]

Thank so much for the comment! When someone showed me that back as a Med student it changed everything! Happy to pass it on! All the best!

[@marwamirgani999]

This is by far the best cannulation video I’ve ever seen, Thank you

[@adafung8789]

Thank you SO much to share your expertise with us, your " low angle entrance , then flatten the cannula " makes so much sense, as we always end up poke through the vein and wasn't even aware!

[@ABCsofAnaesthesia]

thanks so much for the kind words and feedback :)

[@katehill1833]

Student nurse here and I’m excited try this low angle technique in a few weeks for skills validation. Thank you for the videos.

[@amoghdurgam5621]

I’m a med Studnet and I was able to cannulate well my first try by following ur tips!

[@ABCsofAnaesthesia]

Thats so great to hear! Well done and keep it up!

[@edwardvenison8080]

This is the best IV cannulation demonstration video I've seen on youtube - thanks for posting, I'm getting better already :)

[@ABCsofAnaesthesia]

Great to hear! very humbling to hear :)

[@EthiomerejaOfficial]

The best IV cannulation technique I have seen. Keep up the good work Dr. Awesome 👏

[@ABCsofAnaesthesia]

haha, thanks :)

[@esiani9382]

Agreed

[@valeriaesquivel3994]

The best cannulation video I've seen, I now realize what I was doing wrong while practicing. Thank you!

[@ABCsofAnaesthesia]

So kind! Thank you

[@ASMR-pp3hc]

You really nail the explanation. You are a natural educator.

[@ABCsofAnaesthesia]

thanks!

[@LY43537]

Could you do videos on cannulating w/ darker skinned patients, as well as edematous patients, and patients with fragile veins (elderly, dialysis patients, etc.)?

[@eduardodiaz9354]

that’s when you need ultrasound guided

[@sampathabiman2939]

Thats good question ?

[@samahnasser87]

I go by feel so not by look. So by that, a dark skin person would be no different. My skills are with the elderly. They can be rough. Their veins blow too. I am most successful when I keep their skin tight as I advance. They may need more attempts. If they are really skinny, there might be a delicious on in the bicep area.

[@bndanto3207]

Use 70% alcohol, put it on your compress and once your tourniquet is tight enough, apply the compress and tap over it. If you're really struggling because your patient is in a sepsis or even in shock, you still have the little wrist veins if you need emergency antibiotics or drugs. Btw if you can't have a peripheric vein, the doctor may have the skill to get a jugular catheter. My technique, if it is really difficult because of a sepsis or hypotension, is to watch on legs (if there is nothing on forearms, elbow, or biceps or shoulder), put a little catheter to use paracetamol and other medications (or even the time the person warms up), and then when the veins come back I can have it on the arms

[@ozzya9977]

Quick tip for cannulating the oedematous. Squeeze the site tightly for a few seconds with your the palm of your hand and milk out the fluid. You'll be surprised how well this moves the fluid away just long enough for you to spot a juicy vein.

[@Balta211]

I haven't done IV cannulation for a long time. This video refresh my skills. Thanks 👍

[@ABCsofAnaesthesia]

Great to hear!

[@hurleymichelle1]

I am starting my new job on Monday in radiology as assistant. I am going to do my care certificate and train to cannulate. I have been watching your videos over and over to help me when I start. Thank you x

[@InjusticeHater]

Thank You! As nursing apprentice I was in anesthesia pre op for 2 weeks and tried several times. From like 12 times I could try during that time I was successful 5 times. I am happy my last try was a success. I watched several tutorials but I wish I had seen THIS video in advance. Pretty sure I would have been more successful. Oh and btw: We have Braun cannulas that stop bloodflow after extraction of the needles in hospital. Pretty convenient. Looking forward to get the chance to try again.

[@rosabelliu2745]

Thank you so much for this video! The slow demonstration with detailed explanations is exactly what I needed. Hope I can ace my IV cannulations soon!

[@flylee87]

Thank you SO much for these tips. It’s helped immensely with my iv starts and finally I’ve found what I was doing wrong with your videos. Had to start an IV on a surgeon as if that’s not enough to make you nervous, used your tips and did it perfectly! This surgeon was like “A+ for that” and I couldn’t be cheesing more haha thank you 🙏🏼🙏🏼

[@ABCsofAnaesthesia]

Legend!

[@MondolFarmecy]

hii

[@markstylianou7438]

As a student nurse in the UK, I found this extremely useful towards my learning. Thank you.

[@Atlas1198]

Student paramedic here almost in my 3rd year , still needing advice , I really can’t get IV access , my biggest struggle . Thanks for the video! Hopefully my next victim won’t suffer .

[@livinglegend2065]

Next "victim"?

[@RamonQuiro7]

How did it go?

[@wrestle4life234]

This is the only video I’ve seen with proper insertion technique.

[@jeannydaniel2022]

As a dialysis nurse, my skills and techniques have changed. This is a good video to remind myself of the difference in technique.

[@amirrezafahimi6579]

That was the best demonstration of cannulation I've ever seen. Thanks for the amazing content.

[@Dmoon1234]

What an excellent explanation. Beautifully demonstrated and clear instructions and suggestions. Thank you

[@ABCsofAnaesthesia]

thanks!

[@smxyg]

I've always been afraid to do IV cannulation. I am a sophomore nursing student and we're trying IV insertion soon. This video helped me a lot. I hope I could get it right on my return demo. Thank you for sharing your tips! I'm a new subscriber.

[@Harlem55]

Another little trick is to make sure you select an appropriate gauge- rather, in patients with a history of problems that lend themselves toward collapsed veins, don't be above yourself and be willing to go down to a 24G if the vein itself requires it, provided that the gauge is large enough to pass the particular fluid type through it. (if the line you're inserting might be used for administering colloids such as whole blood, you're going to necessarily need a larger gauge). The trick is in figuring out the balance between the two sides- as using smaller bores where possible also decreases the risk of infection because both the skin puncture and the sterile tract then has less surface area from which microorganisms such as viruses, bacteria, fungi, etc. can enter.

[@mkdau01]

@@Harlem55 Very good tips, indeed, sir! Also, if one uses TOO little a catheter for a bigger vein (for instance, a 24G in a large AC vein), the catheter will simply not stay put.

[@Harlem55]

@@mkdau01 Thats where the conundrum lies - large veins that want to roll, where historically one might ask the MD to consider a cut down, though I hear that its not favored much in modern medicine.

[@ASMR-pp3hc]

You just explain things so well, you are a natural.

[@bdogg20101]

Excellent video. And great step by step instructions. And the visualization is amazing.

[@GermanHeul]

that's literally the best video i've ever seen for IV canulation

[@rachelliz4786]

I've always been told faster is better but I tried this and was really happy with how little it hurt. This is an awesome video!

[@WonderfulsVIP]

Agreed someone once told me going slower hurts the patient more, but I’d rather go slower and be more accurate than to hurry in the process

[@MondolFarmecy]

hii

[@jingyun4323]

IV cannulation gives me so much anxiety, I've tried to steer away from doing them, worsening the situation. This makes so much more sense when I'm not having a panic attack putting one in.

[@RR-js5yx]

Thank you very much. Always appreciate the ''out of books'' knowledge given by doctors. Decreases my anxiety of looking dumb in hospital. Subscribed

[@ABCsofAnaesthesia]

yeah! I used to love the doctors giving us their inside tips :)

[@user-vw8jl9py6w]

@@ABCsofAnaesthesia Great teaching

[@gretad3134]

Thank you for making this video! I’m a new EMT who just started practicing on classmates last week, and this was incredibly helpful. Now I can correct all of the mistakes I’m making before my clinical rotation! You have a new subscriber :)

[@Tin_toki]

Nursing student here! I’m going to do my first IV stick in lab this Saturday. I’m watching all these vids and they’re awesome for tips! Can’t wait to try them out on the first try

[@ABCsofAnaesthesia]

Good luck!! you got this!

[@joetaylor486]

Thanks for posting this tutorial. It made me much more aware of the dynamics of the cannula tip and will change my practice. I have always been a very average cannulator and aspire to better.

[@ilovemeforwhoiam]

Oh dear.. Thank you ❤, nobody taught it this clearly ❤. Much respect Sir 🙏😊

[@lauramazzocchitti8509]

Thank you for the really good visuals! The most important lesson was not to rush! And to angle down as soon as you get flash back !

[@Marrissawms]

Thank you, thank you so much for all your tips! They make complete sense and I'm a living witness your advice works! I'm a new preop nurse, so my main job is starting IVs. Your videos have increased my success rate tremendously. Thank you sir!

[@qiwenzhang7855]

A well-made video. Thanks for sharing your tips. We have an expected cannulation tomorrow morning. I will give it a try

[@ABCsofAnaesthesia]

Good luck!! How did it go?

[@tonybrodeur4766]

Thank you! This video definitely makes a lot of sense and I see my mistakes now as new nurse doing iv access!

[@ABCsofAnaesthesia]

Welcome tony! Good luck!

[@jonchoi1233]

I lower the arm before I apply the tourniquet to get even better engorgement of the veins.

[@samahnasser87]

Sweet tip

[@sanjaysomari]

Salute

[@pippaclacherty7854]

Thank you, does it help with dehydrated patients? I’m a nurse learning peripheral intravenous cannulation, and it’s something I want to become accredited in.

[@elianefernandes4733]

Nice tip!

[@jieli206]

I put warm blankets over the arm😂

[@beverlyramsahai7083]

You’re an awesome teacher you speak so eloquently and yr video is so simple to follow 👏👏👏

[@sfsafafadwqqw]

Thank you so much, this is the best demonstration of the cannulation technique I've seen so far.

[@waggingthroughlife]

By far the best vid in IV cannu. THANK YOU!

[@drsaadnaeem]

Your videos are awesome. I'm a Dental Surgeon who recently started practicing sedation and I'm always eager to learn about cannulation and airway management. Thank you for making such awesome videos.

[@tgilb2903]

Great tips! I watched this video, noted your tips and two days later went to work successfully inserted iv. Thanks!

[@ABCsofAnaesthesia]

That’s great! So happy to hear that :)

[@Burgundeh]

Easily the best IV insertion video out there. Thank you!

[@jacoba0030]

This is an awesome demonstration! Thank you for taking the time to share your insight on this. I can’t wait to try this method.

[@aRedstepchild]

YOU deserve the NOBEL PEACE PRIZE when you said FIRST ASK THE PATIENT IF THE HAVE A GOOD SITE THEY PREFER ( and listen for WHY), because they ABSOLUTELY know where other's failed. I had 3 techs, 5 failed attempts today. I told each one just anchor HERE, like you showed, poke here, the vein was bulging just under my skin. Finally they did. Thin skin. Painless. Quick. No bruising. The 5 other attempts are painful throbbing and definitely gonna be bad bruising. Im saving your video. Before someone draws my blood, im going to have them watch this. Because when they gouge me and stubbornly do otherwise, im going to document, note everything, and write letters to the licensing board. I will not be bullied or physically abused because the tech has THEIR preference. I tell them it's no good here, here, here. You poke, get a little blood, it rolls, you gouge some, vein blows, i bruise. Im not gonna be nice. You watch this, do this, we are good. You decide but don't say i didn't tell ya. 6 attempts and 3 techs later, they listened. It was so easy. But im in a lot of pain because they didn't listen to me before they started. You are a trained licensed professional. The patient knows where you will fail if you just ask them first.

[@ABCsofAnaesthesia]

Youre too kind… i really hope it gets better for you :)

[@disturbedme5]

This really is one of the best IV videos. Thank you so much for making it! It's extremely helpful!

[@rachamus4674]

His tips are gold!! This video makes sense AND all his tips work 👌🏾👌🏾 I like that he explains the anatomy of the vein/needle.

[@whcscomlat]

Great video. Fun fact: I'm teaching my anesthesia trainees exactly the same way in terms of cannulation. By the way: in Europe cannulas with an injection valve on top is more common than your setup in Australia or the US. Once this technique is in the students mind even 17, 16 and 14G cannulas are really save and may not hurt if you are performing fast in an awake patient. Greetings from Germany! :-)

[@ABCsofAnaesthesia]

thanks for the comment! Would be great to see the top port cannulas, I've only used them a few times but not readily available here. Fortunately similar principles :)

[@bryanmunar7116]

Potential IV lab partner: "Do you want to be partners for this lab?" Me: "So you've chosen death?"

[@TheBandFLEDGELING]

Thank you DOC! Blew too many veins today going in at a 45...... this is GOLD‼️🙏

[@11zen45]

Thank you . This is the best cannulation video, in my opinion.😁

[@ABCsofAnaesthesia]

Thats so kind of you :) Thank you!

[@dindi380]

Thank you for sharing this video. Im a registered nurse and im anxious about performing this procedure/ starting an iv line... i didnt have practice during my on-the job-training as a nursing student to perfect this procedure, so having this detailed video guide helps a lot!

[@ABCsofAnaesthesia]

Thanks! I’m so happy it was helpful :) let me know if there’s any other content you would like to watch

[@myaussiebabe1]

@@ABCsofAnaesthesia I'm also a Registered Nurse and I'd love to see your technique for forearm insertion. I know the ACF is a popular choice for ED, but it's the worst when patients are on the ward and getting lots of IVAB and fluids. Downstream occlusions and tissuing are all too common occurrences. I tend to go for the dorsal hand, which can be painful. Any new and exciting (😂) tips and suggestions will be gratefully received! Thank you 🌼 Rachel

[@amazinggrace1957]

Very informative for me who is a student nurse going on placement in a couple of weeks. Thanks.

[@nelsaalmanza5716]

Thank u so much because of this channel of yours my confidence in IV cannulation back and I have good insertions

[@ABCsofAnaesthesia]

That's great!

[@virtue1495]

Best demonstration ever and well detailed explanations!!! Thank you. Just subscribed.

[@ABCsofAnaesthesia]

Thanks so much!

[@bubsta1330]

Thank you Dr Lahiru, you are a LEGEND!! Best video for cannulation EVER!

[@GlobbitsGaming]

Yup, be watching this on repeat and trying it out on my next shift, thanks for the tip - Newby Student Paramedic :)

[@ABCsofAnaesthesia]

Best of luck! Such an exciting time being a student on this medical journey! well done!!

[@danutaromanowska7428]

I like that you put a blue pad underneath. Very good practice. ❤️ from a retired RN

[@ABCsofAnaesthesia]

Yeah! Rule #3 dont make a mess. But these days id put a towel… blueys end up in landfill for 100s of years apparently

[@ABCsofAnaesthesia]

Always appreciate the amazing work ethic of my nurses and techs. Love you guys!

[@danutaromanowska7428]

You’re right. I couldn’t stand when I saw a nurse putting an IV kit directly on pt’s bed🙄

[@zenakota7252]

Very well done..simplified and easy to follow...THANKS Hoping for more videos like this..

[@bdogg20101]

For those patients that have a hard time seeing the vein, try using a vein finder or even using a instant heating pack to warm up the area. The heat pack will bring greater blood flow to the veins.

[@heatherr1141]

Such a great teacher. You made it very understandable.

[@navneetjuneja]

Absolutely perfectly explained. Although I'm still scared of my actual patient encounter!

[@mrjoshharvey7017]

Dude great video. The best I've seen yet on iv insertion. I learned alot from the "drop the angle" bit and explanation of the top of the bevel not being as sharp. You have a gift 🎁 for instruction and teaching . Thanks from an RN in the united States. I look forward to watching the rest of your videos.

[@ABCsofAnaesthesia]

Thanks so much for the comment :)

[@SoCalRegisteredNurse]

I have never seen such a magical IV kit 🤩

[@ABCsofAnaesthesia]

haha, yeah, the video location didn't have the normal setup so we went completely over the top with that setup. the usual set up is far more limited!

[@johnreed7736]

Your instruction and technique was very helpful. Thanks for taking the time to make this video and I’ll be watching for more. Helpful techniques with geriatric, obese, and darker skin piv videos would be great! Thanks again!

[@pverde9901]

Would you please make another video with IV placement in the forearm or AC, please?

[@ABCsofAnaesthesia]

that's a great idea! I will put it on the list :)

[@michaeltrubman]

Yes AC would be great! I often need use the AC for CT angiograms and blood draws

[@skye8823]

Wow you guys got a set for that The other day they just handed me a cannula at ER, I also had to use a glove as a tourniquet 🥲

[@ABCsofAnaesthesia]

haha, no, just a funny environment with unusual setups. Yeah the old glove trick is a great substitute! nice one

[@WolfRaging95]

This is so interesting to me and fun to learn. As someone who has to get infusion for RA, it’s nice to learn how the process works.

[@mafiafatale]

Hi Doctor!!! Wow. you made it easier! I am a phlebotomist. Could you please do a video on venepuncture especially on difficult veins or any magic tricks to get the blood flashbacks and also the vacutainer? Please?

[@semregob3363]

Certainly the best video out here about Canulation! no other channel elaborated important points like you guys, well done.

[@joshuanar3821]

Just loving the equipments you are using.. looks so neat

[@ABCsofAnaesthesia]

Thank you! thats an old video, so its got better!

[@AhmedRecon]

The best video ever! Greetings from Germany

[@ABCsofAnaesthesia]

Wow, thanks! my first ever video from 2012 .. i've an updated one now. kzbin.info/www/bejne/qp21aaunrqmdhNE

[@victoriaalexander6223]

Well done. Very well described and good tips I didn't think of prior to watching this video. Thank you.

[@ABCsofAnaesthesia]

You're very welcome!

[@jillmackenzie5978]

Hope it's OK that I used this as a reference in my Capstone on IV insertion for my MSN Ed. Well done !!!!!

[@adjabengbright9140]

Excellent demonstration, well done Dr

[@calistachinagorom9320]

Thanks for sharing. I just subscribed. The cannulation is on point. Now I can correct my shortcomings.

[@beachtallulah]

Thanks, I've watched loads of videos in the past but since watching this on I've felt a lot more confident and had more success. Would love to hear any tips you have for getting chunky 16g in especially for people with high BMI

[@ABCsofAnaesthesia]

Thanks so much! I’ll post a video next time I get a patient needing a large cannula.. One major tip is do more of the basics.. Ie.. after flashback flatten even more (less room for error) Advance more than you think.. ie 14G cannula needs >10mm advancement.. You’ll even feel the pop sometimes as the whole needle and cannula enter.. Use local (patient in pain makes me more Likely to fail) Keep very strict control of your structure... Tension on skin stays throughout Steady hand with optimal grip I describe.. Final tip for learning difficult stuff in general... ‘do what is hard when it’s easy’ Eg if I want to practice a difficult technique in anything... I train it repeatedly in a practice setting... can’t do a backflip before training with assistance.. a foam pit etc.. So I recommend practicing 14G cannulas in patients electively... Ie.. young patient with big veins for a lap cholecystectomy.. they need a big cannula anyway.. put some local anaesthesia in the skin... and insert... Remember this is the training ground for the really important big cannula Insertion in a emergency ruptured vessel case! You need to practice on less critical cases until you have no doubt you will succeed.. then you are ready for the critical case. (And also this isn’t too controversial... we use this principle for training all the time, whenever a junior doctor is learning a technique)

[@05ginOski05]

Felt like I got better just by watching the video, haha! thank you fellow nurse

[@the_nurse_of_your_heart]

I usually prepare everything close to me so i can reach them with no asking for help... 1) Put the tourniquet around the arm with no squeezing to tight. 2) Fill a 10ml syringe with ns 3) Connect to the way extension system and remove the air 4) Uncover the tegaderm and leave on a flat surgace from the non sticky surface or stick a tiny little corner of it at the edge of the bed. 5) Have the 2-3 sizes of iv cannulas close to you 6) Wear gloves 7) Tighten the tourniquet 8) Sanitize the area and let it dry. 9) While drying look for any visible veins 10) If needed sanitize again 11) Gain iv access.

[@shadowbody]

Super helpful with very precise attention to detail. Thank you!

[@tahanykhaled9923]

Best demonstration, covering and tips, thank you!

[@pubudupelarachchi6854]

Excellent!!! Proud to be a Sri Lankan!!!

[@ABCsofAnaesthesia]

haha, thank you :)

[@WIN-c2y]

I watched it in slow motion, it was really good. Thanks for explaining well

[@matangola]

Thank you for this great explanation. I’ve heard some say that going slow may be more painful to the patient and increases the risk of the vein rolling away from the cannula? Is it a misconception? My intuition says it’s better overall to go slow.

[@ABCsofAnaesthesia]

absolutely! most multi step processes/skills require deliberate rehearsal of steps... i definitely started slowly .. check out my playilst... i have some videos on why slow is better when you start out, and for difficult veins..or big needles

[@ABCsofAnaesthesia]

kzbin.info/aero/PLKoga8GNPk1VipzD8wDqvnIcVbHWgX5Qd

[@julietsokalo]

this is such smooth technique, great job

[@tutatehaja1777]

Excellent demonstration thank you so much. 😊

[@YvesGeorge]

I'll definitely apply this the next time I cannulate. It's always been hit and miss for me and I'm glad I found this video. Update: I finally did it!

[@ABCsofAnaesthesia]

that's great!! well done :)

[@dibyendudey8539]

It's so much helpful for me... Thank you sir.... Thank you so much💙 Specially at 08:30 the way you explained cannula feature is awesome 😮👌🏻

[@smzslider]

I'm pretty good at IV insertions, but over the years I've used a 45-50 deg angle approach to the vein, then once I get a flash, then I flattened out, I might have to try this more perpendicular approach, see if it works better thanks.

[@ABCsofAnaesthesia]

Thanks for sharing!

[@abdulrahmanalmahrouk9304]

Perfect and helpful technique

[@amycottrill1283]

This was such a good video!! Thank you for all of the tricks and great demo's :)

[@bdogg20101]

Also got to remember that you do not want to go directly where the vein bifurcates. Go a little above it. You may hit a valve in the vein, which in turn will make it very hard to advance the cannula into the vein.

[@samieralitgecodpro123]

please show us how to do on a difficult veins and on a subject with an excessive adipose tissue. thank you so much!

[@ashjjx287]

Very nice video👍 just wondering why we push the cannula in after 1 inch, why not go all the way through and take out the needle at the end?

[@ABCsofAnaesthesia]

great question! I push only as far as I need. the further I push the needle the greater the chance of puncturing another wall. 22G ~ 2-3mm. 14G 10-15mm

[@ashjjx287]

@@ABCsofAnaesthesia I once tried going all the way in with 18 and 20 G and both worked. I wonder if there is any written proof which says it might puncture another wall! Or is it out of your sheer experience? Thankyou for replying and making a great video 😊

[@AnesthesiaGuru]

@@ashjjx287 In my experience, going in through the needle will puncture the opposite wall most of the time. Sometimes people get lucky without. The time when I go all the way through the needle is when cannulating a baby with difficult venous access using ultrasound

[@mariannatheron7363]

👏👏👏👏👏, Clearly, Beautifully demo'd. Thank you very much!!

[@mohamedsaleh8138]

Clenching the fist to engorged the veins is not recommended in blood sampling though, can cause pseudohyperkalemia. Thanks for the video

[@ABCsofAnaesthesia]

thanks for the comment! that's an interesting recommendation, I've never observed hyperkalemia in this setting.... do you have any articles that I could look at. thanks again!