Intravenous cannulation tips and tricks

[@roy-nk4vq]

Thank you for your videos. I am a Licensed Veterinary Technician in Detroit, Michigan, USA. Watching your videos has helped me improve my success at IV cannulation in dogs and cats!

[@FRACP]

Dr. Amaratunge, what an absolute delight to come across this video on youtube as a final year medical student in Sydney trying to brush up some PIVC skills. This is exactly what I was looking for as I am someone who loves to know the theory and principles behind everything we do rather than just following steps. I am looking forward to doing more cannulations in this systematic way. Thank you!

[@ABCsofAnaesthesia]

Thanks so much for the lovely comment :) all the best with internship!

[@feliciaferrigno7467]

I've watched many of your vids but I always learn something new with each one! This one was no exception. Love your calm, quiet teaching style. Talk about bifurcation and valves, please.

[@ASMR-pp3hc]

Hey lots of midwives and nurses enjoy your tutorials! Really well explained and love you take the time to explain the simple things first.

[@adafung8789]

I want to let you know your teachings Really Works ! Thank you so much !

[@ABCsofAnaesthesia]

You are so welcome!

[@leeriley8035]

I just thought that I would reply to your excellent vids on cannulation, have really helped to reduce my anxiety and boosted my confidence + technique when inserting midlines into difficult veins. Thank you!

[@ABCsofAnaesthesia]

Thanks so much! Sounds like your doing pretty well with midlines!

[@sarasnotherly7482]

Thank you for this! I am a nursing student, graduating next month and I cant seem to get IV’s right. I think I go through the vein. Will try the technique about advancing slowly and almost “lift the vein up”.

[@ABCsofAnaesthesia]

You got this!

[@Plantandpeoplecarer]

I’m a registered nurse and I can’t thank you enough for this!

[@yvonneachterman9305]

I'm a nursing student, and thank you so much!

[@illcitydiaries]

this is amazing info and taught in such a relatable manner! Major thx , from an NYC trauma ED nurse

[@bigtuna4037]

Good Day Doctor, I have learned much from your videos. Someone once told me for elderly small veins, go bevel down. Any thoughts. Thanks

[@ashlynsule6856]

Thank you Doc. I have now have more confidence.

[@meli4035]

Brilliant!! Thank you! God bless you♡

[@edmundkhong2195]

Thank you very much for your IV cannulation videos! Very useful tips that have definitely improved my technique and success rate. I was just wondering if you could please elaborate on why you can re-attempt the same vein in a more proximal location if you initially missed in a more distal location, but cannot re-attempt in a distal location if you initially missed more proximally? I couldn't find an answer online so any explanation would be appreciated, thank you!

[@ABCsofAnaesthesia]

thanks for the question Edmund! as blood is flowing distal to proximal, there a chance that if the vein is traumatised proximally, any fluid or medications could extravasate if the vein is traumatised enough from the previous attempt. if using specific drugs or fluids, extravasation could be a devastating consequence ie muscle relaxants or thiopentone in the subcutaneous tissues. OR if you administer medications that don't make it to their site of action. distal trauma is less of an issue. the cannula inserted proximal to a cannula failure still passes meds/fluids to the heart. does that answer the question?

[@edmundkhong2195]

@@ABCsofAnaesthesia this makes perfect sense, thank you very much for taking the time to answer my question! really appreciate your help, thanks again :)

[@mast3rmin3]

Love this - Very helpful can’t wait to start another IV Monday to try your technique. I seem to be getting in the van and then I lower the needle attached and go in a little more and then it stops everyone always says well that’s a bell and you can’t even flush through it some of the nurses just push it through but I have not been able to do that because I think that would hurt or cause damage to that valve - I cannot find the link to the video can you respond with a link thank you

[@tbip2001]

This video is exceptional. You may be surprised by how badly cannulation is taught in UK (paramedic) universities. This should be required viewing. Do you have a video on occluding cannulas during cap application or drug admin?

[@ИгорьДемидович-х7и]

Hi! Could you make the same video on arterial cannulation technique? Your explanations are great!

[@ABCsofAnaesthesia]

I’ll definitely try, I just need to get the right patient and hospital approval :)

[@jbuccilli1]

excellent and very informative presentation!

[@ABCsofAnaesthesia]

Thank you kindly!

[@ahmedthamir9531]

thank you sir ..that was very helpful ♥️

[@sherlin--babby6251]

Thank you👏very much Doctor this is very helpful 2 me and Dr. U have explained perfectly step by step 'm anesthesia technician Dr.❣

[@juanmiguel1171]

do you have a trick on cannulating a very swollen client

[@amaniwilliam747]

Thank you so much doctor, my main problem with cannulation is rupturing the vein easily and it's really disappointing everytime I fail.

[@ABCsofAnaesthesia]

Keep trying! Don’t they say Every success is built on a mountain of little failures ... 💪🏾

[@amaniwilliam747]

@@ABCsofAnaesthesia I will, thank you for encouraging.

[@yjtan5075]

Thanks for the amazing video! I was wondering if you have any tips for cannulating a vein which you can see but not palpable? I had a patient the other day who was an in-patient for 2 months with bruises all over and the only veins were those visible but non-palpable and I was not able to get a cannula in :(

[@ABCsofAnaesthesia]

great question: I go through this approximate sequence: 1) maximise vein size - heat, gravity, open close fists, tourniquet, tapping vein, 2) Ultrasound scanner 3) try different sites for limited use (feet, wrist eg.. saphenous vein at medial ankle is large and superficial and usually hasn't been attempted yet...) 4) local anaesthesia to minimise patient discomfort 5) escalate to central access (IJV, subclavian, femoral vein, PICC) - 6) intraosseous importantly I never delay access centrally or intraosseous if the patient needs volume asap. so I have someone attempting iv access while I set up for the other techniques. also only use some of these advanced techniques if it is within your scope of practice and skill set and under the correct supervision :) hope that helps!

[@yjtan5075]

@@ABCsofAnaesthesia Thank you!

[@roseobeng4523]

Are u doing the snasthesia in Australia ?

[@seanlarkin7734]

Hey Doc, I looked at your website. Do you ever think of doing mini-courses? Ex. A course in IV cannulation and one for Intubation? Asking for all the paramedic students that binge these videos like me.

[@ABCsofAnaesthesia]

Hey sean! Great thought, what were you thinking… like an in person course on iv cannulation with mannequins …

[@seanlarkin7734]

@@ABCsofAnaesthesia Something like that! Just a detailed course on how to start, set up, pick a vein/IV gauge. Or one going over intubation in a similar step by step process.

[@donpkchannel7203]

Im nurse. Not experienced. Two questions. When I flush salin i can see a small ball , swollling which means I failed. Is this because I damaged the backside of the vein or because the needle and catheter is not inside the vein. I want to know why so I know which mistake I'm making. Second question, one time I could aspirate blood but not flush the salin in to the vein. It worked to aspirate blood but not to flush with salin. Why did this happen?

[@6yxaIL]

1) If you have damaged the deep side of the vein it still means your catheter is not inside. Because if you are in, your canula exit is probably going to be distal to the damaged part, and there shouldn't be any bulging while you inject the saline. It can still be a s/c bleeding though, so be careful. Sometimes the vein you're puncturing can start swelling from the very beginning(happens a lot in older patients. I guess because the tourniquet is too tight), but don't be afraid and don't exit the site straight away unless the swelling keeps on growing. Usually you'll just see a little ball that stops growing after a couple of seconds. Just keep going. 2) You may have passed throught the vein. The very little part of the bevel may still be in the lumen and makes it possible to aspirate. But when you're injecting the saline, it goes to the tissue below. Or the opposite situation. Your bevel didn't fully pass the vein wall. And again you can aspirate, but while injecting a part of it is going out.

[@heatherr1141]

What happens if a nerve is hit? Patient even says they felt a shock in there fingers. How do you not hit a nerve? What to be aware of?

[@sohiniisanyal7326]

Thankyou so much ❤️

[@ABCsofAnaesthesia]

You’re welcome 😊

[@libifurtado277]

thank you!

[@ABCsofAnaesthesia]

My pleasure :)

[@meli4035]

Saludos desde Argentina ; -)

[@donovanlucibello379]

Cheers!

[@Soerup1]

My experience is that a lot of veins tend to roll when you advance slowly. Would you always advance slowly even with bigger cannulas?

[@jessetanko1973]

Sometimes you might have to apply traction on the vein especially in the elderly

[@user-gg1rr6db6d]

Hello, can you please signpost me to your demonstrating an IV cannulation please? Thank you

[@ABCsofAnaesthesia]

kzbin.info/www/bejne/g5vOg3t4Z9JlrZI

[@ABCsofAnaesthesia]

Hope this helps, also i have a playlist on my channel.. for lots of iv cannulation vids

[@kalyan9620]

That's cool✌

[@letachala6936]

❤❤

[@Rajyadav-et3xw]

Whenever i got for intravaenous cannulation my seniors say i go to deep, which concept i cannot get

[@ABCsofAnaesthesia]

haha, go as deep as the vein is ;)

[@mariaannafrappietri229]

Sei bravissimo ma potresti fare un video in italiano

[@ShawnaCostonPhD]

I had a MD today whom does IV and he also does anesthesia sticking me 4 times is UNACCEPTABLE PERIOD.