Synopsis
Create and maintain an aseptic field and insert, secure, access, assess and remove a peripheral IV cannula safely within local competence and infection-prevention standards.
- Asepsis protects key parts and key sites from contamination; sterile gloves do not rescue a contaminated connector or cannula.
- Plan the field, hand hygiene, PPE, antiseptic, compatible cannula, extension, flush, dressing and sharps disposal before skin preparation.
- Choose the smallest gauge and shortest appropriate cannula in a suitable distal upper-limb vein for the prescribed therapy, escalating difficult or specialist access.
Key red flags
Pain, swelling, blanching, coolness, leakage or resistance during infusion requires immediate stop and drug-specific action.
Purulence, spreading erythema, fever or rigors linked to access needs urgent assessment and culture planning.
An incomplete cannula on removal requires immobilisation and urgent senior or vascular management.
Reasoning priorities
Select peripheral versus specialist access and appropriate gauge.
Duration, flow, pH, osmolarity and vesicant risk may make routine peripheral access unsuitable.
Worked reasoning
A patient reports burning and swelling around a peripheral cannula during a vesicant infusion.
- Stop the infusion immediately, call for experienced help, assess the patient and limb and identify drug, concentration, volume and time.
- Reason that extravasation is possible; do not flush and do not automatically remove the cannula because aspiration or a drug-specific antidote may require access.
- Disconnect tubing and follow the current medicine-specific local extravasation protocol, including aspiration, elevation, compress and antidote only where specified.
- Verify neurovascular status, mark and photograph per consent/policy, arrange serial review and document incident, advice and handover.