Help Just About To Jump Overboard

IVRUS, BSN, RN · May 5, 2008

hi I'm just learning about Iv cannulation- I can't understand why u don't do the following.
Why don't you cannulate a A-V Fistula Arm.
Previous Axillary Dissection Or Mastectomy
Bruised or Injuried Areas.
Why do u advance the cannula a further 5mm after u have flash back? Is it so it is inserted properly?.
If you are using a scalp infusion set what would be the most important procedure u should do before accessing the vein?
Which is the largest arm vein to use? Is it the basilic
Why do u not put cannulas in lower extremities? Is this because of reduced circulation.? Would be grateful for enlightenment-Can anyone suggest good sites for learning this stuff?

Hello,

The answer to your questions can be found in your second paragraph. Anything that can possibly cause circulation to be impaired is the reason you don't want to put in an IV cannula in that same arm. If I've have a mastectomy and circulation is already comprimised because of node dissection, placing a cannula in a vein will decrease the already comprimised circulation. Circulation is already comprimised in the elderly populi as it pertains to LE cannulation, so, avoid cannulating these vessels.

Bruised spaces have an increased oncotic pressure and the vessel has already been weakened secondary to this.

If you look at an ONC catheter, the needle protrudes out further than the catheter. Therefore, a flashback may mean that your needle is in the tunica intima, but your catheter may still need to get there. (So, lower your angle and advance)

The largest arm vein is the basilic, but remember to always start as distally as possible to save proximal veins for future VP. The cephalic in the upper arm gets smaller in most individuals, unlike the basilic.

Hope it helps.

DD