IV Cannulation: Step-by-Step Guide
A clinical reference for performing peripheral IV cannulation safely and effectively.
Equipment Needed
Appropriate size cannula (18G-24G)TourniquetAlcohol/chlorhexidine swabsSterile gauzeTransparent dressingSaline flushGloves (non-sterile)Sharps containerTapeCannula Size Guide
| Gauge | Color | Use |
|---|
| 14G | Orange | Rapid fluid/blood |
| 16G | Grey | Surgery, trauma |
| 18G | Green | Blood transfusion |
| 20G | Pink | Most IV fluids |
| 22G | Blue | Fragile veins |
| 24G | Yellow | Pediatrics |
Procedure Steps
Preparation
Verify patient identityExplain procedure and obtain consentPerform hand hygieneGather equipmentPosition patient comfortablyVein Selection
Apply tourniquet 10-15cm above siteIdentify suitable vein (avoid joints, previous sites)Palpate for bouncy, refilling veinRelease tourniquet while preparingInsertion
Reapply tourniquetClean site for 30 seconds, allow to dryDon glovesStabilize vein with non-dominant handInsert cannula at 15-30 degree angle, bevel upAdvance until flashback seenLower angle and advance 2mmHold stylet, advance cannulaRelease tourniquetApply pressure above cannula tipRemove stylet into sharps containerSecuring
Connect extension set/flushFlush with saline (check for swelling)Apply transparent dressingDocument date, time, gauge, siteTroubleshooting
**No flashback**: Reposition, try different angle**Flashback but won't advance**: May have gone through vein**Swelling during flush**: Remove immediately (infiltration)Complications
Infiltration/extravasationPhlebitisHematomaInfectionAir embolism (rare)