How to Fix a Failed IV Cannulation Attempt
IV cannulation is a core clinical competency, but even expert medical professionals can experience failures. Failure to cannulate can lead to the discomfort of the patient, anxiety and delays in treatment. But it is not considered a defeat but a lesson. The second effort will enable you to significantly increase the success rate by analyzing the situation and implementing the appropriate corrective measures, minimizing the chances of failure. The following are four steps to implement to address a failed IV cannula attempt.
Fixing IV Cannulation
Reevaluate the Vein and Patient Factors
Following a failed attempt, rest, re-evaluate, and then re-attempt. Think of the reasons why the attempt failed. Did the vein appear too small, mobile or weak? Spend time analyzing other sites. Search in the veins that are more straight, palpable, and do not roll.
Select an Improved Vein
If the initial site fails, it is usually preferable to choose another vein rather than use the same one again. Search veins that are:
Straight and well-palpable
Seen in good light.
Movement away from the joints.
The dorsal hand or forearm veins are good locations; however, in problematic situations, other locations, such as the cephalic or basilica veins are used.
Good accuracy is greatly enhanced and achieved by the use of a vein finder or ultrasound (where possible), particularly when the patient has challenging venous access.
Enhance Vein Visibility and Stability
Poor vein visualization or movement is among the most frequent causes of failure. The prominence of veins may make a big difference. Learn how to apply a tourniquet and make it tight enough so that it does not hurt the veins. Other techniques that you can use are:
Asking patient to keep his arm below his heart.
Stroke or tap of the vein.
Use a warm compress for a few minutes.
To avoid rolling of the vein, anchor the vein by drawing the skin taut below the point of insertion. It keeps the vein still and provides a more accurate needle entry.
Adjust Your Technique
A failure is typically an indicator that you should master your technique. Record the angle of insertion, normally 15-30 degrees. With angles much too steep, you can easily pierce the vein, and with too shallow, you can never get into it at all.
Slowly and gradually move the needle forward.
Search for a flashback of blood as evidence of vein penetration.
When the vein is reached, reduce the angle a little, and then continue with the catheter.
It is because you have a flashback and cannot withdraw the catheter, perhaps because the needle is partially in the vein.
Be Aware of When to Ask for Help
Failure to achieve success many times may result in patient discomfort and damaged veins. One should know when to quit. The majority of the guidelines suggest that the attempts should be restricted to two per clinician.
If following several attempts fails, have someone more experienced, such as a colleague helps or consider other approaches, such as ultrasound-guided cannulation. It not only enhances patient safety but also trust and professionalism.
Conclusion
Deliberation, re-examination of your decision, finding a more favorable vein, making it more visible, learning your technique, and communicating effectively can significantly boost your success rate. With practice and patience, all IV cannula failures offer an opportunity to perfect your clinical skills.