Cannulation

A 17-year-old girl requires insertion of cannula prior to ward admission

Candidate Instructions 🧒

You are the FY1 working in A&E.

The nurses have been struggling to site a cannula for Miss Thomas, you have been asked to complete the procedure. She is due to be admitted to the general surgical ward.

Please perform the procedure and address any of the patient's concerns.

Patient details:
Name: Miss Lily Thomas
DOB: DD/MM/YYYY
Age: 17
Basic info: appendicitis - due operation, clinically stable, no relevant medical history, non-smoker

Station time: 5 minutes


Station Material (ONLY OPEN WHEN PROMPTED)

There are no station materials for this station

Actor Instructions 🤒

Name: Miss Lily Thomas
DOB: DD/MM/YYYY
Age: 17
Allergies: No known drug allergies

Whilst candidate is gathering equipment offer up/explain ICE IF candidate does not ask

ICE:

  • I: You believe a cannula is a dangerous procedure
  • C: You are scared of the idea of a needle staying in your arm for days
  • C: You are worried about having a cannula put in, your friend told you that it is very painful and uncomfortable
  • E: IF candidate shows empathy and explains the procedure you are become relaxed

Mark Scheme ✍️

Introduction

Wash hands
Polite introduction with patient
Check patient detail against wrist band
Ask about allergies
Explains procedure to patient
all-markschemes.introduction

Ideas, concerns and expectations

Very common/safe procedure
Reassures procedure will explained every step of the way
Needle does not stay in the arm - small plastic tube remains
Only small scratch is felt when needle is inserted
Cannula necessary for bloods and giving fluids
history-markschemes.ideas-concerns-expectations

Before

Gathering equipment

Collect tray/trolley and clean the surface from the inside out
Gathers correct equipment to put in trolley/tray
explanation-markscheme.before

Preparing equipment

Wash hands
Put on apron and gloves
Open up and assemble equipment
explanation-markscheme.before

Preparing the skin

Select vein in suitable location
Apply tourniquet to correct place
Use alcohol swab to clean area for 30 seconds and wait to dry
explanation-markscheme.before

During

Warn patient of 'sharp scratch'
Wait for a flashback of blood
Insert cannula at a shallow angle (at around 20-30 degrees to the surface)
Separate the needle from the cannula by solely pushing the cannula into the skin while keeping the needle stationary
Remove the needle from the cannula, immediately dispose in sharps bin
Attach pre-flushed extension
Undo the tourniquet
Flush the cannula with 10 ml of saline
Secure the cannula with dressing
explanation-markscheme.during

Conclusion

Clean up any blood
Document the procedure in the notes
Thank patient and reassure them
all-markschemes.conclusion

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