7 steps to cannulate the most difficult veins! Live demonstration
ฝัง
- เผยแพร่เมื่อ 23 ธ.ค. 2020
- Sometimes your patient will have veins that are almost impossible to cannulate!
I want to show you that using the techniques in my previous videos, these veins are possible to access!
1) Anchor skin
2) Correct grip of the cannula
3) Shallow angle of entry
4) Enter slowly
5) Flashback of blood visible
6) Level out the cannula (aim up)
7) Advance the cannula the minimal distance (depends on size of cannula)
Thanks for watching!!!
---------
Find us at
Instagram: / abcsofanaesthesia
Twitter: / abcsofa
Website: www.anaesthesiacollective.com
Podcast: ABCs of Anaesthesia
Primary Exam Podcast: Anaesthesia Coffee Break
Facebook Page: / abcsofanaesthesia
Facebook Private Group: / 2082807131964430
---------
Check out all of our online courses and zoom teaching sessions here!
anaesthesia.thinkific.com/col...
www.anaesthesiacollective.com...
---------
#Anesthesiology #Anesthesia #Anaesthetics #Anaesthetists #Residency #MedicalSchool #FOAMed #Nurse #Medical #Meded
---------
Please support me at my patreon
/ abcsofa
---------
Any questions please email abcsofanaesthesia@gmail.com
---------
Disclaimer:
The information contained in this video/audio/graphic is for medical practitioner education only. It is not and will not be relevant for the general public.
Where applicable patients have given written informed consent to the use of their images in video/photography and aware that it will be published online and visible by medical practitioners and the general public.
This contains general information about medical conditions and treatments. The information is not advice and should not be treated as such.
The medical information is provided “as is” without any representations or warranties, express or implied.
The presenter makes no representations or warranties in relation to the medical information on this video.
You must not rely on the information as an alternative to assessing and managing your patient with your treating team and consultant.
You should seek your own advice from your medical practitioner in relation to any of the topics discussed in this episode’
Medical information can change rapidly, and the author/s make all reasonable attempts to provide accurate information at the time of filming. There is no guarantee that the information will be accurate at the time of viewing
The information provided is within the scope of a specialist anaesthetist (FANZCA) working in Australia.
The information presented here does not represent the views of any hospital or ANZCA.
These videos are solely for training and education of medical practitioners, and are not an advertisement. They were not sponsored and offer no discounts, gifts or other inducements.
This disclaimer was created based on a Contractology template available at www.contractology.com.
I'm a junior doctor in Perth, Australia and I just wanted to say thank you for doing such great teaching videos. I literally have not missed a cannula since adopting your technique and have even started helping my friends with difficult cannulations! Thanks so much, you have no idea how much these videos have helped!
Thank you so much for the message! If there’s any other videos you would like please let me know... in the future if you ever wanted to help with this education feel free to email me at abcsofanaesthesia@gmail.com
My vision for this project is to create great material with others, and donate all earnings to an independent and effective charitable cause :)
Great work sir
Hello@Andrew..can I get your contact
Sir plz made a video for iv cannulation in obese patient , in emergency condition where we have no any tools , having only swab , cannula routine G
@@dr.vishnuparihar6497 For obese patients, you really have to use anatomical landmarks and palpate those areas. But if it's truly emergent, you could get a central access or even an intraosseous line.
Some tricks from me:
1) hang the arm below the bed to promote blood flow to the arm. Then place the tourniquet.
2) place 2 tourniquets
3) go for the antecubital. You can feel cephalic and basilic veins in almost any patient.
4) Put warm compress/hot packs to dilate the veins.
Started a new job in NICU in a new country, nurses did canulation back where I worked. Struggling so much with canulation, get depressed everyday for not being able to canulate successfuly even once throughout the week.
Gonna binge watch your videos amd cry at the same time..
You are a legend to all the EMT’s out there. Thank you 🙏🏼
Wow, you could get blood from a stone.
haha, thanks, that's a great compliment :)
@@ABCsofAnaesthesia I love your videos. Thanks a lot
🤣🤣🤣🤣
I know he is really good
😂😂😂😂
Great technique! I would be interested in more cannulation videos, in particular large bore cannula placement, site selection (considering bifurcation and valves) and more difficult access :)
I’ll definitely do a few more videos for large bore cannulas, local anaesthesia injection, and site selection! Great suggestions!
This video is my go to recommendation for all Foundation Drs and med students. Taught >30/40 who have said all their issues went after following this technique.
Bravo!
Impressive! I definitely find the small veins the most challenging ones. Just gotta keep practicing
Overall good technique. Many forget to "level out" and advancing the needle with catheter a few millimeters before advancing the catheter over the needle. Make sure your skin disinfection also covers the skin that gets in contact with the needle when "leveling out". That was not covered in this video, but is sometimes forgotten.
Also, be careful when advancing the catheter with the tip of your finger. You're pushing the part that is supposed to be sterile (the end where you connect the intravenous fluids to) with a non-sterile finger tip. Your patients may get a catheter-related infection this way.
thanks for the comments! great to have critical feedback to improve technique :)
I think that last point is partly why my hospital introduced a policy that requires donning sterile gloves right before cannula insertion
Can I say thank you. It helps to see others doing this, I’m hoping one day to be as confident at pivc as you. Amazing
Any time! Thanks so much for your comment :)
you make this look so easy, man, you are so good at this. 😮
So professional, I mostly struggle at angles like this 🔥
These editing skills are the greatest! Keep them coming!
Perfect. A difficult spot. RN-Prior to OR, had went to school for IV nurse, 1000+ bed hospital. It is a nice skill set to have. Everything from 16ga to 30ga. Every place on body accessed. Direct, indirect, mostly for delivery of just about any med/chemo agent. Rare when you great anesthesiologist & Nurse anesthetist do, if missed, when switched to OR, many would ask me to do the difficult ones. On hard vein team at major hospital. Keep posting wonderful videos. You are highly skilled.
Just sharing my experience, my most difficult branulla insertion was during my housemenship in NICU where every single day I have to do for neonates. First 4 weeks I struggled but after that I mastered the technique and become best intern for the procedure. It was a good memory 10 years ago.
Well done :)
I just thought that I would reply to your excellent vids on cannulation, have really helped to reduce my anxiety and boosted my confidence + technique when inserting midlines into difficult veins. Thank you!
awesome to hear! thanks Lee
Thanks for the demo! Awesome skills🤓
beginning to like this guy alot. good explanations....good logic....all around good stuff.
You just taught me something about the cannulas structure that despite having hands on experience I didn’t know. Now I know how prevent double pricks.
I really appreciate and enjoy watching your videos. Please consider an IV compilation video of at least 10 min. Doesn't even need to have commentary, but show different types of veins. I could only find something like this on one other "IV compilations" video. It's great for us to watch technique over and over again so these compilations could really help. Thank you for considering as that would take a lot of work and editing. Thanks!
That’s a great idea Melanie :)
I’ll try to get a vids for this :)
You really do have a great technique and are able to teach it. My skills have increased watching your videos. Thanks!
Great to hear!!
Woooooow. I have difficulty even locating a good vein. You are amazing at this
Very interesting to watch. I've been out of nursing practice for almost 3yrs now. Hoping to get back in the bedside soon. Good job👍🏼
good luck!
a video of someone great putting in difficult IV's, strong work
You know when youre watching these videos when your success rate is 1 out of five insertions, as a nurse im soul searching right now
hey I hope it keeps getting better! :)
It's just a numbers game bro, keep going!
Practice makes the master.. 💪🏻
Sometimes I can go weeks without missing & others I couldn’t get an IV with a person who has the plumpest & healthiest veins.
I can relate ☝🏼
It's all about the experience. By the way, I like this cannula as it was safe and has a valve.
Experience helps of course but I’ve been virtually impossible for years to cannulate. I’ve had top consulatant/anethetist with vein scanners fail on me, then a newly qualified nurse get one in instead 🤷🏻♀️🤷🏻♀️ rare but has happened
Meanwhile pilipinss. U could get prick by ur own needle hahaha
Hello, I'm a new nurse thank you for sharing these videos!
since you have this experience of cannulating "the most difficult veins" can you please post some videos with tips on how to cannulate veins on patients that are your skin color or darker. I think your video is very helpful and more videos will be helpful in showing execution when it is difficult to see the vein with your eyes.
Hello, I can see that your comment is a year old so you have definitely much more experience and expertise in cannulation. I just wanted to say that I don't really need to see the vein with my eyes, when I feel the vein using my finger it is easier for me. This is just me, my experience. I understand that for others it is better to see the vein(s). How are you getting on now with the cannulation?
Bravo! This will help me in getting those veins the first time. I've been approaching at too great an angle. Insertion being almost parallel to the vein and slowing down the insertion. Thanks much :)
Glad it was helpful!
Your video instructions helped me so much! Thank you!
So glad it helped!
Please share more skills because your method of demonstration are too much good and simple😊
Thank you ☺️
Wooow this is a great demo. Thanks for posting!!! I hope you could also do a video cannulation on pediatric patients.
On my bad days, I get 8-9 out of 10 IV insertions, but to be honest I don’t think I be able to do what you just did right here! 👏🏻👏🏻
Great work, Gj! I have failed multiple times going back of the wrist where previous failed attempts on other sites. Thx, for proving it's possible to get it done, if u 're confident enuf. Bravo!!!!
Haha, yeah it definitely took years of experience before I tried...
And only because I had limited choice 😂
Your videos are so good, you are actually helping out so many doctors and nurses, which in turn helps so many patients!
yeah, I'm so glad TH-cam provides the opportunity to share this knowledge that was so generously shared with me
That area is very painful specially when given meds - the 1st cannulation
Beautiful work!
Fledgling Paramedic here, intend to watch this on repeat for hours and have go on the next shift :)
haha, hope my voice doesn't grate too much! and thanks for the comment!
Your efforts are appreciated .Could you please upload an iv insertion in pediatric (neonates, toddlers)
I would love to, I just have trouble with the consent for live patient videos.... to be honest I use the same principles but will often use these extra things
1) ultrasound more often in the chubby 1-2year olds
2) saphenous vein at the medial ankle
3) if a go through the vein, Childrens veins are often salvageable (ie I can rescue the vein by withdrawing the cannula and reinserting it
unlike adult veins that will be damaged and extravasate blood, most Childrens veins seem to seal very well even after puncture....
would love to video this at some stage but prob a few years off until I get around the proper consent processes.
you truly did this like one who has practice alot. Am sure many have been done, TY
thanks :)
Great technique. As a blood bank phlebotomist I remember times where I had to get the vein. Those needles are bigger than some of the veins I got into. It's satisfying to do so. As a person with non existent veins I am always grateful when I get someone like you. After doing it for years one really gets good at it.When in the ED after losing a great deal of blood they used a 18 or 16 gauge to get access into my thumbs bilaterally to flood me with fluids. I'm always indebted to those skilled folks who got in on the first try. I look forward to more videos.
Thanks for sharing your experience marcia :)
Why didn’t they try intraosseus for you?
@solslastcannula5665 I thought that was used in mostly emergency situations where patients are in v-fib etc needing to be defibrillated??
I don't want a drill in my bone unless I'm dying, but that's just my deal
Impressive! I don't place IV's but I do a lot of phlebotomy in my job as a medical assistant. Your technique is fabulous.
Thank you :)
He make it seem so easy. Thank you sir. Neuro ICU nurse here
You are good teacher.!!!
Really good video, my go to is the back of the wrist, I have got a pink in there before, if not the thumb or extreme the little finger.
You make it look so easy! ❤
haha, years of practice and great teachers :)
Thanks! This video pushes me to try harder in iv cannulation, I really have difficulty in doing this procedure. I always fail.
Glad it was helpful! thanks so much for the comment Zah :)
Great work ! Complimenti!
Amazing! Your video is very useful for me. Thank you!
Glad it was helpful!
That was so smooth.
wow! Great skill. Thanks for sharing
Thank you! Cheers!
Thank you for this!
My pleasure :)
Excellent
Saw the video, went through description, found that u shared profound knowledge.
I am a nursing officer and request you to upload cannulation of dehydrated patients and geriatrics (i.e collapsed vein )
will try!
Super , just what is needed
Excellent video. Thanks for sharing
Glad you enjoyed it Charli!
Thank you so much
Gosh! You are amazing! I didn’t see the first vein at all!!
Oh thank you!
Thank you for the great video! I really would love a video showing how to find the veins in the inner elbow area, if you are up for it!
Thanks alot
Very educative. I enjoyed watching it. Thanks
Thank u!
so amazing,great technique👍
Great demonstration mate, 100% 🇦🇺
You saved my life XD Love it!!!
That’s fantastic technique 👏👏👏
Thanks so much 😊
I listen to ur podcast and found the youtube channel. Ur doing the lord's work.
podcast name pls ?
Anaesthesia coffee break :) it's a podcast going through our part 1 exam which is pharmacology and physiology. we try to have conversations about these concepts and relate it back to clinical practice.. and provide performance tips that helped us during our training to increase our learning curve, memory and ability ....
Wow... The one thing that I'm still challenged by is the sighting of the vein for the flattening out and the 2-3 mm follow through... I was sure the needle was going in the wrong direction!!! Of course, excellent knowledge of venous anatomy helps. You made it look super easy.
Thank you :)
Very good technique. I would appreciate much if you post some cannulation videos in neonates like 2-3 days old and thalassemic babies
Nice tip.Greets from Swizerland,Paramedic.
Thanks
Amazing video thank you! I definitely have cannulation anxiety and this video really helped me to see what I was doing wrong!
> Note to viewers: I watched the video several times after reducing the speed to 0.5, this helped a lot.
Very smooth
Really awesome ❤️
Amazing
Just got back from a really difficult diabetic patient who was really offensive to everyone, tried 6 times, although he had some visible veins and some not so much, I lost all of them. Will go try again in an hour wish me luck!
I'll definitely stealing this technique!
all yours :) someone taught me.. just paying it forward
Helpful
Liked the technique.
Thanks!
Thank you sir...from tamil nadu
Thankyou so much! This video was great 👍😍
Great sir
Thanks👍🏾
Thanks
Go on
The best person I ever saw canulate was a African man called Joshua, a Registered Nurrse, he was I think superanatural at, I never saw or heard of him miss. It was just out of this world. Shout out to you Josh your the man.
A very helpful video thank you for sharing
Thank you!
Easy, did alot of techniques,
Thanks sir
Very good, I have never canulated some in that first location. Do the small caliber veins tissues easily, rather than more proximal viens. Eg lots of Pt on ABX for several days - and often tissue?
Thank you for amazing tips sir
So nice of you
Thanks a lot !!! 💪
that's impressive😮
Thanks for the video. But pls what are the terms: Flashback, Give, level out?
Thanks a lot 💕
You're welcome 😊
Thankyou ❤️
Thank you so much. You have experience a lot about nerves . I hope someday will be able to by nurse like you 👍
Good luck!
Very perfect
Both Please are difficult to taking canulla but you marvelous
Thanks bro
Im an ER nurse and i must say I love the satisfaction of passing a difficult IV line
Wow great video and instructions!!👍
Glad you liked it!
Hello thanks a lot for your videos. i really hope you'd do detailed videos on first aid i'm sure there's lots of things and tricks to learn from you . Have a good day
Thanks! That’s a great idea.. I’ll ‘deep dive’ into some BLS and ALS videos... there’s so much interesting detail I could go into :)
@@ABCsofAnaesthesia Great i'll be waiting Thank you
wow you good work
I wish I could possess even a mere fraction of the skill you display while cannulating difficult patients. I used to be reasonably good at them, until I taught myself how to use the sonosite, and so my MO has always been 1 attempt at a dry stick and then the 2nd with the sonosite but I know as an anesthesiologist, you won't always have the luxury of having an ultrasound readily available....even for a-lines and such.....
ty so much
Thanks for watching!