Thursday, February 4, 2010

Cannulation

I was standing in theatre with my scrubs, booties and hat, feeling useless, so the anaesthetist decided to make me his project for the afternoon. He asked if I’d ever put in an IV cannula before and I answered truthfully, yes I had. I did not elaborate – I had done it twice before, once on a very obliging classmate who generously allowed me a second try after I’d tortured him on my first attempt, and once on my own mother. My mother is a registered nurse, and she gritted her teeth and coached me through the whole process in real-time. Obviously, no patient in “the real world” could be as resilient as these two. But I did not expect my first patient, a massive basketballer, to start retching into his sick bag the minute that needle went into his vein. Clearly I had much to learn about the real world.

The anaesthetist gave me a few tips for new players:
* Cannulate older people, they are tougher (“I don’t feel a thing!” asserted an older gentleman, after I’d poked a 20guage into his cubital fossa)
* Keep your opposite thumb well back from the cannulation site – especially for the hand veins. The thumb can still anchor the vein without getting in the way too much.
* Make sure you can see the chamber! You need to visualise the little flashback of blood that tells you you’re in the vein. I missed it once and accidentally went through the other side of the vein. I did manage to recover, but the poor patient flinched a bit!
* Practice at home. The anaesthetist went through a bunch of cannulae demonstrating the technique on a pillow, and suggested I go home and do the same.

It’s not the easiest thing I’ve done, but by the end of the day I was actually starting to enjoy cannulation. And I’m very much looking forward to the day when I can say, “what, cannulation again? I’m bored with this!”

1 comment:

puddle said...

the instant you say that, you'll be faced with a pregnant woman with gigantic veins you can see from the other side of the room whose veins are so fragile that they will burst by merely suggesting a canula to them. Admittedly i was suggesting a 16G to it. On the plus side, a 16G canula is nothing compared to a 3.8kg baby trying to force its way out of your nethers.
but still. made me feel like a right idiot.