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Peripheral IV Cannulation Policy Appendix A

The document outlines guidelines for selecting the appropriate cannula size for medical procedures, emphasizing the use of the smallest and shortest cannula to minimize complications. It details factors influencing cannula choice, standard wire gauge measurements, and common cannula sizes with their uses. Additionally, it highlights the risks associated with ported devices and the importance of proper maintenance to prevent contamination.

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13 views1 page

Peripheral IV Cannulation Policy Appendix A

The document outlines guidelines for selecting the appropriate cannula size for medical procedures, emphasizing the use of the smallest and shortest cannula to minimize complications. It details factors influencing cannula choice, standard wire gauge measurements, and common cannula sizes with their uses. Additionally, it highlights the risks associated with ported devices and the importance of proper maintenance to prevent contamination.

Uploaded by

prakashnims11
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Appendix A: Choice of cannula

The smallest and shortest cannula for the procedure should always be used, not the largest cannula that can be
placed in the vein. Complications associated with cannulae increases as the size of the cannula in relation to the
vein size increases. For the choice of cannula a variety of factors need to be considered, including the following.

Factor Cannula choice

Larger diameter Smaller Diameter

Lower arm (smaller vein) X

Upper arm (larger vein) X

Irritant drugs (e.g. antibiotics, chemotherapy) X


osmolarity and pH of infusate

Large fluid volumes X

Viscous fluids (e.g. blood) X

The size of a cannula is usually expressed in terms of Imperial standard wire gauge (swg), which measures the
cannula diameter; the smaller the gauge size, the larger the diameter. Standard wire gauge measurement is
determined by how many cannulae fit into a tube with an inner diameter of 1 inch (25.4mm) and uses
consecutive numbers from 13 to 24. The diameter, e.g. 1.2mm, may be expressed as a gauge, e.g. 18g.

The most commonly available cannula sizes in the Trust are as follows:
Size Colour Possible uses

24g Yellow Chemotherapy, medications, short term infusions, fragile veins


22g Blue Most medications, IV hydration
20g Pink Blood transfusion, most medications ,IV hydration
18g Green Rapid IV hydration, rapid blood transfusion, most medications
16g Grey Rapid fluid infusion, massive blood loss replacement, trauma
14g Orange Emergency use rapid infusion blood or viscous fluid

Flow rates vary with equipment from different manufacturers it is usually documented on the cannula packaging.
Flow rate through a cannula is related to its internal diameter and is inversely proportional to its length.
However, as the length of the cannula increases, so does the likelihood of vascular complications, for example a
large-gauge device of longer length (1.6–2cm) will fill the vessel, preventing blood flow around it, which could
result in mechanical trauma to the vessel and encourage the development of phlebitis.

Of note: Many cannulae have small ports on the top of the device. The advantage of a ported device is the ability
to administer drugs without interfering with continuous infusion. However, the caps are often not replaced
correctly, which leaves the system exposed to contamination and the possible risk of air entering. It has also
been found that the ports cannot be adequately sterilized with a swab, as there is no flat surface. The use of
ports may encourage the practitioner to not remove the dressing and inspect the site but merely administer the
drug via the port. It is not recommended that routine medication is given through these ports.

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