How to insert a peripheral cannula

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Rationale and key points

This How to module aims to assist healthcare practitioners to undertake the safe and effective insertion of a peripheral cannula. It provides information on best practice related to peripheral cannulation with an open-ported safety cannula. The same principles for practice apply to non-ported open safety cannulae.
  • Peripheral cannulation enables venous access, the administration of intravenous (IV) medication, infusion therapy and total parenteral nutrition (TPN). It also enables blood samples to be obtained.
  • Peripheral cannulation is a common procedure that requires high standards of care and management to optimise patient outcomes.
aseptic non-touch technique, cannulation, clinical procedures, clinical skills, intravenous (IV) therapy, IV cannulation, peripheral cannulation, vascular access, vein selection

Learning objectives

After reading this module you should be able to:
  • Describe the procedure for inserting a peripheral cannula.
  • Demonstrate best practice in relation to peripheral cannulation.
  • Identify the risks and complications of peripheral cannulation.
  • Understand the importance of safe technique in peripheral cannulation.

Preparation and equipment

  • Discuss the need for a cannula with the patient and explain the procedure. Check if the patient has had a cannula inserted previously and ask if they encountered any difficulties or complications. Determine how the patient feels about the procedure, if they have any concerns, fears, or questions. Ensure that any questions the patient has are answered and their concerns are discussed, and obtain informed consent for the procedure.
  • Ensure you are informed of, and up to date with, the patient’s medical history and condition, their vascular access history and current vascular status, as well as the proposed intravenous (IV) therapy. This will enable the correct cannula and correct vein to be selected.
  • Clean all surfaces with a detergent wipe or as per local policy. If an aseptic non-touch technique (ANTT) tray is used, clean this from the inside out.
  • Ensure the necessary equipment is available, including:
    • Prescription for a minimum of 10mL 0.9% sodium chloride flush (minimum 5mL each flush).
    • Non-sterile gloves and disposable apron.
    • Cannulation pack or ANTT tray.
    • Alcohol hand gel.
    • 2% chlorhexidine in 70% isopropyl alcohol solution in single-use applicator.
    • Appropriate gauge cannula, usually 20 or 22 gauge.
    • 10mL 0.9% sodium chloride flush – pre-filled syringe or drawn up as per local IV administration policy (minimum 5mL for each flush).
    • Needle-free access device.
    • Hub protector cap(s), as per local policy.
    • 2% chlorhexidine in 70% isopropyl alcohol wipes.
    • Tourniquet, as per local policy.
    • Sterile gauze.
    • Transparent cannula dressing.
    • Dressing tape.
    • Sharps bin.
    • Clinical waste disposal bag.
  • Cannulation packs are used in some clinical areas. Cannulation packs contain all the equipment required for this procedure, although some might not include the cannula. Where cannulation packs are not used, place the necessary equipment in the ANTT tray.
  • Confirm the identity of the patient using three identifiers: name, date of birth and unique NHS or hospital number.

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