IV Cannulation of dark skin & what I do when I mess up |
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- čas přidán 3. 12. 2022
- Thanks Dr Sean for volunteering his body for education!
All the principles when cannulating darker skin is exactly the same. EXCEPT it can be more difficult without the same visual cues.
In this video I go through the steps I take to maximise my success!
I also make a bit of a mess due to my unfamiliarity with that particular cannula...
I hope it helps to see that I also make mistakes!
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Always great to have a bit of repetition on the cannulation technique, thanks ever so much
Nicely explained. Thank you
Thanks for your explanation
I like your videos a lot. Thanks for sharing.
God bless you for this!
Great job as usual. Can you do one with darker skin patient pl? 🙏🙏🙏
Great video! Do you have any on how to get an IV on a patient that has short or crooked veins?
thank you and more video please
great video... we use those needles at my hospital... i find that sometimes they don't go into the skin smoothly.... Ive also had some that were faulty as far as having spliced cannula .. right from package. unable to use.
nice demo
Dear Dr.,
The hospital I worked use this IV catheter. My previous work used the Braun IV catheter. I encountered the same accident in your video. I really learned a lot from all your iv cannulation videos. However, I still struggling with IV cannulation in my job. I am wondering if you have any hand-on courses to teach people like me？I really feel so sad when I need to poke my patients more than 1 time. Please help me. Wish you have a wonderful week.
Thank you but that was not darker enough 😅
appreciated can you discuss anesthesia machine components and purposes for each part?
Ha! I changed employer and went from the Braun cannulas that you manually remove the needle to engage the safety mechanism, to these cursed ones that auto retract of you even look at that button with intent. 😩 Oh and they don’t have the automatic valve that stops blood going everywhere until you can put a cap or valve on. Some patients have such awful veins from chemo that holding firm pressure proximal to the puncture site can cause problems from the trauma, small as it is. (Obviously trying not to apply pressure over the actual cannula in the vein, but when I look at general videos , I often see exactly that.) You’re such a great sport to include this in the video, as it absolutely happens to many of us when changing equipment! Not to mention covid still has impacted supply lines, and we get different types of cannulas and dressings, so I never really know what I’ll find next time I go to cannulate.
I enjoyed seeing the example of recovering from accidentally hitting the safety button. Can you show cannulation on a heavily tattooed individual? And as others have stated, an elderly individual? Do you make a C to stretch the skin and keep the vein from rolling?
Can you please give us tips for older patients with wrinkled skin?
Their veins are tiny and it's sometimes very difficult to insert an IV.
I didn't see a response from anyone, so I thought I'd give one:
1. Go small on the catheter. I like to use 22G as the default choice.
2. Try the hand first, as it will often have less excess skin.
3. If going for a forearm or AC, use your support hand to draw the excess/wrinkled skin on both sides of the vein to fix the vein and prevent rolling . I find applying tension distally or proximally doesn't work as well.
4. I find that their veins often extravasate the moment they are punctured when using the standard 1" tourniquet. Minimizing the pressure you put on the vein can help prevent this, so you may be better served not using a tourniquet, or using a BP cuff.
@@GF-qb3uo Thank you very much, I am grateful for sharing.
@@emmanuelaidoo89 Happy to be of service. my friend!
I always chose this area for last this vein was a tricky one...even though it's obvious and palpable.. Most of the time it gives you a problem ...
As a melanated person : Thank you for this particular video sir . Possibly do one on pulse oximetry and consideration for darker skin individuals in that realm. Thanks
What about patients with swollen arms and with dark skin?
Can you demonstrate using other types of cannulas? I’m from the Philippines and the ones we use at the public hospital I work in look very different. It has a wing structure for stabilization.
I’ve seen this same great dr demonstrate using a cannula that does have small winged sides, but otherwise there are plenty of videos out there showing this. You hold the cannula with the same fingers as shown in this video, just folding the butterfly wings up together to grip. I’ve used that for blood collecting.
Thank you. Some health care professionals act as if we do not exist.
I have the most difficult time on Very dark skin and then high BMI.
These types of cannulas always have a bit of a learning curve. It's way too easy to press that button 😂
Nice video sir... We have darker patients over here in Nigeria... with Real menalin supply. . Sir please do for a fat patient with very tiny /less obvious veins, if possible, a darker than your above patient. Thanks
It's no rocket science. If you practice enough, darker skin is just the same, cause you don't relie as much on visual queues.
For a fat patient with less obvious/tiny vein
@@shinedlight1111 I didn't see a response from anyone, so I thought I'd give one. I work in EMS in the Southern US, and frequently have to gain IV access in overweight, dark skinned Pt's. What I find works:
1. Look in the hand first. Unless the Pt is very obese, there tends to be less adipose tissue obscuring the veins, so you'll be able to see and feel the veins more easily.
2. Look in the AC next. One can usually see at least portion of the vein in the fold of the joint. Unfortunately, you may not be able to see the path the vein takes as it runs proximally up the arm due to the adipose in the upper arm. As a result, you may have to adjust the angle of penetration laterally or medially if you do not get flash initially. For obese Pt's that can't fully straighten their arm, one concern is going through the vein. For these Pt's, slightly bending the catheter may help prevent penetrating out the back wall of the vein, as suggested by NYSORA in his CZcams tutorials.
@@shinedlight1111 Also iv cannulation for someone with burns and people with oedema
It's the first time I've seen you preload a bung. It is necessary? Thanks Doc.
Not necessary at all :)
Just useful if i want to flush with saline straight away..
Also preload if the bung is lower quality, helps to loosen the device
Hi ABCoA,
Once I palpate the site of a poorly visible vein to cannulate and "visualize my trajectory", I take my eyes off of the area in order to prepare my equipment. I find it very difficult to reacquire and maintain that visualization after I come back to the site with my needle. Any tips or any chance this factor warrants a video?
Thanks and all the best.
As a paramedic, one of our 'street techniques' on the ambulance is to save a discarded plastic cap covering the needle. We will take this cap and press the base of the cap upon the skin just hard enough to leave an indent on the skin. Usually, the cap is circular, so it makes a nice little circle over the space where we have located a vein, and the indent usually stays long enough for us to remove our gaze to prepare or gather the cannula for insertion! This is especially helpful for larger patients with more subcutaneous tissue as well.
I've used that particular cannula. That button is a hair trigger.
Do you shave very hairy individual?
How can you anchor an elderly patient who’s skin is loose despite applying traction?
How can you stretch the skin/apply traction when the person who is inserting the angiocather has small hands ?
I didn't see a response from anyone, so I thought I'd give one:
1. Try the hand first, as it will often have less excess skin.
2. If going for a forearm or AC, use your support hand to draw the excess/wrinkled skin on both sides of the vein to fix the vein and prevent rolling . I find applying tension distally or proximally doesn't work as well. If your hand is too small to do so by pulling tension from the dorsal side of the arm, you can try placing the arm on a supporting surface and applying tension with the thumb and forefinger on the anterior side by making a "U" around to the site you are trying to cannulate.
@@GF-qb3uo thank you!!!
@@emmabae4426 Happy to be of service!
Please do in a more dark skin , this was somewhat easy
me trying to find the darkskin person
Patient see's their own blood the confidence in you goes to zero
Tapping and pumping is not current practice
What is current practice?
This video is waste of time....He is not a perfect doctor...
That’s ridiculous... I find him very helpful
Hahaha what is a perfect doctor u? He is educating. 🛑. Nonsense!!
I’ve watched 1000 videos on IV insertion. He is the one of the best I have seen and describing the details.