Common & Expected Issues
1. Pain or Discomfort
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Cannula insertion typically involves a needle puncture and may cause mild pain or stinging at the site Some medications—especially acidic or potassium-based—can cause a burning or prickling sensation during infusion
2. Infiltration & Extravasation
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Infiltration occurs when IV fluids leak into surrounding tissue, causing swelling, coolness, pallor, and discomfort at the insertion site
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Extravasation involves leakage of irritant or vesicant fluids into tissue and can lead to blistering, burning, tissue damage, and, in severe cases, necrosis
3. Phlebitis & Thrombophlebitis
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Phlebitis is inflammation of the vein, marked by warmth, redness, tenderness, and possibly a raised vein cord
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Thrombophlebitis involves clot formation within the inflamed vein, potentially causing more pain and risk
4. Hematoma and Bruising
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If the vein is punctured or the catheter damages vessel walls during insertion or removal, blood may leak into tissue, causing a hematoma (bruise) and tenderness
5. Infection
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As IV cannulation breaches the skin, there's a risk of local skin infection or, rarely, systemic bloodstream infection (sepsis) if sterility is compromised or cannula is left too long
6. Air Embolism
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A rare but serious risk if air enters the tubing or catheter and is infused into the bloodstream. It can lead to chest pain, difficulty breathing, or cardiovascular collapse
7. Catheter Occlusion or Failure
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Poor patency, catheter blockage, or catheter failure rates (35%–50% in optimal settings) are common; may require reinsertion
Prevention & Monitoring
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Frequent site checks (pain, redness, swelling, heat, coolness, leakage).
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Ensure proper placement and securement to minimize movement and vessel trauma.
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Use aseptic technique when inserting and handling the cannula.
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Limit dwell time per current guidelines—typically replace every 72–96 hours unless clinically justified otherwise
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Choose appropriately sized cannula (24G may increase phlebitis risk in small veins)
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Promptly stop infusion and remove cannula at first sign of complication; elevate limb, apply compresses, or treat per institutional protocols.