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COMMENTS ON PUBLISHED ARTICLE
Year : 2018  |  Volume : 62  |  Issue : 10  |  Page : 830  

Caution: Intravenous cannula should not be used for arterial cannulation


Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Date of Web Publication9-Oct-2018

Correspondence Address:
Dr. Vandana Agarwal
Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Dr E Borges Marg, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_498_18

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How to cite this article:
Agarwal V. Caution: Intravenous cannula should not be used for arterial cannulation. Indian J Anaesth 2018;62:830

How to cite this URL:
Agarwal V. Caution: Intravenous cannula should not be used for arterial cannulation. Indian J Anaesth [serial online] 2018 [cited 2018 Oct 20];62:830. Available from: http://www.ijaweb.org/text.asp?2018/62/10/830/242895



I read with interest the letter to editor published in May 2018 issue of IJA. The authors have suggested to use intravenous (IV) cannula for arterial lines due to non-availability of dedicated arterial cannula and suggested a modification to overcome low volume of flashback chamber to improve success rate of arterial cannulation.[1]

Using IV cannulas with an injection port for arterial cannulation is an important matter of patient safety. An arterial line is often sited in patients undergoing major surgery and/or requiring intensive monitoring because of patient factors and as a consequence they may have more than one venous access. Using an IV cannula with an injection port as an arterial line can lead to inadvertent injection of medications through the injection port in the artery with serious sequelae.[2],[3] Hence, it becomes imperative to use dedicated arterial cannulae. Secondly, the modification suggested by authors (using the shaft cover to improve the success rate of arterial cannulation) cannot be generalised for all currently available IV cannula brands e.g., B Braun® and thus may not be an option.

To improve the success rate of arterial cannulation particularly for trainees, one can use barrel of 2 cc syringe in the arterial cannula after removing the blocker irrespective of the cannula brand as shown in [Figure 1]. Taking into consideration the dangers of inadvertent intra-arterial injection of medications through the injection port, dedicated arterial cannulas should be used for arterial lines and not IV cannulas.
Figure 1: 2 cc syringe barrel and the arterial cannula

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Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Kaushal A, Bindra A, Singh S, Saeed Z. Modification of intravenous cannula for arterial line insertion: Simple yet effective technique. Indian J Anaesth 2018;62:397-9.  Back to cited text no. 1
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2.
Witkowski M, Mochmann HC, Rauch U, Knie W, Landmesser U, Skurk C, et al. Acute thrombotic occlusion of the left brachial artery after intra-arterial administration of amiodarone. Crit Care Med 2016;44:e227-30.  Back to cited text no. 2
    
3.
Samanta S, Chakraborty N, Samanta S. Accidental intra-arterial injection of paracetamol: Different preparations, different results. Eur J Anaesthesiol 2014;31:236-7.  Back to cited text no. 3
    


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