Intravenous cannulation
March 2013 (f)
| A | Femoral artery | |
| B |
Carotid artery |
|
| C |
Radial artery |
|
| D |
Ulnar artery |
Artery cannulated most commonly for invasive blood pressure monitoring is:
March 2013 (f)
| A |
Femoral artery |
|
| B |
Carotid artery |
|
| C |
Radial artery |
|
| D |
Ulnar artery |
Ans. C i.e. Radial artery
Radial artery is cannulated to measure:
March 2013 (f)
| A |
Heart rate |
|
| B |
Blood pressure |
|
| C |
CVP |
|
| D |
End tidal CO2 |
Ans. B i.e. Blood pressure
Arterial cannulation
- It is a commonly performed procedure in the management of patients who are critically ill.
- An indwelling arterial catheter allows for continuous blood pressure (BP) monitoring, frequent blood sampling, and arterial blood gas measurement.
- Arterial catheters can be placed at the bedside and have been found to be relatively safe, with a low incidence of serious complications.
- Arteries used for catheterization include the radial, ulnar, brachial, axillary, femoral, posterior tibial, and dorsalis pedis.
- Of these, the radial artery is most commonly used in both adults and children.
- The radial artery is chosen primarily because of the superficial nature of the vessel and ease of maintenance of the site
| A |
16 Gauge |
|
| B |
20 Gauge |
|
| C |
22 Gauge |
|
| D |
24 Gauge |
Ans: A. 16 Gauge
(Ref Bailey 25/e p291)
- In a patient with massive bleeding, there is always a risk of patient going into shock and widest bore cannula available showed be used for cannulation.
- The ACLS guidelines recommend securing intravenous access with two large-bore cannulae (14–I6G) in patient needing resuscitation.
|
Gauge |
Color code |
External Diameter |
Length |
Flow Rate |
|
14G |
Orange° |
2.1 mm |
45 mm |
240 ml/min |
|
16G |
Grey(‘ |
1.8 mm |
45 mm |
180 ml/min |
|
18G |
Green° |
1.3 mm |
32/45 mm |
90 ml/min |
|
20G |
Pink° |
1.1 mm |
32 mm |
60 ml/min |
|
22G |
Blue° |
0.9 mm |
25 mm |
36 ml/min |
|
24G |
Yellow° |
0.7 mm |
19 mm |
20 ml/min |
|
26G |
Violee |
0.6 mm |
19 mm |
13 ml/min |
| A | Grey | |
| B |
Green |
|
| C |
Blue |
|
| D |
Pink |
Ans: B. Green
used for routine blood transfusions, transfusing large volumes of fluid, intravenous feeding of patients and the harvesting and separation of stem cells.
Refi ATLS 18th edn; 2018, Chapter 3 Shock
| Color | Size | External diameter(mm) | Length(mm) | Water flow rate (mL/min) | Recommended uses |
| Orange | 14G | 2.1 mm | 45 mm | -240 mL/min |
Trauma, rapid blood transfusion, surgery |
| Gray | 16G | 1.8 mm | 45 mm | —180 mL/min |
Rapid fluid replacement, trauma, rapid blood transfusion |
| Green | 18G | 1.3 mm | 32 mm | —90 mL/min |
Large volumes of fluid, Rapid fluid replacement, trauma, rapid blood transfusion |
| Pink | 20G | 1.1 mm | 32 mm | —60 mL/min |
Most infusions, rapid fluid replacement, trauma, routine blood transfusion |
| Blue | 22G | 0.9 mm | 25 mm | —36 mL/min |
Most infusions
Neonate, pediatric, older adults routine blood transfusion |
| Yellow | 24G | 0.7 mm | 19 mm | —20 mL/min | Most infusions neonate, pediatric, older adults, routine blood transfusion, neonate or pediatric blood transfusion |
| Purple | 26G | 0.6 mm | 19 mm | —13 mL/min | Pediatrics, Neonate |
| A | Green | |
| B |
Blue |
|
| C |
Grey |
|
| D |
Violet |
Ans: C. Grey
• Grey is 16G cannula and wider the bore, higher the flow rate. Here the key is the rapid fluid replacement.
External diameter(mm)- 1.8 mm
Length(mm)- 45 mm
Water flow rate (mL/min)-—180 mL/min
uses- Rapid fluid replacement, trauma, rapid blood transfusion
Green- Large volumes of fluid, trauma, rapid blood transfusion
In a patient with dehydration, which of the following color intravenous cannula will you place for rapid fluid resuscitation?
| A | Grey | |
| B |
Blue |
|
| C |
Pink |
|
| D |
Green |
Ans:. A. Grey
|
Gauge |
Color code |
External Diameter |
Length |
Flow Rate |
|
14G |
Orange |
2.1 mm |
45 mm |
240 ml/min |
|
16G |
Grey |
1.8 mm |
45 mm |
180 ml/min |
|
18G |
Green |
1.3 mm |
32/45 mm |
90 ml/min |
|
20G |
Pink |
1.1 mm |
32 mm |
60 ml/min |
|
22G |
Blue |
0.9 mm |
25 mm |
36 ml/min |
|
24G |
Yellow |
0.7 mm |
19 mm |
20 ml/min |
|
26G |
Violet |
0.6 mm |
19 mm |
13 ml/min |
| A | 18 | |
| B |
20 |
|
| C |
22 |
|
| D |
24 |
Answer- A. 18
| Cannula size | Colour | Time to infuse 1000ml Normal saline under ideal circumstances |
| 22 G | Blue | 22 min |
| 20 G* | Pink | 15 min |
| 18 G | Green | 10 min |
| 16 G | Grey | 6 min |
| 14 G* | Red | 3.5 min |
