Cannulation of Vessels Using a Spring-Loaded Device Cannulation of blood vessels is an important part of man- aging seriously ill patients, especially neonates and infants ‘The procedure requires very fine hand control and consid erable practice. Although it is an operation performed ‘many times, it can be a daunting experience for some (1). Intravenous cannulas are designed with an introducer needle that is slightly longer and narrower than the can- nula. Difficulties are usually encountered once the vessel hhas been punctured by the needle, and the cannula is advanced. The needle may bend considerably during inser- tion, making manipulation dificult 2). Additionally, the needle tip may be accidentally advanced or prematurely, ‘withdrawn, resulting in failure. Figure 1, (a) Central venous presure line gue wire used as spring: () recangulc plastic base; (6) tube to hold the hub ofthe ntl: (2) "2 shaped hook, (@) intravenous cannula. with ANESTH ANALG Issz7sas9-08 By experiment, I have found that spring-loading the ‘cannula greatly eases this procedure. The spring is put tunder tension before the vessel is punctured. Once the vessel is punctured, release of the spring pushes the cannula forward in a swift, smooth motion, avoiding the problems normally encountered. The device (Figure 1) is constructed using central venous pressure line guide wire that acts as a spring, While the cannula is held in place on the needle with a finger on tone of the wings, the free ends of the wire are hooked over the near side of each wing (Figure 2). This puts forward pressure on the cannula. The cannula is held with the wire lunder tension, and the vessel is pierced as usual. Once the needle is within the lumen, signaled by a “flashback” of blood (3), the resisting finger can be released, and the cannula moves forward into the blood vessel. The spring, and the needle are withdrawn, leaving the cannula in situ. ‘This technique was assessed in 50 infants (92% weighing. ‘<4 kg) when cannulation by the conventional method had failed. Cannulation was successful in 47 (94%) of these infants on the first attempt; only 3 (6%) required a second. attempt. By adopting this concept, a new generation of spring- loaded cannulas, long lines, and central venous pressure lines could be constructed. Kadiyali M. Srivatsa, moss References 1. Hope RA, Longmore JM, Moss PAS, Wares AN. Oxord handbook of ‘lineal medicine. nde, OxordsOxlord Unversity ress, 19098. 2. Kestin 1 Pespherl venous cannula. Be) Hosp Med 19873740-3, 46:81 3. Data's Hanning CD. How to insert a perpheral venous cannula. Be) Hoey Nie 190867 3