Consultant:
Ward:
Comments
Ensure these essential elements are completed during cannula insertion
Checklist Summary
In Use Dressing Needfree VIP Score
Check if in use every shift Check intact Check in working order Check every shift
Remove when no longer reqd Change every 7 days Change every 7 days Replace at VIP score 2
1
One of the following is evident: Possibly first signs of phlebitis
PSlight pain near IV site or PSlight redness near IV site OBSERVE CANNULA
2
Two of the following are evident: Early stage of phlebitis
PPain at IV site PErythema PSwelling RESITE CANNULA
4
All of the following signs are evident and extensive: the start of thrombophiebitis
P along path of cannula PErythema PInduration PPalpable venous cord
Pain RESITE CANNULA
INITIATE TREATMENT
5
All of the following signs are evident and extensive: Advanced stage of thrombophiebitis
RESITE CANNULA
P along path of cannula PErythema PInduration PPalpable venous cord PPyrexia
Pain
INITIATE TREATMENT
Adapted with permission from Andrew Jackson IV Nurse Consultant, The Rotherham NHS Foundation Trust, UK Andrew Jackson 1997