Children's cannulation: What is the problem?

February 22, 2017

Cherelle Hibbert

Child admissions to hospitals are in the region of 6 million per year in the NHS alone. Healthcare Practitioners are required to cannulate children (inserting a hollow tube into the vein) on a daily basis but as they have a low threshold for pain and smaller veins (particularly compared to that of an adult), it can often be proved as a difficult procedure to perform with numerous attempts made.

This is an image of a child's hand after multiple attempts at cannulation, causing severe pain and discomfort to the child.

This issue has been addressed in the 'Journal of emergency nursing', who found that the success rate for 1st attempt cannulations within children was only 53%, furthermore, 67% for 2nd attempts, 91% for 4th attempts and only 33% for first time attempts in children. This can be defined as Peripheral Difficult Venous Access (Peripheral DVA), which is described by the writers of the above journal as;

"A clinical condition in which multiple attempts and/or special interventions are anticipated or required to achieve and maintain peripheral venous access."

A collection of statistics gathered by Olberon Ltd.

Common cause and effect factors to take into account for cannulating a child:

Age -

The younger a child is, the smaller and more difficult their veins may be. Furthermore, if the child is distressed after performing the first cannulation, the procedure is likely to become more of a challenge.

Weight -

It may be more difficult to locate and see the vein of a small child. Alternatively, the veins of a child who is obese may prove to have poor venous visibility.

Emotional issues -

As previously mentioned, a failed first attempt is likely to distress a child, causing pain, fear, restlessness or a refusal to cooperate with their healthcare practitioner. This would make any resulting attempts at cannulation to be more difficult with an emotionally challenging situation.

Illness & ongoing treatment -

As cannulations are a regular occurrence for long term patients it can cause in damaged and collapsed veins, resulting in reduced access to veins.

As a medical innovation company, we hope to ease the process of venous access within children with the introduction of our upcoming innovation, the children's Vacuderm™. Interviews conducted by Olberon suggest practitioners would encourage the device to be used on children as the tourniquet has an incorporated dome to pump, helping to make a smaller vein bigger and ultimately reducing the number of attempts at cannulation. Using child friendly interactive designs would make the process less daunting and traumatic, and the child could assist in pumping the dome, adding a dimension for the child to be more involved in assisting the procedure.