Cannula Infection, Cannula Infection, Causes and Risk Factors, Classification of Cannula Infections

Cannula Infection 🩸

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🔹 1. What is a Cannula?

A cannula is a flexible tube inserted into a vein or body cavity. It's most commonly used for:

• Administering IV fluids or medications

• Drawing blood

• Delivering oxygen (nasal cannula)

• Maintaining venous access

🔍 Common Types:

• Peripheral IV Cannula (PIVC) – Most used in emergency and clinical settings

• Central Venous Catheter (CVC) – For long-term or critical care access

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⚠️ 2. What is a Cannula Infection?

A cannula infection is an infection at or around the cannula insertion site. If not managed early, it can lead to systemic infection, including sepsis and multi-organ failure.

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🧬 3. Causes and Risk Factors

🦠 Pathogens Involved:

• Gram-positive bacteria:

  • Staphylococcus aureus (including MRSA)

  • Staphylococcus epidermidis

• Gram-negative bacteria:

  • Pseudomonas aeruginosa

  • Klebsiella spp.

• Fungal pathogens (in immunocompromised patients):

  • Candida species

⚠️ Risk Factors:

Factor	Explanation
Poor hand hygiene	Increases microbial contamination
Long dwell time	Cannulas left in too long = higher risk
Inadequate skin preparation	Bacteria can enter during insertion
Multiple insertion attempts	More trauma and risk of infection
Immunosuppression	Patients can't fight infection well
Not using aseptic technique	Introduces pathogens directly

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🧠 4. Classification of Cannula Infections

Type	Characteristics
Phlebitis	Inflammation of the vein; can be mechanical, chemical, or infectious
Local infection	Infection at insertion site: redness, warmth, pus, pain
Catheter-related bloodstream infection (CRBSI)	Infection spreads into bloodstream – serious condition

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🧪 5. Signs & Symptoms

🔎 Localized Symptoms:

• Redness and swelling at site

• Pain or tenderness

• Warm skin over vein

• Purulent (pus) discharge

• Hardening or thickening of the vein (cord-like feel)

🌡️ Systemic Symptoms (if infection spreads):

• Fever >38°C

• Chills, rigors

• Increased heart rate (tachycardia)

• Hypotension

• Confusion or altered mental state (in elderly)

• Elevated WBC count and CRP

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🧬 6. Diagnosis

Test	Purpose
Visual inspection	First step – look for local signs
Swab from cannula site	Sent for culture to identify bacteria/fungi
Blood cultures	If systemic signs present
Full blood count (FBC)	To assess white cell response
C-reactive protein (CRP)	Marker of inflammation/infection

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💊 7. Management & Treatment

🛑 Immediate Steps:

• Remove the cannula immediately if signs of infection

• Send tip and swab for culture if available

🧴 Local Infection:

• Clean with antiseptic (chlorhexidine)

• Apply sterile dressing

• Oral or topical antibiotics

💉 Systemic Infection:

• IV antibiotics as per sensitivity

• Blood pressure monitoring and IV fluids

• Admit if sepsis is suspected

🚨 Sepsis Protocol (ABCDE):

• Airway – assess and secure if needed

• Breathing – oxygen if required

• Circulation – monitor BP, give fluids

• Disability – assess neurological state

• Exposure – check for rashes, site infections

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🛡️ 8. Prevention: Nursing & Paramedic Role

✅ Best Practices:

Practice	Why it matters
Hand hygiene	Reduces contamination
Use of gloves	Barrier protection
Aseptic non-touch technique (ANTT)	Prevents cross-contamination
Proper skin antisepsis	Chlorhexidine or iodine-based prep
Securement devices	Prevent movement that causes irritation
Daily site inspection	Early detection of infection
Documentation	Helps track changes or trends
Rotate sites regularly	Every 72–96 hrs or per hospital policy

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🧠💡 Mnemonic: "I.C.A.R.E."

• I – Inspect daily

• C – Clean site

• A – Aseptic technique

• R – Rotate cannula site

• E – Educate patient to report pain or swelling

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📌 Summary Chart

Step	Key Points
Recognize early	Redness, pain, discharge
Act fast	Remove cannula, send for cultures
Treat appropriately	Local vs. systemic treatment
Prevent always	Hand hygiene, site care, documentation

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