cannula

Dear khy,

My name is Penelope and I am one of the Macmillan Cancer Information Nurse Specialists. Welcome to the online community. I am sorry that you have such difficulties when you need a cannula. It sounds like this has been a problem for you before. No wonder you are sweating before you go in.

You may have tried lots of things to help this situation already, but you may like to give us a ring and talk through your experiences with one of the nurses on the Macmillan Support Line.

Here are a few general suggestions that may be helpful for you in the future. If you can eat and drink prior to needing the cannula then drinking plenty can help to make your veins more visible. If you are warm this can also help the veins to be more prominent. Some departments use heat pads or warm water on the hand or arm to be cannulated to help to make the veins easier to access.

As you mentioned it is often not possible to have a specific nurse or radiologist to do your cannula. We would always suggest speaking to someone before the appointment if possible, or when you arrive about the fact that cannulation has been difficult before.  If your previous experience is making you more anxious about cannulation and blood tests, please do let the staff know so that they can take any steps necessary to reassure you and make the procedure as straight forward as possible. In some areas an ultrasound scan of the arm can be used to help identify suitable veins for cannulation. Not all departments have access to this equipment or staff that are trained to use it, but you could certainly ask if it might be available.

You mentioned that you are sweating before you go in. I am sorry to hear this and can appreciate that hospital appointments can be difficult even without the added concern about cannulation and blood tests. I wonder if you have ever tried any relaxation techniques or distraction prior to and during the procedures?

There are lots of resources available to help with anxiety. For example this NHS resource has a 5 minutes anxiety control audio guide (you need to scroll down the page to find the audio guide). Whilst waiting for appointments anything that will distract you such as music or funny videos can also be very helpful to pass the time.

Finally, you mentioned that your arm once ached for a week after a blood test. Following any blood test or cannulation do keep an eye on the site and report any concerns such as pain, redness or swelling to your GP or hospital team so that they can assess the site if necessary.

I do hope that the above information is helpful, and I wish you well with any future procedures.

Best wishes,

Penelope, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref/ SMc

Thanks for your reply, but it seems to talk about things that I can do to help the situation and nothing about what the nurses can do themselves, so going on that advice nothing is going to change and I am obviously wasting my time.

Why do you always stick up for each other, that's why nothing changes, its the patients fault for not drinking enough or the patients hands are cold, its not our fault its the nurses and radiologists they need more training.

these are professionals and I look around the chemo unit and there are patients sat there soaking their hands in buckets of hot water, also they have two attempts each with the cannula so you could have three nurses attempting to put it in.

Now I have been told to go to GP or out patients for bloods because the chemo unit is short staffed

Dear khy,

My name is Gemma and I am another of the cancer information nurses here at Macmillan Cancer Support. Thank you for your reply and further information.

I hope that you managed to get your bloods done the other day without too much hassle or waiting around.

I understand that you feel there is a training need in the unit where you are having treatment. This may well be the case.  As a national information and support service, separate to the front line or ‘patient facing’ services within the NHS we are unable to offer any solutions to specific situations within units. That said it is clear how much this situation is impacting on you, and we will do our best to offer ideas of how to move it forward in a better way.

Have you discussed it with the chemotherapy unit manger? He/she would be best placed to answer questions about the unit that you attend.  They may also be able to offer some reassurance about what plan they might have in place already if this is a need that is already being addressed?

One suggestion that might help your own situation going forward is to consider whether a ‘Port’ or a PICC line or Hickmann line (Sometimes called a central line) might suit you better?

They are all flexible tubes that you could have chemotherapy, fluids, blood products given through.  They are inserted either through chest or arm and stay in place for a period of time; such as a course of chemotherapy. 

Ports lie under the skin and involve a small needle prick when they need to be used; They are usually much easier to find and you should be able to put on local anaesthetic cream with a plaster ahead of each time it needs to be done.

PICC lines and Central/Hickmann lines have a portion of the flexible tube coming out of your body and require a dressing to hold them in place and help keep them clean.

Many Chemotherapy nurses, oncology outpatient nurses and community nurses have had the extra training required to be able to care for these ‘lines’. 

If they are of interest to you it might be worth asking the nurses at your local practice whether they have this training and potentially arranging with your oncology team a routine that is better for your own quality of life while on treatment.

If the thought of a line is not for you, you could again speak with the unit manager and explain just how much the ongoing cannula issues are affecting you.  Put the ball in their court so to speak, to see if there is anything, they themselves can come up with. They will know the limitations of what they can offer.

Another thing to consider is speaking to other people going through intravenous treatment and sharing ideas of what has worked for them.  We have our friendly Cancer Treatment Forum where you could meet others going through a similar time and hopefully get some more tips on what might make things better.  Central lines are a topic of conversation that come up in many different groups, so if you don’t fancy asking your own question, you could always read over what has already been asked?

I hope this information helps improve what I appreciate is a tortuous situation for you.