Fracture of an Intravenous Cannula in the Hand: A Case Report

• Published in: Journal of emergency nursing Vol. 49; no. 2; pp. 156 - 161
• Main Authors: Woo, Seungho, Nah, Sangun, Kim, Giwoon, Han, Sangsoo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2023; Elsevier Limited
• Subjects: Administration, Intravenous; Autopsies; Blood tests; Cannula; Cannula - adverse effects; Case reports; Catheterization; Catheterization, Peripheral - methods; Catheters; Complications; Delayed; Dyspnea; Embolization; Emergency medical care; Emergency services; Female; Fractures; Humans; Inflammation; Infusions, Intravenous; Intravenous drugs; Intubation; Middle Aged; Nurses; Ovarian cancer; Pain; Patients; Peripheral catheterization; Phlebitis; Phlebitis - etiology; Physicians; Resuscitation; Risk factors; Strength; Vasculitis; Veins & arteries; Vital signs; Cannula; Complications; Peripheral catheterization
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2022.11.012

Intravenous cannula insertion is important, given that it is the most common invasive procedure in the emergency department for blood sampling, fluid resuscitation, and intravenous drug administration. Complications of intravenous catheterization include pain, phlebitis, extravasation, inflammation, and embolization. Fracture of an intravenous cannula is rare, but delayed removal may result in secondary damage, such as vasculitis or embolization, with critical consequences. Here, we report a case of intravenous cannula fracture that occurred in our emergency department. A 63-year-old woman with a history of left ovarian cancer visited our emergency department owing to poor oral intake and general weakness. Intravenous catheterization using an 18 gauge cannula was attempted for intravenous fluid administration by a skilled operator, but it failed owing to collapsed veins and poor skin condition. After several attempts, a vein in the patient’s hand was ruptured, and the patient complained of severe pain. The cannula was removed, but one-third of the cannula tip could not be seen. X-ray imaging was performed to locate the fragment of the cannula, and venotomy was performed for removal of the foreign body in the emergency department. Emergency physicians and nurses should be vigilant about potential risk factors that can cause fracture of an intravenous cannula, and after the fracture is discovered, rapid removal of the cannula tip should be performed in the emergency department.