Intended for healthcare professionals


Local warming does help when inserting cannulas

BMJ 2002; 325 doi: (Published 02 November 2002) Cite this as: BMJ 2002;325:1038
  1. Jeanette Beer, clinical nurse specialist, chemotherapy ({at}
  1. Department of Clinical Oncology, United Lincolnshire Hospitals NHS Trust, Lincoln County Hospital, Lincoln LN2 5QY

    EDITOR—Lenhardt et al say that local warming improves the success rate for insertion of peripheral cannulas.1 For people working in a busy outpatient chemotherapy unit, insertion of peripheral cannulas is a core activity and can be extremely difficult, particularly in patients who have had repeated courses of chemotherapy.

    Until recently we asked patients to immerse their hands in warm water. This manoeuvre was not always successful because by the time patients had returned to their chair and dried their hands, any benefit was rapidly reduced. This led us to investigate other forms of local warming methods, which included proprietary wheat filled bags. These can be readily purchased in many gift and health shops. A donation of a sack of wheat has enabled us to provide a number of wheat filled bags easily and cheaply. Removable cotton covers have also been made to facilitate laundering. Each bag measures approximately 150 cm×50 cm and is heated in the microwave on high for 2 minutes. This method also reduces the number of attempts at cannulation.

    Our own inhouse approach has provided us with an effective low cost option and has now been fully adopted. It may be that further research is needed to compare other methods used within different clinical areas to provide data for evidence based practice.


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