Spring-Loaded Cannula Introducer with Manual Needle along with the Blood Collecting Chamber withdrawal to prevent contamination and needlestick injury.

What is a Cannula?

A cannula (from the Latin "little reed") is a small, flexible tube inserted into the body, most commonly into veins or arteries. It is used to:

• Deliver fluids, medications, blood, or nutrition (IV therapy)
• Remove fluids or draw blood for investigations
• Continuously monitor blood gases and acid base in critically ill patients

Venous and arterial cannulation are among modern healthcare's most frequently performed invasive procedures, spanning emergency rooms, operating theatres, ICUS, and general wards.

A Brief History of Cannulation

• 1656: Christopher Wren first attempted infusion using a pig's bladder and quill.
• 1662: JD Major achieved the first human injection.
• 1945: Plastic cannulas were introduced to reduce infiltration.
• 1950 - 1960: David Massa's design led to today's "over-the-needle" IV cannula.
• 1970 - 1980: Nurses in the UK began administering IV therapy and learning cannulation.
• 1980 - 2000: The technique spread to other healthcare professionals and support staff.
• 2019 - 2020: Cannulation proved to increase death due to sepsis during Covid

Yet despite all this progress, the fundamental method of introducing the cannula has not changed since the disposable, single use cannula known as “Brounula” was introduced in 1954. The return on investment for shareholders of the cannula manufacturers after introducing the “Safety Cannula” trebled.

How Cannulation is Currently Performed

Two primary techniques exist:

• Two-handed technique (common with ported cannulae): Easier for beginners, but often results in blood spillage and multiple punctures.
• One-handed technique: More technically demanding but associated with a higher first-attempt success rate and less patient trauma.

Training methods vary across institutions:

• Traditional "see one, do one, teach one" approach
• Mannequin simulations or peer practice
• Short workshops to multi-week courses
• Online modules paired with supervised practice

Unfortunately, even with training, the failure rate remains high, especially in patients with poor veins (elderly, dehydrated, or critically ill).

The Present-Day Problem: A Crisis Hidden in Plain Sight

Despite widespread use of so-called "safety cannulas", we are still struggling with:

• Low first-attempt success rates
• Painful multiple attempts increase pain, suffering and risk of infections.
• Increased infection risks of Antimicrobial Resistant Infections in hospitals resulting in prolonged hospitalisation, cost and risk of developing sepsis.
• Increasing environmental pollution from contaminated plastic devices.
• Increased cost of hospitalisation by up to 40% due to non-consumable items.
• Delay in administering lifesaving drugs, fluids, blood, and analgesics results in pain, suffering and even death.
• Healthcare-associated sepsis, cross-infections and death

The Safety IV Cannula was introduced to protect healthcare workers from accidental needlestick injuries. However, it did not address the actual insertion process. The design still depends on the operator's skill to guide the cannula over the needle into the vein—a technique unchanged in nearly 70 years.

A safety feature that activates after cannulation is not a safety solution for the patient. The trauma caused by failed attempts, especially in emergencies or resource-limited settings, is both dangerous and unethical.

Antimicrobial Resistance (AMR) and Sepsis: 

An Overlooked Connection

Studies now show a parallel rise in:

• Nurse-led cannulation practices
• Hospital-acquired infections
• Cases of sepsis and antimicrobial resistance

While this does not blame nurses, it reveals systemic failures:

• Poor training in aseptic techniques
• Inconsistent application of skin antisepsis
• Disregard for manufacturer-recommended drying times

In a pilot study, the inventor of VenaiCan asked nurses to explain "Drying Time" after skin antiseptic application. None were aware of it. This oversight likely contributes to the transfer of microorganisms into the bloodstream, leading to sepsis.

Antiseptics like chlorhexidine are bacteriostatic, not bactericidal. Unless the skin is rehydrated, it cannot offer optimal protection. When combined with failed cannulation attempts, this becomes a recipe for disaster.

A Missed Opportunity for "First Do No Harm"

The Hippocratic oath demands we "Do No Harm." But current practice allows harm through:

• Painful, repeated needle insertions
• Bypass of infection control protocols
• False safety reassurance with incomplete solutions

The inventor of VenaiCan published an article titled "How Safe is the Safety Cannula?" in Arab Health World (2006), arguing that current designs protect the operator, not the patient.

The Future of Cannulation: “Venaican”

VenaiCan is the name of a spring-loaded, self-introducing mechanism that:

• Ensures first-attempt success.
• Reduce complicated manoeuvring of cannula before moving cannula forward.
• Reduces the need for skilled operators.
• Can be used as a traditional cannula or with the plunger system.
• Minimizes trauma, delays, and infection risk.
• Reduce doctors or nurses prolonged contact with serious infected patients.

There's no need to retrain staff. The device works conventionally or with one-handed spring deployment, adapting to any user.

Conclusion

We have made significant strides in material science, nurse training, and sharps safety, but not in insertion success. Every failed cannulation is a missed opportunity to prevent harm, sepsis, and suffering.

VenaiCan offers a real solution to the problem we've ignored for decades. It's time for regulators, healthcare systems, and manufacturers to embrace innovation, prioritising patient safety over operator protection.

References

1. Corrigan, A. (2010). Intravenous Therapy as a Speciality. In J. Hankins, R. L. Waldman, C. Henrick, & M. Perdue (Eds.). Infusion Therapy in Clinical Practice. (3rd ed.). Philadelphia, PA: WB Saunders.
2. Hyde L (2008) Legal and Professional Aspects of Intravenous Therapy, in Intravenous Therapy in Nursing Practice, 2nd edition, Blackwell Publishing
3. Kunac, T (2013) Intravenous Therapy: Then and Now, http://www.ivnnz.co.nz/files/file/7748/Intravenous%20Therapy%20%20The
4. n%20and%20Now%20%20July%202013.pdf
5. Millam, D. (2006). The History of Intravenous Therapy. Journal of Intravenous Nursing, 19, 5-14.
6. Rivera, A.M., Strauss, K.W., van Zundert, A., & Mortier, E. (2005). The history of peripheral intravenous catheters: How little plastic tubes revolutionised medicine. Acta Anaesthesiologia Belgica, 56, 271-282.