Challenging the distal-to-proximal cannulation technique for administration of anticancer therapies: A prospective cohort study

Raymond Javan Chan, Alison Alexander, Maree Bransdon, Joan Webster, Brett Gordon Maxwell Hughes, Leisa Brown, Therese Graham

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Distal-to-proximal technique has been recommended for anticancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous venous puncture proximal to the administration site. Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anticancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anticancer therapy via an administration site distal to at least 1 previous venous puncture on the same arm in a tertiary cancer center in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was 1 incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and 2 incidents of phlebitis at the administration site. Conclusion: A 24-hour delay is unnecessary if an alternative vein can be accessed for anticancer therapy after a proximal venous puncture. Implications for Practice: Infiltration can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anticancer therapy at a distal site if the nurse can confidently determine that the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

Original languageEnglish
Pages (from-to)E35-E40
JournalCancer nursing
Issue number5
Publication statusPublished - Sep 2012
Externally publishedYes


  • Ambulatory cancer care
  • Anticancer therapy
  • assessment tool
  • Cancer
  • center
  • Cytotoxic
  • Extravasation
  • Infiltration
  • Intravenous administration
  • Nursing assessment
  • Venous puncture
  • Vesicant


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