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What is Butterfly Cannulation? – Step-by-Step Guide

Phlebotomy Training Institute
9 Mins Read

We all know how thin and wiggly veins make cannulation procedures difficult, and the perfect solution to this problem is the Butterfly Cannulation! But “What is butterfly cannulation?”

Butterfly cannulation is when medical professionals use a special needle with wings shaped like a butterfly to put medicine and fluids or draw blood from a vein.

What makes this needle a popular option is it is easier to hold, it hurts less and it feels more comfortable, especially for those with small or weak veins. Another important aspect of this type of cannulation procedure is it stays in place for up to 14 days, depending on the medicine.

So, in this blog, we will get into the details of what Butterfly Cannulation is and also have a look at the steps to follow for the butterfly cannulation procedure.

Cropped view of phlebotomist filling up a vial of blood from patient using a butterfly needle.

What is Butterfly Cannulation?

Butterfly cannulation, also known as butterfly needle insertion, is a procedure used to access a vein for purposes like blood draw or administering fluids/medication. Definitely, you might wonder what’s the speciality of this butterfly needle from the typical straight needles.

Here’s why:

  • Gentler: They’re thinner and have wings for stability, which ultimately makes them more comfortable for patients compared to thicker straight needles.
  • Better for small veins: They work well with thin, wiggly veins that might be tricky to hit with a straight needle.
  • Faster access: They often allow for quicker access to veins, saving time during procedures.

So, regular needles are strong, but for quick tasks and finicky veins, butterfly needles are the champions!

Why Use a Butterfly Needle?

Butterfly needles are typically used in the following situations:

  • Blood Draws: For routine blood tests.
  • Infusions: To administer medications, fluids, or nutrients directly into the bloodstream.
  • Paediatric and Geriatric Care: The small size and flexibility make them ideal for use in children and older patients.
  • Patients with Difficult Veins: They are easier to use on veins that are small, rolling, or hard to find.

Cropped view of phlebotomist wearing latex gloves drawing blood from a patient using a butterfly needle.

A Step-by-Step Guide to Butterfly Cannulation

Knowing the right steps for Butterfly Cannulation is important because it helps medical professionals do the procedure safely and correctly. If not done correctly, it can cause pain, bruising, and infection, and it might not work properly.

That’s why check out the steps one by one.

Gathering the Essentials

Here’s what you need to perform the procedures.

Butterfly Needle Set

  • A small needle (23 to 25 gauge)
  • Two plastic wings
  • Clear plastic tubing
  • A connector

Other Supplies

  • Chlorhexidine 2% solution or 70% isopropyl alcohol swabs to clean the skin
  • Tape
  • Clean, disposable gloves
  • Medicine in needleless butterfly syringes with a LuerLock
  • Extra 0.4 mL of medicine to prepare the tubing and needle
  • IV connector without needles
  • Transparent dressing to secure the needle and syringe
  • Sharps container to dispose of needles safely

Make sure you have all these tools ready before you start to keep the procedure safe and efficient.

As a next step, follow the below instructions.

  • Wash Hands: Thoroughly wash your hands with soap and water to ensure a sterile environment.

Wear Gloves: Put on clean, disposable gloves to maintain hygiene and protect yourself and the patient.

Delighted adult female lying on couch and talking over mobile phone while getting skin nutrition via venous cannulation

Patient Preparation

First prepare your patient following the below steps.

  • Explain the Procedure: Inform the patient about what you are going to do to help reduce anxiety and gain their cooperation.
  • Position the Patient: Make sure the patient is comfortable and position their arm in a way that makes the veins easily accessible.
  • Apply the Tourniquet: Tie the tourniquet around the upper arm to make the veins more visible. Be careful not to tie it too tightly.

Site Selection and Cleaning

Site selection is a very important step. Follow the below methods carefully.

  • Choose a Vein: Select a suitable vein, usually in the arm or hand. The cephalic, basilic, or median cubital veins are common choices.

Clean the Area: Use an alcohol wipe or chlorhexidine solution to clean the selected area in circular motions. Dry the area completely to reduce the risk of infection.

Cropped view of phlebotomist wearing latex gloves drawing blood from a patient using a butterfly needle.


Here’s how you’ve to perform the cannulation.

Prepare the Butterfly Needle:

  • Remove the slide clamp and vent plug if not needed.
  • Attach the needleless connector or LuerLock to the Y port.
  • Fill the syringe with medication, adding an extra 0.4 mL to prime the tubing.
  • Rotate the white safety shield to loosen the needle.
  • Make sure the bevel (slanted tip) is up.

Insert the Needle:

  • Hold the needle by pinching the plastic wings together.
  • Pinch the skin at the infusion site.
  • Insert the needle at a 30 to 45-degree angle into the subcutaneous tissue.
  • Release the wings and hold them flat on the skin.
  • Remove the white safety shield.

Secure the Needle:

  • Once the needle is in the vein, use the wings to tape it down securely to the patient’s skin to prevent movement.

Release the Tourniquet:

  • Once the needle is in place and blood flow is established, release the tourniquet.

Drawing Blood or Administering Medication

Follow the below steps either to draw blood or administer medication to the patient.

Attach Syringe or IV Tubing:

  • Connect the syringe or IV tubing to the butterfly needle.

Draw Blood or Administer Medication:

Slowly draw the required amount of blood or administer the medication/fluids as needed.

Close-up of doctor’s hand using sanitiser gel.

Completing the Procedure

Here’s how you’ve to finish the procedure.

Remove the Needle:

  • Once the procedure is complete, carefully remove the butterfly needle. Apply gentle pressure with sterile gauze to the insertion site to stop any bleeding.

Dispose of the Needle:

  • Immediately dispose of the used needle in a sharps container to prevent any accidental needle sticks.

Apply Bandage:

  • Cover the insertion site with an adhesive bandage to protect it.

Remove Gloves and Wash Hands:

  • Dispose of your gloves and wash your hands thoroughly.

Label the Dressing:

  • Write the medication name, dose, insertion date, time, your initials, and your role on the dressing.

Record the Procedure:

  • Note the date, time, medication concentration, dose, route, injection site, catheter size, site assessment, patient response, and your details.

Read our informative blog if you want to learn the step-by-step process of Hand Cannulation.

Cropped view of medical worker wearing latex gloves doing disinfection before sampling blood for test.

What You Must Check in the Injection Site

Checking the injection site is really important to make sure the patient is okay, especially when they’re getting their medicine under the skin. Here’s what to look for:

  • Make sure the needle or tube hasn’t moved.
  • Check if the skin feels hard or sore where the medicine went in.
  • Look for any bruising.
  • See if there’s any liquid leaking from the site.
  • Watch out for swelling.
  • Check if the skin looks red or irritated.
  • Look for blood in the tube.
  • Ask the patient how they feel and if they’re in pain.
  • Make sure the infusion device is working right.
  • Check how much medicine is left in the syringe.
  • Make sure everything is connected properly.

It’s important to keep an eye on these things to catch any problems early and keep the patient safe. And remember to switch where you put the needle regularly to avoid issues from having it in one spot for too long.

Want to learn about different types of cannulation needles? Check out our recent blog now.

Tips for Successful Butterfly Cannulation

Here are some tips for you to successfully perform the butterfly cannulation:

  • Stay Calm and Confident: Your confidence can help relax the patient.
  • Be Gentle: A gentle approach stops discomfort and makes the process smoother.
  • Use Proper Lighting: Good lighting can help you see the veins more clearly.
  • Warm Compress: Applying a warm compress to the area can help dilate the veins. Thus, you can easily find the vein.

Want to learn the detailed process of IV Cannulation? Visit our informative blog on this topic now.

Wrapping Up

So, that’s all about your question, “What is Butterfly Cannulation?” with a step-by-step guide. Butterfly cannulation is a helpful way to reach veins, especially in patients with difficult veins. By preparing well, using the right method, and taking care afterwards, you can do this procedure easily and without problems.

No matter if you’re a healthcare professional or a student still learning, getting good at butterfly cannulation, helps you take better care of patients. Plus, you know that using cannulation without the right training can be risky. That’s why it’s important to learn from a good institute. Knowing how to put a tube in someone’s vein is really important in healthcare.

Getting certified from a recognised program, like the one at the Phlebotomy Training Institute, makes sure you learn everything you need. This training, CPD-accredited and NHS-accepted, boosts your skills and makes you more confident in cannulation. It mixes hands-on practice with online lessons for a full education.

Before you start learning cannulation, make sure you’ve already done phlebotomy training.


1) Are butterfly cannulas painful?

No, butterfly cannulas are not painful because they’re small and shallow. They access veins near the skin’s surface with less discomfort.

2) Can butterfly cannulas be used for blood transfusions?

Butterfly cannulas are generally not ideal for blood transfusions. Their small size makes the process slow and risks clotting. Larger needles or central lines are preferred for safe and efficient blood transfusions.

3) What happens if a butterfly cannula leaks or infiltrates?

If a butterfly cannula leaks or infiltrates (fluid seeps outside the vein), stop the infusion immediately. Remove the cannula and apply pressure to the site. A trained healthcare professional will evaluate and restart the procedure at a different location.

4) Are there any aftercare instructions for a butterfly cannula insertion site?

Yes, keeping the insertion site clean and dry and avoiding pressure on the area is crucial.

5) What are the differences between butterfly cannulas and scalp veins for blood draws in infants?

Butterfly cannulas are tiny needles for short-term blood draws. On the other hand, scalp veins are the accessible veins on an infant’s head, often used for quick blood draws because they’re easy to see. Think of a butterfly cannula as a thin straw and a scalp vein as a bigger drinking tube – both get the job done, but the bigger one works faster.


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