Intravenous Catheters

Question 1

Cephalic Vein

Answer 1

• Most common IV site

- Normally placed at the dorsomedial aspect of forelimb

Question 2

Saphenous Vein

Answer 2

• Commonly used
• Lateral saphenous is preferred as it’s easier to secure the catheter
• Medial saphenous is a less commonly used in cats

Question 3

External Jugular

Answer 3

• May be used in very small animals where the size of the limb makes placement very difficult

Question 4

Aseptic Placement Technique

Answer 4

• Hand hygiene including gloves (immune compromised or infectious patients)
• Clip with generous margin (ring bark on limbs)
• Prep with 2% clorhex then clorhex/alcohol wipe
• Place aseptically (15 degree angle) and secure
• Wrap with soffban and elastoplast with tport exposed for access

Question 5

Care

Answer 5

• Hand hygiene
• Check and rewrap q24h
• Monitor for phlebitis, pyrexia, inflammation around site (cellulitis), swelling of leg, catheter malfunction
• If using opsite do not remove unless above noticed, replace q72h
• Replace if soiled
• Clamp and bung if taking for walk
• Replace extension if soiled
• Replace tport/extension/giving set if visible blood clots
• If placed in emergency without aseptic technique, replace ASAP using aseptic techique
• Swap ports with sterile meths before using to inject
• Flush IV q4h with saline
• If patient chewing, check site for damage then put cone on
• If administering lipid products (e.g propofol) must replace lines q24h

Question 6

Arterial Flushing Technique

Answer 6

• Flush with heparinised NaCl q1-2h
• Check site q12h
• Replace q72-96h

Question 7

Peripheral Flushing Technique

Answer 7

• Flush NaCl q4h
• Check site q24h
• Replace q72h

Question 8

Central Flushing Technique

Answer 8

• Flush heparinised NaCl q4h
• Check site q8h
• Replace as per vet instructions

Question 9

Complications - Oedema

Answer 9

• Swelling distal to catheter may indicate bandaging materials too tight
• Swelling proximal to catheter may indicate catheter no longer in vein and fluids/meds are going SQ
• May indicate cellulitis

Question 10

Complications - Phlebitis

Answer 10

• Inflammation of vasculature
• Signs include erythema (superficial reddening of skin), oedema, tenderness on palpation, increase in skin temperature over vein and pyrexia

Question 11

Complications - Cellulitis

Answer 11

• Tissue inflammation around vasculature

- Signs include oedema, erythema and pain

Question 12

Complications - Thrombosis

Answer 12

• Blood clot
• Maintain patency through regular flushing
• Clots can travel and cause obstructions in the vasculature, or cause obstructions in the catheter preventing fluid therapy/medications to be delivered

Question 13

Complications - Self Mutilation

Answer 13

• Could result in catheter breaking while in vessel, potentially resulting in emboli and obstruction in the vasculature
• Could be caused by pain

Question 14

Complications - Oyrexia

Answer 14

• If no other known source it could be a sign of inflammation at the catheter site
• Remove catheter and replace in new location
• Clean and place a light bandage
• Closely monitor temperature

Question 15

Complications - Wet Bandage

Answer 15

• Occasionally the tport or extension may become loose if not tightened sufficiently
• If wet, retighten ports if needed
• Replace bandaging if wet or soiled