Intravenous Catheters Flashcards by Emily Ulrich

What are some functions of IV catheters

Fluid administration 
Drug administration
Blood products and transfusion medicine
Monitoring blood pressure 
Sample
Blood collection

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What is the difference between IV fluid administration and oral/SQ

Oral and SQ have a limit to amount and time for absorption

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What method of fluid administration has the fastest onset of drugs

IV -almost immediate

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What are the parts of a catheter

Bung -cap/needle cover
Hub -usually has wings/coloured part
Flashback chamber -needle grip where you see the flash of blood
Cap -closes off the catheter

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What are the 4 types of IV catheters

Indwelling
Intracath
Butterfly
Central venous

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Describe an indwelling catheter

The catheter is over the needle -catheter is 2 gauges larger than the needle -needle is inside the catheter

Most common

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Describe an intracath catheter

Catheter is smaller than the needle -inside the needle

Allows for a longer catheter

Used for jugulars and central lines

Sturdier than other catheters

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Describe a butterfly catheter

Long hollow tube attached to a short rigid needle

For Very short term fluid administration (bolus) or blood collection

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What is a central venous catheter

Used for jugular catheter placements

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What is the equipment needed to place a catheter

Clippers
4 pieces of gauze 
Surgical scrub and alcohol
Scissors 
3 pieces of tape (two 1/2 inch and one 1 inch)
2 catheters
Infusion plug or cap
3cc syringe of flush with 22g needle

For long term:
Vet wrap
Kling wrap
E collars

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What factors should you consider when choosing a catheter size

Size of patient/vein
How long the catheter will be in
Rate of fluid administration

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Longer catheters are more stable, so these are recommended for ___ term use and will reduce risk of ___

Long term use

Phlebitis

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What is phlebitis

Inflammation of the blood vessel

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A larger gauge catheter will allow ___ fluid rates (important in shock)

Faster

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What is the general rule when choosing catheter length and gauge

The largest and longest catheter possible that sits comfortably in the vein

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What is a rough estimate for catheter gauge in a <2.5 kg cat and a 4-6 kg cat

<2.5 kg: 24 gauge

4-6kg: 22 gauge

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What is a rough estimate for catheter gauge in small, medium and large dogs?

Small: 22 gauge
Medium: 20-22 gauge
Large: 18-20 gauge

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When should you select a smaller gauge catheter

Dehydration
High risk of bleeding
Friable veins (hypertension)

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When should you choose a large gauge catheter

Staying in longer
High fluid rates
Veins with lots of valves

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When should you select a shorter catheter

Chondrodysplastic dogs (short legs)

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When should you select a longer catheter

Staying in longer

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What is the most commonly used vein for IV catheters and why? what is one possible alternative?

Cephalon vein is most common: it is straight, Unbranched and easily accessed

Lateral saphenous is an alternative

True or false

It is okay to put a catheter in a limb with pathology or a mass

False

Avoid these limbs

True or false

The restrainer can be on the same side as the limb being used for IV catheter placement

False

Should stand on the opposite side

How much should you shave the area for an IV catheter

2-3 inches by 1-2 inches -varies with size of patient

Where should you shave the limb for catheter placement, why this area?

Distal 1/3 or 1/2 between the elbow and carpus If the vein blows and you need to try again, try again above the “blow”, never below

Why should you avoid areas on the limb like the carpus and elbow

Carpus has too many branches, the vein tapers and it can be Irritating to the patient The elbow bends and the catheter may kink

Describe how to clean the site for IV catheter placement

After shaving, take gauze soaked in surgical scrub and start where you will poke on the vein. Move outwards in circular motions while rotating the gauze to keep the edge touching the hair on the hair. Do this At least 3 times or until clean. Then do at least 1 gauze with alcohol using same technique or pour alcohol directly onto puncture site

What should you do right when you open the catheter

Check for any damage Loosen the moveable parts Keep sterile with packaging

What parts of the catheter do you not want to touch

Cannula Needle/catheter End of cap

True or false | It is okay to have the bevel pointed any direction

False | Bevel is always up

After you see a flash when placing a catheter, what do you do

Advance the whole unit 1-3mm then advance just the catheter until the hub meets the skin

True or false | Once the catheter is in you can let go of the limb

False | Always have one hand on the patient until all the tape is placed

How much of the hub should be kept clear when taping

Top 1/3 of the hub (to leave room for infusion plug or cap to be put on

What is best practice when taping a catheter in place

All tape should be tabbed and wrap around the limb in the same direction

Why do you flush a catheter after taping it in place

To test patency

What can air in your flush cause

An air embolism

How do you know the flush is going into the vein and that the catheter is patent

Smooth flow while pushing with no resistance Can feel a steady stream when palpating the vein and can also feel a pulsed stream

What are two ways to keep a catheter protected and clean for long term use

E collars Long term wraps with kling and vet wrap

What does a long term wrap also prevent

Pooling in the distal limb

How often must you remove and replace long term wraps on catheters

Every 24 hours to check limb and puncture site

If the catheter is not attached to fluid, how often should you flush the catheter and why

Every 4 hours to prevent clotting

How often should you discard of bags of saline

Every 12-24 hours

What are things you should check for on IV catheters

``` Patency (flush) Swelling Redness Pain Temperature (hot and cold) Hematoma or adverse reactions Discharge (infection) Exposed catheters Thrombosis ```

How often should catheters be changed

Every 72 hours

What do you do if the bandage around a catheter is wet

Remove bandage and ensure patency of the catheter Find reason for wetness: if it is because the catheter is out of the vein, replace catheter in a new area or just change the bandage

What does swelling distal to the catheter mean

Tape/wrap is too tight

What does swelling of the toes mean

Bandage/wrap is too tight

What does swelling proximal to the catheter mean

Infiltration: fluid is escaping the vein into the SQ Need to remove the catheter and replace elsewhere. Massage area to relieve swelling

What is thrombosis

The vein stands out and has a cord like feeling (looks like it is being occluded) Must remove the catheter

What are some potential complications associated with IV catheters

Animal pulls out the catheter Occlusion (from positioning or clotting) (common in short legs) Catheter breakage (can cause foreign body emboli) Phlebitis Infiltration (if the vein is punctured or catheter goes through vein or if it is leaking into SQ at the venipuncture site) Hemorrhage/hematoma Air embolism Infection or allergic reaction

What is the rate of bacterial colonization of catheters

7-20%

How long should you apply pressure on the area when removing a catheter

Minimum of 20 minutes Maximum of 30 minutes (can occlude blood flow to the limb)