Intravenous Catheters Flashcards
What are some functions of IV catheters
Fluid administration Drug administration Blood products and transfusion medicine Monitoring blood pressure Sample Blood collection
What is the difference between IV fluid administration and oral/SQ
Oral and SQ have a limit to amount and time for absorption
What method of fluid administration has the fastest onset of drugs
IV -almost immediate
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
What are the 4 types of IV catheters
Indwelling
Intracath
Butterfly
Central venous
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
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
Describe a butterfly catheter
Long hollow tube attached to a short rigid needle
For Very short term fluid administration (bolus) or blood collection
What is a central venous catheter
Used for jugular catheter placements
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
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
Longer catheters are more stable, so these are recommended for ___ term use and will reduce risk of ___
Long term use
Phlebitis
What is phlebitis
Inflammation of the blood vessel
A larger gauge catheter will allow ___ fluid rates (important in shock)
Faster
What is the general rule when choosing catheter length and gauge
The largest and longest catheter possible that sits comfortably in the vein
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
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
When should you select a smaller gauge catheter
Dehydration
High risk of bleeding
Friable veins (hypertension)
When should you choose a large gauge catheter
Staying in longer
High fluid rates
Veins with lots of valves
When should you select a shorter catheter
Chondrodysplastic dogs (short legs)
When should you select a longer catheter
Staying in longer
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)
