IV catheters

Question 1

IV catheters are

Answer 1

 Small rubber tube
 Placed in a peripheral vein

Question 2

Functions of IV catheters

Answer 2

1. Fluids administration
    Largest volume administered over time
    Electrolytes and water
    Nutrients (dextrose, lipids)
2. Drug administration
    Fastest onset of action
3. Blood products and transfusion medicine
4. Monitoring blood pressure (special type of catheter)
5. Sample blood collection
    Can draw blood on insertion
    Repetitive sampling requires special types of catheters (cannulas)

Question 3

Types of catheter

Answer 3

 Indwelling/over-the-needle
 Intracath/through-the-needle- catheter
 Butterfly catheter
 Central venous catheter

Question 4

Indwelling/over the needle catheter is used when

Answer 4

 Most commonly used
 Catheter is usually 2 gauges larger than the needle
 Needle (stylet) is inside the catheter

Question 5

Intracath/Through the needle catheter

Answer 5

 Catheter is smaller than the needle
 Allows for a longer catheter
 Used for jugulars and central lines

Question 6

Butterfly catheter

Answer 6

 Long hollow tube attached to short rigid needle
 Very short term fluid administration
 Blood collection

Question 7

Equipment for placing an IV catheter

Answer 7

 Clippers (to shave fur)
 Surgical scrub diluted with water
 Alcohol
 3x3 or 4x4 gauze sponge (at least 4)
 Dampen minimum three with dilute surgical scrub
 Dampen one with alcohol (can also use alcohol wipe or bottle of alcohol)
 Scissors
 3 pieces of tape:
 2 pieces –>1/2“ (length should be 1.5 - 2x
diameter)
 1 piece –> 1” (length should be 1.5 - 2x diameter)
 2 Catheters –> one to use + one in case
 Infusion plug (optional)
 3cc syringe with sterile 0.9% saline or heparinized saline (aka “flush”), with 22g needle

Question 8

Factors to consider when selecting a catheter size

Answer 8

1. Size of patient as gauge is dependent on diameter of vessel
2. How long catheter will stay in
    Longer catheters are more stable in the vessel and less likely to cause mechanical irritation with resulting phlebitis
3. Rate of fluid administration
    Larger gauge will allow for faster fluid rate –> Especially important for treating with shock rates

Question 9

Catheter size for cats

Answer 9

<2.5 kg –> 24 g
4-6 kg –> 22 g

Question 10

Catheter size for dogs

Answer 10

Small –> 22g
Medium –> 20g – 22g
Large –> 18g - 20 g

Question 11

Select a smaller size catheter if

Answer 11

 Very dehydrated
 Risk of bleeding
 Friable veins (e.g., old cats with untreated hypertension)

Question 12

Select a larger size catheter if

Answer 12

 Staying in longer
 High fluid rate
 Veins have lots of valves

Question 13

Select a shorter catheter if

Answer 13

Chondrodysplastic

Question 14

Select a longer catheter if

Answer 14

Catheter will stay in longer (one or more days)

Question 15

how to select a vein

Answer 15

 Cephalic vein is most commonly used
 Alternative is the lateral saphenous vein
 Avoid limbs with pathology such as a mass or wound
 When starting out, place catheter on the limb on the side closest to your dominant hand

Question 16

How to restrain a patient for catheter

Answer 16

 Animal is preferably in sternal recumbence on table or floor. Can also place in lateral.
 The person restraining is on the side opposite from leg having catheter placed

Question 17

Site selection and prep for IV

Answer 17

 Shave hair from area over the vein
 Allow area 2”- 3” (length) x 1”- 2” (wide)
 Start in distal 1/3 of limb between elbow and carpus
 Clean shaved site:
 Take a gauze with diluted surgical scrub (e.g., Hibitane, chlorhexidine) and starting in the centre of clipped area, wipe in gradually larger circles until edges reached
 Repeat twice more starting in centre and working outwards
 Hair is contaminated, so never go back towards the center
 If skin is still dirty, continue until cleaned
 Follow with an alcohol soaked gauze or wipe; or pour small amount of alcohol over surface and allow to drip dry

Question 18

What to monitor for IV

Answer 18

 Patency - Are fluids running? Has catheter clotted?
 If bandage is wet
 Remove bandage, ensure catheter is performing (connected to fluids, not pulled out), find reason for wetness and correct, replace with fresh dry bandage
 Swelling distal to catheter
 Tape is too tight
 Swelling of toes if wrapped
 Bandage too tight
 Swelling proximal to catheter
 Indicates infiltration (fluid is escaping the vein)
 Need to remove catheter
 Massage of affected area may be indicated to relieve fluid pressure on the tissues
 Place new catheter in new vein
 Redness, pain, increased skin temperature
 Hematoma
 Purulent discharge (infection)
 Exposed catheter
 Remove and place new catheter
 Never push an exposed catheter back into the vein
 Thrombosis
 Vein stands out on its own and has a cord like feeling
 If seen  remove catheter, clean site with antiseptic solution, cover with sterile gauze, inform attending
 Place new catheter in new limb

Question 19

Potential complications of IV

Answer 19

 Animal pulls out catheter (lack of treatment)
 Occlusion – Flow stops
 Can be positional, or clotting
 Catheter breakage
 Damaged or bent catheters have higher risk of breaking off –> can cause foreign body emboli
 Phlebitis
 Infiltration of subcutaneous tissues
 If vein is punctured or catheter goes through vein
 Can also leak around catheter at venipuncture site
 Hemorrhage and subcutaneous hematoma formation
 Air embolism – During flush or other injection
 Infection
 Allergic reaction

Question 20

Removing a catheter

Answer 20

 Equipment
 Tape, scissors, alcohol (optional)
 Antiseptic ointment (optional), clean gauze, vetwrap, wash hands
 Have patient restrained
 Stop any fluids
 Remove all tape
 Can easily remove by pouring alcohol over tape
 Place folded piece of gauze flat over catheter insertion site and apply gentle pressure while pulling out catheter
 Optional: Apply small amount of antiseptic cream to gauze prior
 Apply pressure for minimum of 20 minutes by wrapping with vetwrap
 Do not leave longer than 30 minutes as may occlude blood flow to distal limb
 Remove wrap and check for hematoma or oozing
 Clean any blood from area with hydrogen peroxide