IV Catheters

Question 1

What are the 5 functions of catheters?

Answer 1

1. Fluid admin - lgst Vol/time + electrolytes/water/nutrients
2. Drug admin - Fastest onset
3. Blood products & transfusion machine
4. Monitoring BP (special type of cath)
5. Blood collection - cannulas for mult blood draws

Question 3

What are the 4 types of catheters?

Answer 3

Indwelling/overtheneedle
intracath/THRU the needle
butterfly cath
central venous cath

Question 4

What is an indwelling catheder?

Answer 4

most common, cath usually 2 gauges lrger than needle
needle (stylet) inside cath

Question 5

What is an intracath catheter

Answer 5

cath smler than needle
allow for longer cath
used for jugs + central lines

Question 6

What is a butterfly catheter?

Answer 6

long hollow tube attached to a short rigid needle
very short term fluid admin
blood collection

Question 7

What do you need to place a cath?

Answer 7

clippers, 3x clorhex scrub, 1x alcohol, scissorcs, 2 1/2” tape, 1x 1” tape, 2 cath, 3cc flush w/ 22g needle

Kling, vet wrap, e-collar, sharps container

Question 8

How do you select cath size?

Answer 8

1. size of patient? (diameter of vessel)
2. How long cath is in (longer caths more stable and less likely to cause mechanical irritation with phlebitis)
3. rate of fluid admin (lgr gauge for faster fluid rate - good for shock rates)

Question 9

What is the general ruse for cath size selection?

What do you do for cats <2.5kg and 4-6kg?
What do you do for dogs sm, med and lg

Answer 9

Always select the longest cath possible

Fel: <2.5kg (24g), 4-6KG (22g)
K9: Sm (22g), Med (20-22g), LG (18-20g)

Question 10

When do you select a smaller or larger cath?
A longer or shorter cath?

Answer 10

Smler - very dehydrated, bleed risk, friable veins
Lger - staying in longer, high fluid rate, valvy veins
Shorter - chondrodryplastic
Longer - catheter in for >1 day

Question 11

Which vein should you select?

Answer 11

Cephalic most common, alt is lat saphenous, avoid pathology limbs, place cath on limb closest to your dom hand

Question 12

How do you restrain your patient for iv cath?

Answer 12

Normally sternal on table/floor, also lat. Restrainer on OPPOSITE side as cath placement

Question 13

How do you prepare your site for placement?

Answer 13

shave over vein 2”x2”
Start distal 1/3 limb
Chlorhex scrub x3 scrub updown -> in circle
Repeat with alcohol

Question 14

What do you avoid when poking?

Answer 14

Avoid carpus - many branches, vein size tapers, irritating to patient,
avoid elbows - long caths will kink if elbow bent
alt loc - lat saphenous

Question 15

What do you do after you’ve opened your catheter

Answer 15

Remover bung and put back on
move stylet up to loosen it
no kinks, burrs or bent

Question 16

Describe inserting the catheter

Answer 16

hold hub/flashback chamber
bevel up -> flash -> advance 1-3 mm -> advance cath until hub meets skin -> hold off above and remove needle -> remove bung to put on cath

Question 17

How do you secure your cath?

Answer 17

Tape as close to bottom of hub as possible, tabbed.
Tape 1 - sticky up, butterfly, wrap around
Tape 2 - Sticky up, cross over, wrap around
Tape 3 - cut slit, sticky down, wrap around

Question 18

How do you flush the cath?

Answer 18

To check if still in
3cc saline, remove any air
attach syringe to hub. PULL BACK, then inject 1cc in a pumping manner

Question 19

How to keep the cath clean and secure?

Answer 19

e-collar
wrap for long term cath but 1 layer kling w/ 3+4 digits exposed, keep cath exposed, extend to before elbow
2nd layer vetwrap, same as kling,
Prevents fluids pooling in distal limb.
Must remove every 24 hours to monitor

Question 20

How do you maintain the catch?

Answer 20

if no continuous fluids, flush Q4h w/ saline - discard saline every 12-24h
check frequently for swelling, hematoma, reactions, temperature
cath change q72h unless otherwise directed
cath wrap removed q24h

Question 21

What do you monitor in a day with a cath?

Answer 21

patency - fluids running, cath clotted?
wet bandage - remove, double check cath, why bandage wet, replace
Swelling below cath - tape too tight
toes swelling if wrapped - bandage too tight
swelling above cath - infiltration (fluid escaping vein), remove cath, massage affected area for fluid relief, place new cath in NEW vein
Redness, pain, purulent discharge, exposed cath (remove and renew)
thrombosis (vein had cord like feeling - remove cath, clean w/ antiseptic solution, cover sterile gauze, alert dvm, new cath new limb)

Question 22

What are some potential complications of cathetics?

Answer 22

animal pulls out cath
occlusion - positional/clotting
catheter broke - damage of bent cath high risk of breaking off - foreign body emboli
phlebitis
infiltration of SQ tissues - if vein punctured or cath thru being, can leak around cath
Hemorrhage and SQ hematoma formation
air embolism - during flush/other injection
infection
allergic reaction

Question 23

How can you maintain asepsis? What are some things you should worry/know about

Answer 23

Wash hands before, clean insertion site, maintain sterility of cath (ends, caps, connectors)
hair, hand, table contaminated
rate of bacterial colonization of caths is 7-20%

Question 24

How do you remove a cath?

Answer 24

tape, scissors, alcohol, antiseptic ointment, clean gauze, vetwrap, wash hands, patient restrained
remove all tape
place vetwrap around gauze over site and pull out cath
apply pressure for 20 min w/ vetwrap - no longer than 30 min or occlude blood flow to distal limb
remove wrap + check for hematoma/oozing
clean blood w/ hydrogen peroxide