IV Catheters Flashcards
What are the 5 functions of catheters?
- Fluid admin - lgst Vol/time + electrolytes/water/nutrients
- Drug admin - Fastest onset
- Blood products & transfusion machine
- Monitoring BP (special type of cath)
- Blood collection - cannulas for mult blood draws
What are the 4 types of catheters?
Indwelling/overtheneedle
intracath/THRU the needle
butterfly cath
central venous cath
What is an indwelling catheder?
most common, cath usually 2 gauges lrger than needle
needle (stylet) inside cath
What is an intracath catheter
cath smler than needle
allow for longer cath
used for jugs + central lines
What is a butterfly catheter?
long hollow tube attached to a short rigid needle
very short term fluid admin
blood collection
What do you need to place a cath?
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
How do you select cath size?
- size of patient? (diameter of vessel)
- How long cath is in (longer caths more stable and less likely to cause mechanical irritation with phlebitis)
- rate of fluid admin (lgr gauge for faster fluid rate - good for shock rates)
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
Always select the longest cath possible
Fel: <2.5kg (24g), 4-6KG (22g)
K9: Sm (22g), Med (20-22g), LG (18-20g)
When do you select a smaller or larger cath?
A longer or shorter cath?
Smler - very dehydrated, bleed risk, friable veins
Lger - staying in longer, high fluid rate, valvy veins
Shorter - chondrodryplastic
Longer - catheter in for >1 day
Which vein should you select?
Cephalic most common, alt is lat saphenous, avoid pathology limbs, place cath on limb closest to your dom hand
How do you restrain your patient for iv cath?
Normally sternal on table/floor, also lat. Restrainer on OPPOSITE side as cath placement
How do you prepare your site for placement?
shave over vein 2”x2”
Start distal 1/3 limb
Chlorhex scrub x3 scrub updown -> in circle
Repeat with alcohol
What do you avoid when poking?
Avoid carpus - many branches, vein size tapers, irritating to patient,
avoid elbows - long caths will kink if elbow bent
alt loc - lat saphenous
What do you do after you’ve opened your catheter
Remover bung and put back on
move stylet up to loosen it
no kinks, burrs or bent
Describe inserting the catheter
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
How do you secure your cath?
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
How do you flush the cath?
To check if still in
3cc saline, remove any air
attach syringe to hub. PULL BACK, then inject 1cc in a pumping manner
How to keep the cath clean and secure?
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
How do you maintain the catch?
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
What do you monitor in a day with a cath?
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)
What are some potential complications of cathetics?
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
How can you maintain asepsis? What are some things you should worry/know about
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%
How do you remove a cath?
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
