LA Injections and Phlebotomy Flashcards
What terms are used for a needle’s size?
- gauge
- length
The smaller the gauge number for a needle, what happens to the diameter of lumen?
it gets bigger
What needle gauges are typically used in vet med?
25 ga –> 14 ga
What needle lengths are typically used in vet med?
5/8” –> 1.5”
Picking the correct needle size is based on what?
- site of injection (SC, IV, IM)
- species being injected
- size/age of patient
- viscosity of medication
What is a deeper structure, therefore requiring a longer needle to inject this structure?
muscle
What is more superficial, therefore requiring a shorter needle to be used?
subcutaneous region
The species, size, and age of the animal you are injecting will affect what?
the thickness of skin your needle needs to puncture
Does a more viscous drug need a larger or smaller gauge needle to allow more ease while administering?
larger
Syringe size is selected based on what?
volume of medication being injected
What is the generale rule when it comes to selecting a syringe size?
use the smallest syringe size that holds the necessary drug volume and still allows you to aspirate
What needle size (gauge and length) is needed for an equine IM injection?
most commonly used is 20g, 18g if viscous medication
1.5”
What is the most commonly used site for an equine IM injection?
neck muscle
What are the neck borders for an equine IM injection?
dorsal border = nuchal ligament
ventral border = cervical vertebrae
caudal border = scapula
Other equine IM injection sites include pectoral muscle, semimembranosus and semitedinosus muscles. Why use these sites?
- rotating injection sites during multiple days of IM injections to prevent soreness
- pectoral muscle drains well so use that if horse has history of reaction to injection
Why do we no longer use the gluteal muscle as an equine IM injection site?
- this site does not allow drainage if the body reacts to the injection
- can result in abscess formation
Describe the equine/bovine IM injection technique.
- can create skin pinch to distract horse with non-dominant hand
- insert needle at 90 degree angle to the skin and insert all the way to the hub
- aspirate to confirm you did not hit a blood vessel
- steadily push plunger until all desired medication is administered
- pull needle out smoothly at the same 90 degree angle as you entered the skin
When injecting the pectoral or semi muscles for equine IM administation stand on the opposite side of your injection site. Why?
if the horse decides to strike or kick they will likely do so on the side you’re injection and not where you’re standing
Ideally, how much medication should you inject per IM site?
10mL max
What are the 2 techniques used to divide IM injections?
- fanning
- multiple injection sites
When using multiple injection sites, how far apart should they be?
at least 2” from initial site
Why should you switch needles if using the multiple site injection method?
to avoid dragging medication through skin layers
What needle size (length and gauge) is used for equine IV injections?
- 20g
- 1.5”
What part of the horse’s neck is used to access the jugular vein?
cranial 1/3
In the cranial 1/3 of the neck, what muscle separates the vein and artery?
omohyoideus muscle
Describe the technique used for equine IV injection.
- locate jugular groove
- hold off vein with non dominant hand a few inches below where you intend to insert needle
- insert needle bevel up at 15 degree angle to skin
- level out needle angle once half of needle is through skin
- insert needle to hub
- ensure you have drop(s) of dark blood in your needle hub
- attach syringe to needle
- aspirate to ensure you are still in the vein
- inject half of medication, aspirate again, inject rest of medication
- aspirate 1-2x at the end of injection to ‘flush’ needle hub
- smoothly pull out needle at the same angle it entered the skin
What sites are used for equine phlebotomy?
- jugular vein (most common)
- transverse facial vein
What needle size is used for jugular vein?
- 20g
- 1.5”
What needle size is used for transverse facial vein?
- 22-25g
- 1”
What are the two phlebotomy techniques used for equine?
- needle and syringe
- vacutainer
Describe the vacutainer phlebotomy technique in equine.
- remove cap from short needle
- screw needle into holder so that short needle is inside holder
- uncap long needle
- insert needle into vein
- push blood tube into holder until short needle pierces rubber top of blood tube
- allow blood to fill tube
- remove blood tube from holder
- remove long needle from vein
Which association dictates which routes of administration that are legal for medication and information provided on drug inserts and labels?
FDA (food and drug administration)
Which act provides guidelines on ethical extralabel use of drugs?
AMDUCA (animal medicinal drug use clarification act)
What refers to the length of time drug residues can be found in animal products?
withdrawal times
What program that sets the ideal practices, guidelines, and suggestions for responsible cattle management (but these are not legally binding rules)?
Beef quality assurance
What needle size (gauge and length) is used for bovine IM injection?
- 18-16g
- 1.5”
What is the recommended site if IM injection for bovine?
neck muscle
What are the borders for neck muscle IM/SC injection for bovine?
dorsal border = nuchal ligament
ventral border = cervical vertebrae
caudal border = cranial to the slope of the shoulder
For safety reasons, bovine IM injections should be done with one or two hands?
one handed
What needle size (length and gauge) should be used for bovine SC injection?
- 18g-16g
- 3/4”
Describe SC injection technqiue for bovine.
- needle should be inserted into the skin at a 45 degree angle into the SQ space
- aspirate to ensure you haven’t hit a blood vessel or gone through the skin on the other side
- administer the medication and remove the needle
Do you perform a skin tent for a SC injection in bovine?
no, you do them one handed for safety reasons
What needle size is used for a bovine jugular IV injection?
- 18-16 g (14g for thick medication or large volumes)
- 1.5”
What needle size is used for a bovine tail vein IV injection?
- 18g
- 1” (1.5” for fat cattle)
Descrobe tail vein injection technique in bovine.
- hold tail in non dominant hand approx. 1/3 from base of tail and lift tail up so ventral aspect of tail is accessible
- located and palpate the groove on midline then palpate the spaces between vertebrae
- insert the needle on midline, between the vertebrae at a 90 degree angle with the skin
- once you have approx. half the needle length inserted you may hit bone, back out your needle slightly and you should be in the vessel
- aspirate to ensure you are in the vessel
- inject medication
- pull needle out (do not hold off due to likelihood of contamination in this area)
What are the two location sites for bovine phlebotomy?
- jugular
- tail vein
What needle size should you use for bovine jugular blood draw?
- 18-16g
- 1.5”
What needle size should you use for bovine tail vein blood draw?
- 18g
- 1”
What are some IM injection complications?
- local tissue reaction (edema, heat, pain)
- hematoma
- abscess
- necrotic myositis
- anaphylaxis
What are some IV injection complications?
- local tissue reaction (IV drug administered perivascularly or hub of syringe isnt flushed with blood prior to removing needle from skin)
- hematoma (injection site not held off after needle is removed)
- seizure (medication administered in artery or too fast)
- collapse (medication administered in artery or too fast)
Why do we give all IM and SQ injections in the neck for bovine?
to comply with beef quality assurance guidelines
