Routes of Administration (ASAN002/10) Flashcards
Fluid Therapy – Routes of Administration:
Oral\nSubcutaneous\nIntravenous\nIntraosseous\nIntraperitoneal
Oral
Most physiological route of fluid admin.\nFluid absorption not rapid enough via this route for cases were fluid loss has been extensive or blood flow is inadequate.
Oral route – Contraindications:
in vomiting patient.\ncontraindicated due to illness.\nsurgical procedure.\ninadequate for animals that have had acute or extensive fluid lossess.
Subcutaneous
Rate of absorption approx 6 – 8hrs (in the absence of vasoconstriction &/or hypovolemia).\nIsotonic fluids only to be administered SQ.\nPotassium supplementation can be added to fluids up to 40 mmol/L.
Subcutaneous – Fluid Administration:
Fluid injected in the subcutaneous tissues over dorsal neck and cranial trunk.\nFluids should be body temp to ↓ patient discomfort & improve absorption.\nRate & volume of fluids will vary from patient to patient.
Subcutaneous – Administration tips:
Massage area being injected – this will help prevent formation of a lump.\nIf large amts need to be administered, divide into small amts and inject into different sites.\nie if 100mls needed = 4 separate injections of 25mls.
Subcutaneous – Complications:
Skin necrosis\nInfection
Intravenous
Best choice for restoring vascular volume.\nRapid fluid absorption.\nRate & volume of fluid will vary from patient to patient, based on patient condition and desired outcome.
Intravenous – Solutions that can be administered:
Isotonic\nHypertonic\nHypotonic
Intraosseous
Fluids administered via the bone marrow.\nFluid absorption is rapid.\nVeins in bone marrow drain into the systemic venous system, enabling quick & effective absorption of fluids.
Intraosseous – when to choose this route:
This route is indicated when it is difficult to gain venous access using standard techniques.\nNeonate patients.\nPatients with collapsed circulation.
Intraosseous – sites for catheter placement:
Tibial crest\nInter–trochanteric fossa of the femur\nWing of ilium\nTibial tuberosity\nGreater tubercule of the humerus
IMAGE – Intraosseous Injection Sites
https://images.cram.com/images/upload-flashcard/65/28/30/34652830_m.png
IMAGE – Disposable Intraosseous Needles
https://images.cram.com/images/upload-flashcard/65/28/33/34652833_m.png
Intraperitoneal
Administration of fluids into the peritoneal cavity.\nRate of absorption roughly equivalent to SQ route.\nDoes not have advantages over other routes, therefore is used as a last resort.
Intraperitoneal – Potential Complications:
Peritonitis\nIntra–abdominal abscess
Intravenous Catheters
Intergral part of everyday vet med.\nVN must understand reasons for use, type, placement & monitoring of IV catheters.
IV Catheters – Reasons for use:
Administration of IV medications\nAdministration of IV fluids\nAdministration of blood & blood products\nEnsure IV access available if required\nMultiple blood sampling\nCentral venous pressure
IV Catheters – Admin of IV Medications:
Meds may not be able to be given orally due to patient condition.\nPO may be contraindicated for the medicine.\nRapid onset of meds may be required & IV is the fastest route for drugs to be absorbed into the blood stream, ie ↑ onset of action.
IV Catheters– Admin of IV Fluids:
Rehydration & maintaining hydration of patients.\nAll types of fluids can be administered IV & are rapidly absorbed.
IV Catherters – Admin of Blood & Blood Products:
IV is recommended route for blood & blood products.
IV Catheters – Ensure IV access available:
ie. During Surgical Procedures\nfor induction agent admin\nin case of emergency under GA, iv access is already in place.
IV Catheters – Multiple Blood Sampling:
Type & site of IV catheter placement will be dependent on patient, illness and tests required.\nPrevents multiple venipuncture to obtain blood samples.
IV Catheters – Central Venous Pressure (CVP):
CVP is measured by placing a central line via jugular vein.\nTo monitor fluid therapy & hydration in critical care patients.\nCPV is the pressure of blood in the thoracic vena cava, near right atrium of heart. \nReflects the amt of blood returning to the heart and the ability of heart to pump blood into the atrial system.
Choosing type & site of venous access:
Factors to consider:\nPatient’s condition\nPatient’s treatment plan\nReason for venous access\nAccessible vein(s)\nAvailability & type of catheter\nSkill of person placing catheter
Types of Catheters
Winged or Butterfly \nOver–the–Needle\nThrough–the–Needle
Type, length & gauge of catheter to use:
Dependent upon:\nSpecies & size of patient\nAvailable veins to be used\nReason for catheter placement
Winged or Butterfly catheters
Generally short–term use\nPatient not overly mobile (ie during anaesthetic, medication admin)\nCatheters easy to place\nDifficult to maintain\nCan easily puncture the vessel wall
IMAGE – Butterfly Catheter
https://images.cram.com/images/upload-flashcard/66/35/21/34663521_m.png
Over–the–Needle catheters
Most commonly used\nCatheter is placed over metal stillette\nEasy to place\nPrimarily used in peripheral veins (e.g. cephalic)
IMAGE – Over–the–Needle catheters
https://images.cram.com/images/upload-flashcard/66/35/43/34663543_m.png
Through–the–Needle catheters
Catheters are passed through the stillette\nPrimarily used in jugular veins
Multi–lumen catheters
Have 2 or 3 catheters in one lumen (tube)\nUsually placed in jugular veins\nExpensive\nRequire a skilled operator
IMAGE – Through–the–Needle catheter
https://images.cram.com/images/upload-flashcard/66/35/53/34663553_m.png
IMAGE – Peel–away Central Line Catheter
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Suggested Lumen Uses for \nTriple Lumen catheters\n(e.g. Cook products)
Lumen 1 – Red (proximal port):\nMedication\nFluid \nMedication\nAcute hyperalimentation\nBlood or blood products\nBlood sampling\nCentral Venous Pressure (CVP)
Central Lines or Jugular Lines
recommended for long–term use\nNo. of lumens needed dependent on patient condition, fluid therapy, blood sampling & IV meds required.\nCentral lines – used to measure CVP\nMulit–lumen catheters – generally made from silicone (least reactive for IV use).
