Test 1: Medication Administration (Yvorchuk)

Question 1

Can you explain how to cut the syringe to prepare meds?

Answer 1

Cut barrel at injection end and completely remove and smooth the edge so it’s not so rough and irritating and make sure to mix it with molasses or apple sauce or peanut butter, desired consistency between watery and ball (medium)

Question 2

How is oral medicine administered in horses?

Answer 2

directly by mouth

Question 3

Why would you not just administer drugs directly in their food? or why sometimes would you need to do that and what extra step would you do following?

Answer 3

Disadvantages: powder settles to bottom, lost, and not eaten

Can be used in horses is they are difficult to give meds or head shy, if used should mix with handful of feed and binder, feed directly by hand

Question 4

True or False:

We generally use balling guns in equine and bovine medicine administration.

Answer 4

False!!!!

Not in equine because it creates trauma in the back of the mouth!

Question 5

What needle size and technique do we typically use for IV injections

Answer 5

typically 18G 1.5 stage needle; always seed the needle to the hub (hub leading edge against skin)

Question 6

Where do we typically place IV in horses?

Answer 6

Jugular vein

Question 7

What do you have to avoid and is most important to look out for when placing an IV?

Answer 7

Carotid artery

Question 8

What 2 methods are there for IV access?

Answer 8

• Toward the head (for blood draw)

- Toward the heart

Question 9

Why would we place an IV toward the heart?

Answer 9

you can tell more easily the difference between the vein and the artery (artery it would shoot at you you could fix it fast!)

Question 10

IV catheters:

-Where can you place your hands and fingers

Answer 10

Only touch the hub

Question 11

What is the most common organism when introducing organisms

Answer 11

clostridium (high mortality rate)

Question 12

What colors are most needles

Answer 12

pink or green

Question 13

Needle shy horses shoed be injected IV or IM toward the heart or toward the head?

Answer 13

Toward the heart! If they spook and rear up and away they drive the needle into their neck (better) come back to them

Question 14

What types of syringes do you typically use?

Answer 14

Luer slip tip syringes, and typically use eccentric (better) when you enter vessel be somewhat parallel to jugular vein (within that vessel), allows you to be closer to the neck (centrally located port comes off the horses neck eccentric lays right up along the neck, use 6cc)

Question 15

Where on the neck is the jugular and carotid artery usually found for injections? Why wouldn’t we perform these higher up?

Answer 15

• distal portion of the neck (middle third ideally)
• if you’re too high at the bifurcation of the jugular higher risk of thrombosis if the jugular

-

Question 16

Why do we place the needle seeded up to the head? Describe the mechanics and basic what if process?

Answer 16

to ensure we don’t mistakenly inject into the carotid, make sure it’s all the way in and well placed into the jugular vein,

to be sure where you’re at when performing this injection

1. first place needle away from the syringe make sure where you’re at then hook on syringe
2. aspirate and get nothing

Now what do you do??

HOLD off jugular!! and aspirate again and get blood flash now!!

Now do you let go of jugular and inject? NO!!!! why??

Have to fill that jugular to get blood in that syringe so what does that mean about your needle?? so that indicates in the needle is up against the wall, in the wall or through to other side

so when you held off that jugular it popped back into the center of the vessel, so if you let go of vessel and inject needle goes back to where it was and its an intramural or extravascular injection…..SO leave the vessel held off and inject and then let go and pull out!!!!

Question 17

Why is it important that the substance enters the vein?

Answer 17

• damage and trauma if given extravascularly
• muscle necrosis
• pain
• pharmacokinetic effects of drugs
• scar tissue formation causing roaring
• perivascular jugular vein injections can cause roaring!!!! recently laryngeal hemiplegia

Question 18

Recommendations for needs size for IM

Answer 18

18-20 gauge (less specific)

Question 19

Needle size for IM depends on?

Answer 19

• how fast you need to get meds in
• viscosity (higher viscosity larger needle)
• where you are placing it

Question 20

What size needle can you NOT use for semimembranosus/tendinosis?

Answer 20

21 gauge (too small will bend the needle if they move)

Question 21

Want the _____ size needle that can be used to cause the least amount of trauma

Answer 21

smallest

Question 22

Meant to be injecting deep IM, is 1 inch okay?

Answer 22

No!!!

Always IM 1.5 inch

Question 23

Steps for IM

Answer 23

1. Needle in hand, holding it in hub (fingers fisted) not touching the needle
2. warn them
3. insert needle
4. hook on syringe
5. aspirate to check not in vessel, not meant to be there, why it needs to be to hub

Question 24

What are the landmarks of the neck injections?

Answer 24

1. Ventral to ligamentum nuchae( can abcess and don’t absorb drugs if injected in
2. Lateral processes of vertebrae (above or dorsal
3. Leading edge of shoulder
   - Avoid fascial planes

Question 25

What are the landmarks of the semitendinosus and membranosis injections?

Answer 25

1. One hand’s width below tuber ishia
2. One hand’s width above start of gastrocnemius tendon
3. Outside thigh

rectangle

Avoid fascial planes, don’t inject over croup or rump area or near tuber ishei

Question 26

Don’t be too ____ on pectorals? Why?

Answer 26

at thoracic inlet and they have a problem and has infection and can dissect through septic mediastinitis very bad,

be more ventral so it can drain if an abscess forms

Question 27

For neck/ semimembr. + tend. injections what is the volume limit per site?

Answer 27

10-15 cc maximum per site in the whole neck location

10-15 cc max for semi’s but you can have 2 sites of injection in the same limb at one time

Question 28

Death seizures and mild fasciculations are all caused by _____ injections?

Answer 28

Intracarotid injections

Question 29

Neuro dys (LH), sloughing, infections like septic thrombophlebitis, phlebitis, cellulitis, inflammation, and fibrosis are caused by ______ injections

Answer 29

Perivascular

Question 30

Intrathoracic dz (septic mediastinitis), cellulitis (clostridiosis), myositis, fibrotic myopathy, lameness, local inflammation/pain are all caused by ______ injections?

Answer 30

IM