1. Intravenous Catheters
Reading Assignment: CTVT pages &

2. Vocabulary Words Patent Lumen Injection port Osmolality OTN / TTN/ CLC
Thrombosis
Stylet
Erythema
Flash Chamber
Chlorhexidine scrub
Aseptic technique
Phlebitis

3. Catheter Placement Sites
Peripheral Vein Catheterization
Cephalic, Medial Saphenous, Lateral Saphenous
Usually OTN
Cheap, simple and quick to place
Central Vein Catheterization (CLC)
Catheter placed into the jugular vein or femoral vein
TTN (jugular only) or Wire-guided
Multi-lumen options
Expensive, more complicated to place, most invasive to patient

4. Indications for an IV Catheter
Fluid therapy
Replacement fluids
To correct _______________
To correct ___________imbalances
Daily maintenance fluids
Fluids given during surgery
Medication administration
Repeated doses over an extended period of time
Quick access for critical/unstable patients
CRIs (fluids + medication)
Pain management and/or anesthesia

5. Indications for a Central Venous Catheter
_______________ drugs can be given simultaneously
Repeated blood collection
TPN
CVP monitoring
Note: IA catheters can be placed to directly monitor a patient’s blood pressure

6. Central Line Catheter Jugular is most common location
Animal is generally critically ill or
sedated
Usually is multi-lumen

7. CLC Placement Placed using the Placed using the Seldinger technique
Placement requires extra supplies:
Sterile gloves
Sterile drape
Suture supplies

8. Parts of the OTN Catheter

9. IV Catheter Gauges
Always use the largest gauge catheter the patient can comfortably accommodate!

10. IV Catheter Supplies For each item, please know what it will be used for.
Clippers with a 40 blade
Antiseptic scrub (chlorhexidine scrub & alcohol)
Appropriately sized catheter
Syringe filled with (heparinized) saline flush
Injection port or T port
White Tape (Zonus porus)
Vet Wrap
*Sterile gloves, suture supplies, sterile drape

11. Prior to retrieving patient:
Gather your supplies
Plug in clippers and test blade
Loosen your catheter parts, break the seal on the port
ALL PARTS MUST REMAIN STERILE
May or may not place with the plug attached
Flush your t-port if using one
Why?
Prepare your tape
Two thin, one large with slit, one large no slit

12. Prep the Site
Shave all the way around the leg on the most _________ aspect the vein is accessible.
Avoid clipper burn
Make edges neat!
Find the vein and remember where it is
3. Apply a “dirty” antiseptic scrub
This involves one chlorhexidine scrub gauze & one alcohol gauze
Purpose of this is to:

13. Aseptic Technique 4. Begin aseptic technique scrub
Alternate chlorhexidine and alcohol soaked gauze x 3 (6 pieces total)
The gauze/cotton is placed over the insertion site and then directed away from the insertion point
Gauze should not touch hair
You do not go over tissue twice with the same gauze
What is happening if you do?
Once your site is prepared you MAY NOT TOUCH IT AGAIN!

14. Catheter Placement
With the bevel up, place the stylet/catheter into the vein (stay parallel to vein) while watching the flash chamber.
The bevel should be visible past the catheter
These two pieces move as a single unit until in the vessel
Once you have obtained a flash, you then, very steadily, advance the catheter off of the stylet and feed it completely into the vein.
This is done with your ____________ finger.
The stylet DOES NOT move during this process
Purpose of the stylet:

15. Notes About Placement
It is sometimes necessary to advance the stylet and the catheter a little further into the vein (after you have a flash) before advancing.
This is only if the catheter needs more stability
Must stay parallel to the limb!
The step of advancing the catheter takes a lot of practice to make perfect.
If redirections are required: must move stylet and catheter TOGETHER as one
Facilitative incision may be required
When?

16. Continue Placement
Once you have the hub of the catheter up to the skin, ASK THE RESTRAINER TO STOP OCCLUDING
Remove the stylet
What do you think will happen once you do this?
How can you/restrainer prevent that from happening?
Never place your thumb/finger over the open hub
This can cause bacteria to go directly into the animal’s vein!
Place the injection port or T-port onto the catheter
Restrainer should release pressure now, but hold the limb

17. Secure in Place
1. Using one of your ½ inch tape strips, place it STICKY SIDE _____, underneath the hub of the catheter
Tape should go all the way up to the skin
Make a short side and a long side
Flip the short side over the hub and then the long side back over the short side
Wrap around the patient’s limb at least ___________.
“pinch pinch pinch”
2. Using the 1 inch piece with the slit, sticky side ________, place the slit under the hub, all the way up to the skin and wrap around the limb at least twice.

18. Checking Patency Now the catheter is secure
Flush the catheter to determine patency
Sterile saline or ______________ sterile saline
Technically this may be done at any point that you feel the catheter is secure
But don’t wait too long!
What should you do if the fluid forms a SQ bubble?

19. Continue to Secure
3. Using a ½ inch strip, sticky side _______, secure the port onto the catheter
Go under the port leaving a short tab and a long side
Wrap the short side around the port
Wrap the long side towards the other direction around the port and then around the limb at least twice
Pinch pinch pinch
4. The fourth piece of tape (1 inch) is used sticky side _______ and goes around limb once
Covers the entire area and used to record information:
5. Lastly place a piece of VetWrap (with a small hole in it for the port) over the whole set up to ensure cleanliness

20. Maintenance
Patients with an indwelling catheter that are not receiving fluids:
Must flush catheter every ___________ to check patency
All catheters should be constantly monitored for any signs of infection:
Erythema
Swelling
Tenderness upon palpation
Site is hot to the touch
Purulent discharge
Increased body temperature
Lethargy, change in vitals

21. Complications
Remove bandaging at least once every 24 hours to check for phlebitis or these other complications:
Swelling above site:
Swelling below site:
Catheter lumen visible:
Thrombosis-
Bandaging must be removed immediately and replaced if it becomes soiled or wet
Regardless of if there are complications or not, all peripheral IV catheters should be changed q __________.

22. Additional Information
For a quick reference to the information presented, please see pages in your DRG.