Intravenous Catheterization Techniques & Taping Procedure

Introduction

I.V. (Intravenous) Catheters:

1. Used extensively in sick pets or pets about to be anesthetized.

2. Allow administration of medication directly into the venous system

    Rapid distribution to the whole body. 
    Medication acts faster and is more controllable.

3. Placement of catheter requires technical skill and knowledge.

4. As in small or dehydrated pets

    The veins in these pets are small and damage easily.

Catheter Principles:

• Because the catheter is introduced directly into the venous system, it must be placed in an aseptic manner. 
• Catheter should be replaced after 3 days in order to minimize the chance of infection. 

I.V. catheters are usually placed in one of three veins: 

Cephalic Vein:
This is by far the most common vein to use. It runs along the top of the foreleg of dogs and cats. 

Jugular vein:
This vein is in the neck. A catheter placed in this vein allows longer term use and the ability to give larger volumes of medication with different viscosity's.

Saphenous: 
This vein is on the back legs. It is mostly used when the cephalic.

Placement of a Butterfly Catheter 

Butterfly catheters have a steel needle (a) attached to flexible plastic wings (b) and a short piece of extension tubing (c). A 3 way stopcock (d) is attached to the catheter in this slide but is not used when the butterfly catheter is placed IV.

Cephalic Vein (View 1)

Cephalic Vein (View 2)

Cephalic Vein (View 3)

The needle is inserted into the vein to the level of the plastic wings. Notice that the catheter has been placed at the junction of the cephalic vein with the accessory cephalic vein. 

Taping Procedure

Puncture the skin and vein in one swift movement.

As the needle is removed, blood will flow from the catheter at this time the holder should remove their thumb from the dorsum of the leg.

• After the stylette is removed, an injection cap is placed and the catheter is flushed well with saline or heparinized saline, to assure patency. 
• Dry the leg and the catheter with gauze before applying tape.

Using a piece of tape ~ 1.5 times the circumference of the leg, make a longitudinal tear about 5 cm long.

Fold one of the narrow pieces, sticky side to the sticky side, onto the untorn part of the tape.

Place the thin piece of tape, sticky side up, under the catheter.

Wrap the wide piece of the tape around the leg.

Saphenous Vein

View 1

Notice the venipuncturist has placed thumb adjacent to the vein to  stabilize it. 

Placement of a Jugular Catheter 

Materials required are shown in the picture.

• A jugular catheter can be placed with the patient in sternal recumbency, with the neck extended upwards or in lateral recumbency. 
• Digital pressure is applied at the thoracic inlet to cause the jugular vein to distend with blood. 

Jugular Catheter

The pictures below shows placement of a jugular catheter using an Intracath. 

The needle guard is folded over the needle like a clamshell. 

• The tip of the needle (a) is within the needle guard so the needle does not lacerate the catheter.
• The wire stylet (a) is removed, Make sure that the hub of the catheter (b) is firmly locked into the hub of the needle (c) when the stylet is removed.

Gauze square under the catheter.

Venipuncture of the Cat

Jugular Vein

• A canvas or nylon, zippered bag can be used to restrain a cat for jugular venipuncture or catheter placement. Some bags have multiple zippers to allow access to limbs.
• The cat is held in dorsal recumbancy.
• Place a finger in the thoracic inlet to impair venous return from the head and cause the vein to distend with blood.

Medial Sephanous Vein

• The same techniques for placing cephalic and jugular catheters as described for the dog, are applicable to the cat.
• The medial saphenous vein of the cat has a long straight course and is very superficial. The red arrows point to the vein.
• The cat is restrained in lateral recumbancy. The holder applies pressure in the inguinal region to occlude venous return and cause the vein to engorge with blood.

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