Intravenous catheter techniques
Objectives: To familiarize the veterinary technology student with the basic techniques of placement of intravenous catheters. The student should be able to accurately place a secure catheter using aseptic technique in a peripheral vein.
Keywords: peripheral veins, sterile scrub technique, heparin, flashback, stylet, hub, over the wire, double-bore
Below is a step by step diagram and brief explanation of one of the techniques used at the Veterinary Technology Program NVCC.
A) Aseptic patient preparation
2) A heparinized saline flush is prepared, intravenous fluids are ready,
an over the needle catheter of proper size (20 G) for mid-sized canine is
flushed with a heparin/saline mixture, and 3 strips of adhesive tape
readied. A long one inch strip is split in half lengthwise and a shorter 1
inch strip is prepared.
A) Vein held off by an assistant
How might you know you’ve
inserted the catheter into the carotid artery vs the jugular vein in a
1) The first piece of tape (1/2 wide and long enough to form a
"butterfly" on the catheter hub) is placed below the hub of the catheter
sticky side up. Three inches of tape should extend beyond the hub on the
left side of the hub.
2) A butterfly tab with two wings extensions is formed
a) Bring 2 inches of the shorter length of the tape (on the left side of the hub) back over the hub of the catheter and press it down, a 1 inch wing is formed on the left side. Extend the tape over the hub to about 1 inch on the right and press it down. A double layer butterfly with 1 inch wings has now been formed.
b) The long length of the tape on the right side of the hub is brought
over the wings of the butterfly and pressed down. There is now a three layer
butterfly formed around the hub of the catheter. The rest of the tape is
placed around the leg and the catheter is secured around the leg with
butterfly tabs on each side to stabilize.
c) The 1 inch piece of tape is secured over the tip of the catheter
(under the skin) and around the leg. Antibiotic is often placed below this
piece at the point of skin insertion.
d) The third ½ inch tape is placed below the injection port and around
the leg to create a clean easily visualized area below the hub.
e) Short tabs are placed on the ends of tape by folding over the edges.
This enables easily grasping tape edges when the catheter is removed.
Sometimes if "your legs are short and your ears are long" the catheter can be placed in non-traditional sites! Note the well secured catheter, padded collar, infusion port and coiled infusion line.
Special thanks to Lynn Chipkin and the ICU unit at the College of Veterinary Medicine, Virginia Tech, for this photo.
This website is a good description of how to place a catheter provided from another perspective http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00447.htm
Go to this website to explore one company that makes long-term over the wire catheters… http://www.milaint.com/GWPicc.php
Long term catheters can be placed. These are designed to be minimally reactive, and stay in the animal for weeks at a time with little irritation at the catheter site. Often these are designed to be placed in a large central vein – such as the jugular – and are longer than traditional short-term catheters. They are placed in a similar manner, with special attention to sterility. Many have “over the wire” placement, which can be challenging to learn initially.
Double and triple bore catheters are designed to deliver multiple drugs, fluids, and partial parenteral nutrition through one catheter without mixing of the compounds within the catheter. One should always pay attention to the appropriate port with these types of catheters, as often mixing of the drugs will cause precipitation, leading to clogging of the catheter and the need to replace it, which is EXPENSIVE!!!
What is meant by Parenteral Nutrition?________________________________________________________________________
Questions: E- Mail answers to Dr. Bidwell: firstname.lastname@example.org
Don’t forget to answer the question posed within this lesson – there are two this time!
1) What are the 4 types of catheters used for peripheral IV veins?
2) What type(s) is used for longer term indwelling?
3) What are 3 common complications if aseptic technique is not used when placing a catheter?
4) Why and how is heparin used in IV catheterization?
5) At about what angle should the catheter enter the patient?
6) What size and length is preferred for cats? Dog? Horses?
7) Describe the technique that you have been taught at your clinic. Also, please answer these questions: Where is the catheter inserted into the vein (lateral or over the vein)? Is the stylet moved or the catheter when "seating" the catheter? How is the catheter taped to the leg?
8) What should you monitor at least twice a day in any animal that has a catheter in place?