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Intravenous Catheter Placement 1123.e5

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Procedures and Techniques

INTRAOSSEOUS CATHETER PLACEMENT The stylet is removed by twisting
it counterclockwise to the EZ-IO catheter.
INTRAOSSEOUS CATHETER PLACEMENT After placement of the EZ-IO
catheter in the medullary cavity, the catheter is stabilized with the thumb and
forefinger, and correct positioning is confirmed by aspiration of marrow through
the catheter.

• Catheter obstruction is common with spinal leakage from the original needle site of entry invasive, possibly with a greater risk of local
needles and often is prevented by proper and SQ pooling of the administered fluid/ infection
placement (not too deep in the bone, blood/drug commonly occur. • Intraperitoneal administration: acceptable
causing blockage from the distal cortex) • EZ-IO catheters are low profile and less prone in mildly/moderately ill neonatal animals,
and proper securing and protection of the to bending. including for blood transfusion. Lack of
spinal needle so the animal does not bend • The IO catheter can usually be removed direct access to the circulation is a substantial
it. Prevention also is possible by regular without sedation or general or local anes- drawback compared to IO catheterization.
flushing or infusion to keep the catheter thesia and without eliciting signs of pain
patent. from the animal. AUTHOR: Søren R. Boysen, DVM, DACVECC
• If the spinal needle becomes obstructed or EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
Thompson, DVM, DABVP
bent and needs to be replaced, a different Alternatives and Their
bone should be chosen for IO catheter Relative Merits
placement. A minimum of 24-48 hours • Venous cut-down for peripheral or jugular
is needed for the bone to heal. Otherwise, catheter: acceptable alternative but more

Intravenous Catheter Placement

Difficulty level: ♦ • Euthanasia where client can be present ○ Winged infusion set (butterfly catheter)
• Blood collection (especially butterfly ○ Through-the-needle catheter
Synonyms catheters) ○ Over-the-wire guided catheter
Peripheral venous catheterization • ± 20-gauge hypodermic needle (to nick tough
Contraindications skin, as in tomcats)
Overview and Goal There may be contraindications to the use of • T-port/injection cap
Intravenous (IV) catheters allow ready venous a specific site (e.g., mass, infection, injury). • 0.9% NaCl flush in several 3- to 6-mL
access for administration of medications, fluids, syringes to use as flush
and blood products. This chapter focuses on Equipment, Anesthesia • Bandaging material for long-term or posi-
commonly used peripheral catheters; jugular • Clippers tional catheters:
catheters are discussed elsewhere. • Chlorhexidine scrub and solution ○ Roll gauze
• Gauze ○ Cast padding
Indications • ± Antimicrobial ointment ○ Vetrap
• Anesthetic procedures • White medical tape • ± Elizabethan collar
• Hospitalization of ill or epileptic patients • IV catheter, 24-18 gauge, depending on • Sedation typically not necessary
• IV fluid therapy (dehydration) patient and vessel size; 20 gauge is appropri- • Rarely, scalpel blade to cut down to visualize
• Fluid resuscitation during shock ate for most dogs vessel
• Cardiopulmonary resuscitation • Catheter
• Anemia ○ Over-the-needle catheter (most common; Anticipated Time
• Chemotherapy placement described below) 5-10 minutes

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