Term
| • What are the indications for a central line IV catheter? |
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Definition
- Lg vol crystalloid or collaid infusion
- Continuous drug infusion
- Repeated blood sample collection
- Infusion of parenteral nutrition or other hyperosmolar substances
- Central venous pressure measurement |
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Term
| • What are the contraindications for placing a central line IV catheter? |
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Definition
- Coagulopathies
Thrombocytopenia
Thrombocytopathia
Vit k antagonist rodenticide
- Hypercoagulable states
Hyperadrenocorticism
Disseminated intravascular coagulation (DIC)
Protein losing enteropathy
Protein losing neuropathy |
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Term
| • Which vessels should central venous catheters not be placed into? |
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Definition
| - Not placed in the jugular vein in cases of increased intraocular or intracranial pressure or thrombosis of one jugular vein |
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Term
| • What are the indications, and contraindications, for a vascular cutdown to facilitate the placement of an IV catheter? |
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Definition
Indications
- Catheterization of vessel in pts w/ extreme hypotension, peripheral vasoconstriction, or obesity
- Infusion of crystalloid or colloid fluids
- Infusion of blood products
- Infusion of drugs
- Obtain blood samples
Contraindications
- Abrasion, burn or pyoderma over catheter site
- Direct percutaneous catheterization is possible |
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Term
| • Which scalpel blade is recommended for use in performing an IV cutdown? |
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Definition
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Term
| • Which suture material is recommended for use in performing an IV cutdown? |
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Definition
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Term
| • What specific types of catheters are indicated when performing IV cutdowns? |
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Definition
| - 14 – 18 g venocath or over the needle peripheral catheter |
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Term
| • How long should catheters placed by cutdown in emergency situations be left in place? |
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Definition
| - Only until pt’s vol and BP have been normalized |
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Term
| - Supplies needed for placing cutdown IV catheters |
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Definition
Clipper/blades
Antimicrobial scrub soln
Sterile gauze 4x4, sterile gloves,
sterile sx pack (#11 blade/handle, field towels, towel clamps, tissue/thumb forceps, mosquito hemostats, metzenbaum scissors, needle holders)
3-0 absorbable
14 – 18g venocath or over the needle peripheral cath
Heparinized saline flush soln
T-port or male adapter
2” Kling bandaging material
1” white tape
Elastikon bandaging material |
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Term
| • Be able to describe the process of preparing and placing cutdown IV catheters. |
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Definition
- Clip/scrub/drape w/ sterile field towels
- Tent skin over site of proposed vascular catheterization (gently move skin to avoid cutting vessel)
- Incise skin with #11 blade
- Visualize vessel under incision
- Bluntly dissect fascia overlying the vessel using a curved mosquito forceps
- Make sure all fascia dissected away from the vessel, or else attempts at placing the catheter into the vessel will be difficult
- Insert curved hemostats under the vessel and raise the vessel to the skin surface
- Place two separate absorbable stay sutures securely w/ mosquito hemostats to raise the vessel to the level and parallel w/ the skin surface
- w/ vessel raised and parallel to the skin surface, gently puncture vessel w/ needle and insert catheter
- gently tie stay sutures, occluding the vessel
- suture skin overlying the point of the catheter insertion.
- Bandage in place as with a reg cath
- Vessel will remain ligated, collateral circulation will suffice
- If vessel not occluded then too much hemorrhage
- Cath can be removed when a percutaneous catheter is placed |
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Term
| • Which vessel is used for the placement of a CVP catheter? |
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Definition
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Term
| • What is the normal CVP of a canine in cm of H2O? |
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Definition
| - 5 – 10 cm H2O (2 – 5 cmH2O in cats) |
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Term
| • CVP catheters should have their tip right at the opening of, or near to, which structure? |
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Definition
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