peripheral cannulation

Re: peripheral cannulation

Victoria Nielsen RVN — Sun, 01 Jan 2012 22:55:11 GMT

[quote user="Victoria Cossou"]

Never seen them pick up a mop though!

[/quote]

Oh my vet does! ;-) She does help out when she has time and we are busy etc... I have her well trained! :-D

Also I'll like to add that I also love Durapore! :-) Much easier to remove than the dreaded Elastoplast!

Re: peripheral cannulation

Victoria Cossou — Sun, 01 Jan 2012 21:41:31 GMT

[quote user="Freckle"]

[quote user="Nick Shackleton"]

[quote user="Vicky C"]

The person was practicing on their friends mum!!!

[/quote]

Maybe I should do that before trying out on a human patient lol

www.youtube.com/watch

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i spotted a few errors in there also!

didn't like the way she was referring to the vn either - in most cases its the nurse placing the iv line (and doing a better job of bandaging it in place than the vet!)

personally i like to take a small piece of swab, place a cut half way up it, and slide it beneath the catheter before taping in - to give some padding between the catheter and the skin - i have seen sores beneath catheter hubs before, so always prefer to do this

[/quote]

Sorry- I realise this is a really old post, I was just browsing through looking at items of interest to me! I wanted to comment on this being as I am a veterinary nurse in New Zealand (only just qualified and been working for a couple of months) and it seems to me that UK nurses get to do FAR more stuff than us NZ ones! This video highlights what I have seen in most practices I have been to here - the vet placing the catheter and bandage while the VN restrains. This is common practice here our job mainly comprises restraint, reception, monitoring anaesthesia and cleaning and that's pretty much it! I am not a Diploma trained nurse (yet) and I will learn to place catheters then but not sure if I will ever get to use that skill. I know I can't speak for all NZ clinics but certainly the ones i've been in I haven't even seen a nurse re-bandage a wound dressing as it is done by the vet. Maybe it works both ways though as our vets also answer the 'phones and help people at reception when the need arises :-) Never seen them pick up a mop though!

Re: peripheral cannulation

Claire Cameron — Wed, 10 Feb 2010 20:13:34 GMT

A vet specialising in anaesthesia recently commented that if the IV site is fine, ie no phlebitis, etc. she would leave the cannula in place. Her comments were, why remove the catheter when no problems are apparent.

Re: peripheral cannulation

Lovemyjob1 — Wed, 10 Feb 2010 20:12:08 GMT

I agree with Smegslayer, research shows that surgcal spirit does not kill microbes so is only really there as an aid to visualising the vein. 2 -3 days is the usual max length of time , but i would always er on the side of 2 days just in case!

I also went to a lecture by North Kent Refferals which pointed out that it is importent to clip a big enough space so that the cannula opening does not fall onto a hairy bit ! I know it sounds obvious, but i've placed many where i've clipped, put the catheter in and then found the comnnection just touches an unclipped part. Especially if you need to allow for going into the vein more then once if it blows !

What size catheters do you tend to use ? I know its supposed to be biggest that you can manage for the vein but we use quite a lot of 24g for cats.

Re: peripheral cannulation

emvn80 — Thu, 04 Feb 2010 16:24:36 GMT

I've got pics if you like? I'm also giving a talk for nurses at BSAVA congress entitled 'how to place an iv ' which has a video etc and also discusess different techniques/risk of infection, complications etc...too much to write all down here, but any specific questions let me know and I'll help if I can

Re: peripheral cannulation

Jen — Mon, 25 Jan 2010 13:35:13 GMT

We use cheap tape from IMS and I must admit, it is wonderful, stays in place really well and does not cause problems removing it.....loving it! Prob similar to Durapore

Re: peripheral cannulation

dinkyd — Sun, 24 Jan 2010 21:49:01 GMT

We have eaze off to but tbh i always end up using spirit to get the sticky ones off usually nearsest thing to hand to grab lol- we only use micro pore for our iv lines and never have a problem - find as long as site dry when apply tape then it usually sticks.Have to admit i think it must depend on the brand used though.

Re: peripheral cannulation

Siobhan Steven — Sun, 24 Jan 2010 21:18:23 GMT

I agree with the Elastoplast being a bugger to remove, but we have 'Zoff', the wonder product for the stubborn sticky stuff. I moisten a swab and dab it on as it has a strong smell and cats especially don't like it being applied. I work at a university where we can only have so much of each 'thing', we currently have 3 types of tape which covers most peoples preferances.

Re: peripheral cannulation

SmegSlayer — Sun, 24 Jan 2010 20:12:00 GMT

[quote user="Freckle"]

14yr old dental will only get ivft if nurse pushes it

sadly, same with pyo's and ex-laps.................

[/quote]

I think i would actually refuse to monitor a GA for these ones without IVFT, same for a c-section.

Re: peripheral cannulation

SmegSlayer — Sun, 24 Jan 2010 20:09:07 GMT

I love eaze off too! We fought head office who said we shouldn't by anyhting from millpledge as they won't do the company a deal and still get it. It's quite expensive but worth it! However hope it will soon come in antoher form other than a spray coz the cats HATE the noise and go spacko!

Re: peripheral cannulation

Maisy — Sun, 24 Jan 2010 16:42:22 GMT

Love Durapore - I am sad and keep a roll with me as when I'm locuming not that many places I've been to use it! Micropore isn't great especially for keeping iv catheters in place. However I do love Eaze Off (? think thats what its called, its the tape removal spray from Millpledge), tried this out at BSAVA last year and have carried on using it since.

Re: peripheral cannulation

Steph Worsley — Sun, 24 Jan 2010 16:34:25 GMT

[quote user="Siobhan Steven"]

I tape in with Leaukoplast (the pink elastoplast), I find Micropore doesn't hold that well,

[/quote]

I HATE elastoplast.......we had an ongoing battle at work about this as it is an absolute nightmare trying to get it off and it generally annoys the already angry animals more and who is it thats to take it off...me! but I agree with the micropore thing. however we have started using durapore which is a silk tape and microfoam which is a foamy one and both are pretty good and keeping caths in!!

Re: peripheral cannulation

Siobhan Steven — Sun, 24 Jan 2010 08:36:41 GMT

Sounds like a Kiwi nurse in the You Tube vid, but going by the tree outside the window (gum tree) she's in Australia, handy as I use the same catheters she is using. At the uni we catheterise all surgeries and all my surgeries get IVFT, though all of mine are major ortho and neuro cases. I often give boluses even to my follow up rad patients as they have obviously recently had a GA, and may have had a couple in close proximity at the referral clinic as well, so I keep an eye on my NIBP.

I tape in with Leaukoplast (the pink elastoplast), I find Micropore doesn't hold that well, and with all the maneuvering during prep etc, even though we try to minimise it, it's a bummer to have to replace! I do the 'under and over the hub' tape. I have seen the under the hub, sticky side out, then over the top, but find that the patient only has to move a tiny bit while you fiddle with that and all your hard work is undone! We clip with good margins, and allow for the length of the catheter to be introduced without contacting any hair. I wipe with Clorohex/alcohol 'eggs' at least three times, and find that gives enough 'relief' for me to visualise the vein. I don't bandage mine in for surgery, but obviously will if the patient is to be hospitalized overnight/long term. I have heard the 3 day rule is open to interpretation, again, as we get referral cases the veins, usually the right cephlic, has had its fair share of use, so I go for the left (sometimes to be terribly disappointed!). But I want to minimise scarring. Also, with big dogs (Rotti's etc) I may do a cut down due to the combination of thick skin and 'roly poly veins' that try to escape you, especially the sephenous ones.

We also flush with Hep Saline, mind you in the past I've just used Hartmanns from the bag, there is conflicting thoughts on both of those practices as well.

Re: peripheral cannulation

Freckle — Sun, 24 Jan 2010 00:25:21 GMT

I work in a practice that is99 % of the time POOO!

BUT IVFT is included in the GA price..... sad part is that it is up to the nurse to get the patients on ivft.........

14yr old dental will only get ivft if nurse pushes it - even tho it is in the price!

same with bitch spays - its included in the price, but depends which nurse is on ops, coz the vets don't care - will mostly only ivft if nurse insists-adhhhhhhhhh!!!!!!!!!!!!!!!!

sadly, same with pyo's and ex-laps.................

i would never pretend to know more than a vet, but if ivft is included in the ga price - then give it! the animals bp will thank you for it!

Re: peripheral cannulation

Nick Shackleton — Sat, 23 Jan 2010 20:52:12 GMT

[quote user="dinkyd"]

[quote user="Nick Shackleton"]

ALL our patients that undergo General anaesthesia do receive IV fluids

[/quote]

As do ours.

[/quote]

Re: peripheral cannulation

dinkyd — Sat, 23 Jan 2010 20:50:38 GMT

[quote user="Nick Shackleton"]

ALL our patients that undergo General anaesthesia do receive IV fluids

[/quote]

As do ours.

Re: peripheral cannulation

Maisy — Sat, 23 Jan 2010 20:26:37 GMT

Getting corporate groups to change their mindset and offering opinions/ideas on potentially saving them money generally isn't listened to so would imagine this would be difficult! It would be ideal to incorporate IVFT costs into routine procedures though have never worked in a practice where this has happened, but luckily there are clients who see through the additional costs and are happy for their pet to go onto fluids.

Re: peripheral cannulation

SmegSlayer — Sat, 23 Jan 2010 18:53:32 GMT

try telling that to head office- we're technically supposed to charge a full consult fee on top of a nail clip or emptying anal glands, even if the vet does nothing else in the consult, bringing the total for these to over £30. The vets basically refuse to do this despite getting shouted at by head office

Re: peripheral cannulation

Claire Cameron — Sat, 23 Jan 2010 18:47:08 GMT

[quote user="SmegSlayer"]

Would def not work for us- we already get "£58 to spay a cat- you must be bloody joking!" which includes the GA.

A 500ml NaCl bag cost the client about £6, ironically, an Accurate giving set costs the client more than the bag of fluids and then there's the i/v set up charge (which is expensive) so in total you'd be looking at another£50-60 added to the bill

[/quote]

Could you not reduce the IV set up fee as ideally GA patients should have IV access anway so should cut the cost slightly? You could also recommend 250ml bags of Hartmanns (Vetivex) and use a cheaper giving set?

Re: peripheral cannulation

SmegSlayer — Sat, 23 Jan 2010 18:42:56 GMT

Would def not work for us- we already get "£58 to spay a cat- you must be bloody joking!" which includes the GA.

Re: peripheral cannulation

Claire Cameron — Sat, 23 Jan 2010 18:23:05 GMT

[quote user="frog and cat mad!"]

[quote user="Nick Shackleton"]

ALL our patients that undergo General anaesthesia do receive IV fluids

[/quote]

in an ideal world I agree every GA would have IVFT whether routine or not!!

[/quote]

I agree,

[quote user="frog and cat mad!"]

Snap, these fluids are incorporated into our GA price!

[/quote]

That;s a good idea!

Re: peripheral cannulation

Steph Worsley — Sat, 23 Jan 2010 18:20:01 GMT

[quote user="Nick Shackleton"]

ALL our patients that undergo General anaesthesia do receive IV fluids

[/quote]

Snap, these fluids are incorporated into our GA price!

in an ideal world I agree every GA would have IVFT whether routine or not!!

Re: peripheral cannulation

Nick Shackleton — Sat, 23 Jan 2010 17:50:05 GMT

ALL our patients that undergo General anaesthesia do receive IV fluids

Re: peripheral cannulation

Maisy — Sat, 23 Jan 2010 17:39:36 GMT

Ideally all patients would receive iv fluids, whether its a routine op or not. Wouldn't discourage a client from having it for their pet but it tends to be more of a cost issue for most.

Re: peripheral cannulation

Claire Cameron — Sat, 23 Jan 2010 17:37:41 GMT

[quote user="Bouncyfi"]We have the option of ivft on our consent forms and when people ask me what to do, I reply I wouldn't put any of my animals under GA without it. I would love that all patients have ivft[/quote]

I second that. All my critters have IVFT whilst under GA