IV Catheterization
VTHT 1491- Special Topics
Ms. Liddell
CTVT: Chapter 20 (pg: 607-610)
VTDRG: Chapter 8 (pg: 349-351)
Learning Objectives
 Describe the procedure for placement and
care of a peripheral intravenous catheter
 Describe the indications and procedure for
placement and care of a jugular catheter
 List requirements for monitoring of
patients with intravenous catheters
IV Catheterization Used for:
Temporary access for medications, fluid
and electrolyte replacement therapy, or
transfusion of blood products
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IV Catheterization
Catheter site selection depends on:
 Available vessels
 Condition of vessels
 Patient
 Expense
 Urgency of situation
IV Catheterization
Complications
Phlebitis
Local cellulitis
Septicemia
Collapsed veins or hematomas rendering
veins unusable
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IV Catheterization Types
Winged needle (butterfly) catheter
Plastic wings on needle shaft facilitate
placement and taping (if needed)
Tubing extending from needle to syringe
connector port allows maneuverability
Is for short-term use
Used for:
blood collection
Administration of non-irritating
medications
Moves out of vessel easily because of
needle
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IV Catheter Types
 Over-the-needle catheter
Used primarily for peripheral vein
catheterization
Come in many different sizes (gauges) that
coordinate (color) with needle sizes
Needlepoint extends beyond catheter tip for
entry into vein
Once catheter is placed, needle is withdrawn
from insertion site
MOST COMMON IV CATHETER USED
IV Catheter Types
 Through-the-needle
Usually longer than over-the-needle
catheters (8- to 12-inch) and are primarily
used for jugular vein
Once catheter is placed, needle is
withdrawn from insertion site and a needle
guard is placed over needle
Protects needle from sticking animal and
shearing catheter
http://www.youtube.com/watch?v=AxSCCwd
N1nI
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IV Catheter Types
 Multi-lumen catheter
Have two to three separate lumens
allowing simultaneous infusions at one
catheter site
Placement is usually completed percutaneously with a guidewire
More expensive than other catheters
Used primarily in Jugular catheterization
Peripheral Catheterization Sites
Dogs and cats
 Cephalic, medial saphenous (cat) and
lateral saphenous (dog)
 20-gauge, 22-gauge, and 25-gauge, 1- to
1.5-inch catheters
 20-gauge, 22-gauge, 23/25-gauge, ` 5/8”
butterfly catheters
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Peripheral Catheterization
ALWAYS REMEMBER
Start on the distal portion of the limb
and move proximal for all catheter
placement
Peripheral Vein Butterfly
Catheterization Supplies
Clippers
Antiseptic scrub and solutions
Catheter
A syringe filled with flush
heparinized saline
Saline
Tape and/or non-absorbable suture (not
always used)
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Butterfly Catheter Placement
Procedure
 Venipuncturist can hold the wing of the catheter
up or down when placing catheter
 Once in vessel, blood will flow back into the
clear tubing
 Syringe can be attached to tubing end and blood can
be pulled into syringe for blood draw
 Digital pressure required from restrainer
 Syringe can be attached to tubing end and medications
or flush can be administered through tubing
 Release of digital pressure required from restrainer
Butterfly Catheter
Placement
http://www.youtube.com/watch?v=qsTAKiA3Uf0
Peripheral Vein
Catheterization Supplies
Clippers
Antiseptic scrub and solutions
Catheter
A syringe filled with flush
heparinized saline
Saline
Injection cap or T-connector
Tape and/or non-absorbable suture
Bandage material
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Peripheral Vein
Catheterization Procedure
 Shave area of insertion site
 Surgical prep with antiseptic scrub and solution
 Aseptic technique is important to prevent infection
 A relief hole may be made with a #11 blade or 20gauge needle to reduce friction
Indicated in severely dehydrated patients or patients
with tough skin
 Occlude vein proximal to insertion site with
tourniquet or an assistant
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Peripheral Vein Catheterization
Procedure cont..
Grasp distal portion of leg and extend it to
help immobilize the vein
With bevel up, insert catheter through
skin or relief hole at approximately 15degree angle
Advance catheter into vessel; when blood
flashes in (hub), needle and catheter are
advanced together as a unit for an
additional 1-4 mm
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Peripheral Vein Catheterization
Procedure cont..
Hold needle still and advance the catheter
ONLY into vessel
Cap catheter with an injection cap or Tconnector and flush catheter
Secure catheter with tape wrapped around
hub of catheter and then around leg
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Taping in of Peripheral Catheters
 Taping techniques vary from person to
persona and hospital to hospital
 There is not one “right way” to tape a
catheter in
 Always remember to:
 Secure the catheter hub and injection port
 Never secure tape to tightly
 Be sure patients leg is dry prior to applying tape
Peripheral Catheter Placement
http://www.youtube.com/watch?v=wt_K1beUZEI
http://www.youtube.com/watch?v=pUdJqaEe4Fw
Jugular IV Catheterization
 Procedure
 Site chosen is shaved and surgically prepped
 Wipe or spray with betadine solution, left to dry
on
 2-5 ml of lidocaine given ID over and above
insertion site
 Create sterile field by opening sterile gloves,
and laying opened catheter on gloves
 Other items are either placed on sterile field or
in cold sterilization tray
 Sterile gloves are worn
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Jugular IV Catheterization
 Hold catheter in dominant hand—other gloved
hand occludes jugular
 Insert catheter into skin at approximately 45degree angle, toward heart
 Flash of blood in hub indicates vessel is hit,
advance centimeter more
 Hold needle still, sliding catheter into vessel;
remove needle
 Check to make sure vein is still catheterized by
applying digital pressure
 Attach a PRN or T-port and suture catheter into
place
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http://www.youtube.com/watch?v=AxSCCwdN1nI
Multi-Lumen Catheter Placement
http://www.youtube.com/watch?v=RGXP-FSjih8
Jugular IV Catheterization
Apply small amount of antibacterial
ointment before placing wrap over
catheter
Wrap neck or apply stents over catheters
to stabilize them and to prevent them
from getting rubbed out
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 Examples of four types of IV catheters. Catheter A is a butterfly; catheter B is an
OTN; catheter C is a multilumen (Triple-lumen); and catheter D is a through-theneedle.
IV Catheter Maintenance
 If any of these things occur, remove catheter and
place a new one in a different location:
 Phlebitis
 Infection
 Thrombosis
 Leaking at insertion site by itself or during a flush
 Pain upon injection
 Any portion of the catheter is exposed
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IV Catheter Maintenance
 If catheter site looks good, then clean with
iodophor or chlorhexidine solution
 Recommended not to leave a catheter in place
longer than 72 hours
 If bandage gets wet, reason should be
identified and bandage changed
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IV Catheter Maintenance
 If patient is chewing at bandage, reason should
be investigated
 Catheters not continuously used should be
flushed with 4 U/ml of heparinized saline (1000
units/ 250 ml normal saline) every 4 hours
 Bags of heparinized saline are discarded every
12-24 hours to minimize risk of contamination
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