Overview
This lecture covers step-by-step technique for intravenous (IV) catheter placement in large animals, focusing on right-hand dominant procedures for both sides of the neck, with emphasis on maintaining sterility.
Preparation & Equipment
- Use sterile gloves on both hands (video shows mixed gloves for demonstration only).
- Prepare and flush IV catheter before starting the procedure.
- Clip and aseptically prep the chosen site on the animal's neck (jugular vein area).
Hand Roles & Sterility
- The dominant (right) hand is the "clean hand" and holds the IV catheter.
- The non-dominant (left) hand is the "dirty hand" and is used to hold off (occlude) the jugular vein, after touching unprepped skin.
- Do not let the dirty hand touch the prepped area to avoid contamination.
Catheter Insertion Technique
- Hold the IV catheter hub with two fingers; place index finger on top of the stylet hub for better control.
- Use pinky finger of the clean hand to palpate the jugular vein and locate the center of the vessel.
- Insert the catheter at a 20–30° angle, bevel up, advancing through the skin and vein wall.
- Check for blood "flash" in the hub to confirm venous entry.
- Flatten angle to ~10° and advance the catheter further into the vein lumen.
- Recheck for blood flash as you advance to avoid exiting the vessel.
Advancing & Securing the Catheter
- Remove the dirty hand from the vein, then use it to grasp the stylet hub.
- Stabilize the catheter hub with the clean hand, slide it into the vein until flush with skin.
- Remove the stylet smoothly, clamp catheter, and prepare to connect the extension set.
Attaching Extension Set & Flushing
- Keep the end of the extension set sterile; dirty hand can remove the insert, but must not touch the sterile tip.
- Screw the extension set onto the catheter hub and unclamp before aspirating blood and flushing.
- Stabilize all parts while handling needles and flushes to avoid injury or loss of access.
Securing and Removing the Catheter
- Secure catheter with a clamp and fixation (suture, superglue, or elastic tape, as appropriate).
- To remove, place gauze at insertion site, withdraw catheter smoothly, and hold pressure to prevent bleeding or hematoma.
Left-Sided Technique
- Process is the same; requires adjusting hand positioning for opposite side.
- Maintain same angle and sterility principles as on the right.
Key Terms & Definitions
- IV Catheter — a device inserted into a vein to provide venous access.
- Jugular Vein — a large vein in the neck used for venous access in large animals.
- Stylet — stiff inner needle inside the catheter used for vascular penetration.
- Flash — visual confirmation of blood in catheter hub indicating vein entry.
- Dirty Hand — hand that contacts non-sterile areas, used for occluding the vessel.
- Clean Hand — hand that remains sterile and manipulates catheter.
Action Items / Next Steps
- Practice IV catheter placement on both sides of the neck.
- Review sterile technique protocols.
- Secure and remove catheters as demonstrated.