so we're going to be going over how to do an IV catheter placement in a large animal as a right-hand dominant person and you're going to notice for this video I have two different gloves on so I've still got my sterile gloves on but I've got an exam glove on my left hand and that's only for video purposes so you can understand what I'm talking about when I say clean hand and dirty hand um when you do this procedure you're either going to have two sterile gloves on or two exam gloves on so this is just for video purposes um but we are going to start on the right side of the neck of the animal because that's what's going to be most comfortable for a rightand dominant person I'm going to show you how you can successfully do it as a right-and dominant person on the left side of the neck as well so just a reminder head is over here rest of the body is over this direction this is our clipped and prepped area for our IV catheter and we are good to go so I'm going to go ahead and grab my IV C catheter that is all flushed and ready so what I want you to focus on first is my grip on my IV catheter this is really important and it's a huge key to success in large animal IV catheter placement so I've got two fingers on my actual IV catheter Hub this colored gray part and if you've got really tiny fingers you can do three fingers um but for most people it's going to be most comfortable for two fingers on the IV catheter Hub and my index finger finger is on top of my stylet Hub this is going to help you one keep your flush in your catheter and two it's going to help you push through that really tough skin of your cower horse and then also your jugular vein wall um which can be pretty thick in your cow and horse as well so got my catheter in my right hand cuz I'm right hand dominant and my left hand which has been sterile up to this point is now going to hold off the jugular vein and this is why I now call my left hand my dirty hand because I'm touching an area that was not prepped so I'm never going to reach up with my dirty hand and palpate my prepped area because then I've contaminated it and I got to start all over so with my um my clean hand usually my pinky I'm going to go ahead and palpate my jugular vein I want to make sure that I'm going to be inserting my catheter in the middle of that jugular vein and we are going to be going from cranial to cogle Direction so keep in mind the length of your catheter I've got a short catheter here today so I can go kind of anywhere in this area and not run into my hand but if I had that Big 5 and a/4 inch catheter I've really got to think about when I'm going to run into where my hand is holding off the jugular vein so palpate my jugular vein I'm going to bring my bevel towards me and I'm going to have an angle of about let's say 20 to 30° um with my catheter to the skin and the first thing I'm going to do is keeping this angle I'm going to press through the skin and I'm going to press in until I feel my cath go through the wall of the jugular vein which I felt it just then I'm going to check that I'm in my vein by lifting my index finger off my stylet Hub and checking for flush or a flash so I've got my flash put my finger back on cuz no one wants blood everywhere I'm going to change my Angle now so I'm going to flatten out come closer to the animal's neck so more like a 10° angle and that's so that I can continue my catheter down the Lumen of the jugular vein I'm just going to advance another half inch or inch or so check for a flash to make sure I haven't popped out of my vessel still have my flash perfect and this is the tricky part I'm going to take my dirty hand off my jugular vein I'm going to reach up and grab the hard plastic Hub of the stylet because that's not staying in the vein so that can get dirty at this point and then my clean hand is going to hold on to the hub of my IV catheter and slide it down towards the skin this is the point where I said the stylet cannot move so I've got my dirty hand steadied against the animal's neck so I don't move I'm going to slide my catheter down until my Hub is up against the skin like that and then I'm going to smoothly remove my stylet from my IB catheter and I'm still in my ban I'm going to go ahead and clamp this model off so I don't have fluid running everywhere so at this point I'm going to grab my extension set and the part that has to stay the most sterile is this part here that's going to be attached to my IV catheter so I can use my dirty hand to remove this little insert here but I'm not going to touch the inner part so I'm going to stabilize my IV catheter Hub I'm going to go ahead and screw this extension set into place it's a little tricky when it gets slippery like that all right feels pretty good and then what I'm going to do is I'm going to go ahead and check that I still have access to my jugular vein so I'm going to grab that flush that I still have remember to unclamp your extension set always stabilizing your hands so you don't accidentally stab yourself and you can aspirate I've got my pink fake blood here and then flush my extension set remove my needle stabilizing hands safely cap and so in a live patient you would secure this now so you would clamp and you would secure either with suture you could do super glue you could just do elastic on tape wrapped around the neck we are not going to keep this in today so how to appropriately remove an IV catheter is you can use either alcohol or uh just dry gauze and you're going to place it here where the catheter goes into the SE skin and then you're going to smoothly remove this catheter like so and then you're just going to hold off for a little bit one to make sure we don't have blood going everywhere this was an 18 gauge often times we use a 14 gauge so we still have a pretty decent hole in the jugular vein and the skin and then also so we don't get a hematoma so we just went over how to do a rightand dominant IV catheter placement in the right side of the neck and I assure you you can o do this in the left side of the neck it's just a little bit more awkward so I still have my dirty hand as my left hand and my right hand is going to be my dominant hand with my sterile IV catheter so head is here body is over to my right and so my dirty hand is going to hold off my jugular vein theoretically I would see my jugular vein stand up and I'm going to palpate that with my pinky so you can see how I'm Angling in my hand so that I've got it kind of up towards that animals um if this is a horse their Mane um or dorsal part of their neck and I can still get the same angle on that jugular vein it's just a little bit um different and takes a little practice so still going to have that 20 to 30° angle through the skin into the Lumen of my jugular vein felt it pop in I'm going to check for my flash which I have I'm going to flatten my angle out so closer to the neck and I'm going to advance down the Lumen of the jugular vein another inch or so make sure I still have my flash taking my dirty hand off my jugular vein grabbing my stylet Hub holding this still stabilizing on the neck my sterile hand is going to move my Ivy catheter down until it's tight with the skin very important it's tight with the skin because this is where you're most likely going to get bacteria travel down your catheter and cause an infection and now we're going to smoothly remove our stylet we still have Venus access I'm going to go ahead and clamp that off in this model and then again you would do your extension set um you would pull back blood into your extension set and then flush and then safely remove that