Veterinary Emergency and Critical Care Procedures

Timothy B. Hackett, Elisa M. Mazzaferro

• Publisher: Wiley-Blackwell
• Year: 2012
• ISBN:
  9781118369449
• Edition: 2
• Topic: Medicine
• Subtopic: Veterinary Medicine

Veterinary Emergency and Critical Care Procedures, Second Edition is a step-by-step guide to key emergency and critical care procedures encountered in bothgeneral and specialty practice. Now in full color, the second edition includes several new procedures, two new chapters covering cardiopulmonary resuscitation and continuous rate infusions, and a companion website offering videos demonstrating most of the procedures featured in the book. Helpful hints have also been added throughout to make the book even more useful in the practice setting.

Each procedure includes information on the background, supplies needed, indications, and contraindications, followed by a series of images demonstrating the technique. This practical resource, ideally designed for use in fast-paced emergency situations, is an indispensable reference for any member of the veterinary team.

CHAPTER 1

Vascular Access Techniques

INTRODUCTION

A variety of methods can be used for placement of peripheral, central venous, and arterial catheters. If a peripheral or central catheter cannot be placed due to small patient size, severe hypovolemia or dehydration, or hypotension, intraosseous catheters can be placed in the femur, humerus, or wing of the ileum. This chapter will discuss indications, contraindications, and methodologies listed above.

Through-the-needle catheters or over-the-wire central venous catheters can be placed in the jugular, medial saphenous, or lateral saphenous veins. The indications and contraindications for central venous catheter placement, irrespective of type, are similar.

CENTRAL VENOUS CATHETER PLACEMENT

Introduction

Central venous catheters can be placed into the jugular, lateral saphenous, and medial saphenous veins. Central venous catheters can be used for infusion of colloid and crystalloid fluids, infusion of continuous or intermittent drugs, and infusion of hyperosmolar solutions including parenteral nutrition. Catheters placed into the jugular vein can be used for measurement of central venous pressure to guide fluid therapy and help avoid volume overload. An additional benefit of indwelling central venous catheters is ease of repeated blood sample collection without the need for repeated venipuncture.

Supplies Needed

Antimicrobial scrub and solution

Central venous catheter(s)

Cotton roll gauze

Electric clipper

Electric clipper blades

Gauze, 4- × 4-inch squares

Heparinized flush

Kling or gauze bandaging material

T-port

1-inch white tape

Indications

Large volume crystalloid or colloid infusion

Continuous drug infusion

Repeated blood sample collection

Infusion of parenteral nutrition or other hyperosmolar substances

Central venous pressure measurement

Contraindications

Coagulopathies

Thrombocytopenia

Thrombocytopathia

Vitamin K antagonist rodenticide

Hypercoagulable states

Hyperadrenocorticism

Disseminated intravascular coagulation (DIC)

Protein losing enteropathy

Protein losing nephropathy

Catheters should not be placed in the jugular vein in cases of increased intraocular or intracranial pressure or thrombosis of one jugular vein

Go to www.wiley.com/go/hackett to view a video of this procedure.

Fig. 1.1. Set-up for central venous through-the-needle catheter placement.

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Helpful hint: Have all components ready before restraining the patient and attempting to place the catheter.

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Fig. 1.2. Place the patient in lateral recumbency. Clip the jugular furrow from the ramus of the mandible caudally to the thoracic inlet and dorsally and ventrally to midline.

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Helpful hint: In long-haired patients, make sure to clip the “feathers” that might lay over your field.

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Fig. 1.3. Aseptically scrub the clipped area.

Fig. 1.4. Drape the sterile field, then occlude the jugular vein at...

Table of contents

• Cover
• Series page
• Title page
• Copyright page
• Preface
• CHAPTER 1: Vascular Access Techniques
• CHAPTER 2: Nutritional Support and Orogastric Lavage
• CHAPTER 3: Thoracocentesis and Thoracostomy Tube Placement
• CHAPTER 4: Oxygen Supplementation and Respiratory Sampling Techniques
• CHAPTER 5: Urinary Catheter Placement, Urohydropulsion, and Temporary Antepubic Cystostomy Catheter Placement
• CHAPTER 6: Abdominocentesis and Diagnostic Peritoneal Lavage
• CHAPTER 7: Pericardiocentesis and Pericardial Drainage Catheter
• CHAPTER 8: Central Venous Pressure
• CHAPTER 9: Cardiopulmonary Resuscitation
• CHAPTER 10: Continuous Rate Infusions
• Index