Reaching Goals, Bananas, and the IV Catheter

As I posted a bit ago, I wanted to try my hand at setting an IV catheter. Realistically, the best choice would be a largish, calm dog that wasn't in a critical condition. I've been biding my time, carefully watching my fellow nurses set and tape IV catheters in an array of animals, and continuing to practice taping a catheter using bananas: cheap, leg-shaped, and entirely sacrificial.

An opportunity finally presented itself. I'll be ending my job with the clinic in a couple of weeks and decided to take advantage of my enormous employee discount while I've still got it and get a dental cleaning done on Mimi.

Ah, the perfect dog at last. She's in excellent health with great veins (I stare at her and Azza's veins all the time). Plus, although the goal is to stick the animal only one time (less pain, less anxiety, more professional all around), if I had to poke her more than once, I would have no guilt about it. You might find that odd but I would feel really bad practicing on someone's sick animal. Mimi? No problem poking her with needles!

I scheduled her dental for 8am Tuesday, immediately after I ended my work shift. I brought her into work with me at 1am and she got to spend the night barking in a kennel and running around the treatment office when I wasn't too busy with other tasks.

And thankfully, the nurse assigned to Tuesday morning surgeries was one that I like and trust. I told her my plan: I wanted to do the blood draws on Mimi for the pre-anesthetic blood tests and I wanted to place her IV catheter. I told the nurse that I would not keep poking Mimi indefinitely but that I wanted to try. She was quite supportive of my plan.

We started with the blood draw. I needed about 1.5 ml for the two tests. Mimi was very wiggly and I ended up poking her four times, two in each leg, before I got barely enough. Unfortunately, one of the tubes clotted too soon and we needed more. I let the other nurse do this since I figured I had already used up all my tries on blood draws on Mimi.

Now, the IV catheter.

I got out alcohol-soaked and chlorhex-soaked cotton balls, clippers, a T-port, my four pieces of carefully measured and torn tape, a catheter, some gauze.

I could see Mimi's accessory vein really well. A lot of the nurses I work with insert the tip of the catheter at the point that the accessory vein and cephalic vein join. You have to get the tip of the catheter past a valve that lies in the cephalic vein just up from this Y; inserting at the Y positions you well for this. I couldn't see her cephalic vein at first but suddenly it was like her skin went clear and I could see everything. The noise in the clinic disappeared. The entire world had telescoped down to Mimi's left front leg and the quiet murmur of the nurse holding her. The nurse had an excellent hold on Mimi, so critical when you are drawing blood or placing catheters. I slowly inserted the needle...suddenly there was a flash of blood so I pushed the catheter (a small hollow plastic tube) off the needle and into the vein. This was followed by half a dozen drops of blood flowing out of the catheter. I rushed to cap it off, and realized two things. One, I needed to remember to breathe. Two, I successfully put that IV catheter in Mimi's leg on the very first try.

I taped it up, slowly to be sure, but after my banana practice, rather neatly all things considered. The other nurse kept coaching me along, offering advice when I needed it and encouragement too.

When I finished, I carried Mimi around to show everyone. I don't care one bit if they thought I was ridiculous. It was my first IV catheter ever and it went really well. One of the doctors, a bit of a curmudgeon, high-fived me! I was so excited.

Of course an e-collar was necessary for a dog like Mimi. You can see the green vet wrap on her hind legs where I had to keep poking her for blood.

I hope that the nurses I've worked with are proud too. I have watched them, learned from them, and hopefully can execute some things with accuracy and confidence. They deserve a big, big thanks for their patience in putting up with me this summer. I will be a better vet because I worked with them.