I mentioned that the other night I did my first successful jugular blood draw on a non-cow, in fact a heavily coated springer spaniel. This was followed that same night by a saphenous blood draw from a very sick corgi whose veins were shit and whose skin kept sticking to the needle. I got that blood in one poke. That one was significant not only for its inherent difficulty but because before that dog, I had not had much luck with leg vein blood draws (recall that I had to poke Mimi four times, twice in each hind leg, to get a single blood sample). So double success with the corgi.
Tonight I had to draw blood twice from a yellow lab who had eaten rat poison and who had received a blood transfusion earlier in the night. Both were saphenous draws. The second one was for a clotting test. For this particular test, the stick has to be clean which means you have to hit the vein in one poke, no fishing around for the vein once you are under the skin with the needle. Even though I had already had done a one-poke blood draw on this dog, I was going to let my colleague draw the sample for the clotting test, but she already had the dog restrained, telling me, you can do it. And so I did. It was a perfect stick. Big dogs are much easier, that's for sure.
But perhaps the most amazing of all, tonight I did a jugular blood draw on an 8-week old boston terrier puppy with parvo while I was wearing a surgical gown and gloves for biosecurity. Think about that for a second--most of the time we can't see the jugular vein, especially if the animal has a lot of coat, has thick skin, or is very sick (dehydration, low blood pressure, wounds, blood diseases, heart conditions, etc. can all make the veins flabby) so we go mostly by feel alone. We weren't wearing sterile surgical gloves but the regular nalprene exam gloves which are pretty thick. I nicked the vein with the first needle but changed to the other side of the neck and hit it in one poke with the second one. I was a little freaked out by having to jab a needle into the neck of such a small and very sick animal but I think that having a little pressure helps me focus.
And I've had some success with making blood smear slides. We have machines that examine blood cells but sometimes you have to have human eyeballs on the sample. Platelets in particular can clump and be miscounted by the machine. After we draw blood into a tube with anti-clotting chemicals and analyze it, we have some perfectly good whole blood left over. Once the animal is treated and sent home, that sample is tossed. So if you want to practice making smear slides, there is usually plenty of material to practice with.
To make a blood smear slide, you take a clean slide and place a drop of blood near one end. With even pressure, drag another clean slide across the first just until you touch the drop. Capillary forces will cause the blood to flow out along the line where the second slide is touching the first. Then you quickly swipe the second slide all the way back the other direction. The goal is to make a perfectly thin layer where the cells are uniformly distributed without clumps or gaps.
My first attempts were pathetic. But once I got the hang of it--blood drop can't be too big (top slide below) nor too small (middle slide below), and the pressure of the slide that you drag across to make the smear has to be even (air bubbles in the middle slide below), and so forth--I managed to produce some very acceptable smears. My most perfect slide is the bottom one below. The slides are stained before we look at them under the microscope; these slides were not stained yet.
It's a little frustrating that all this is coming together during my last few days at the clinic. But that tells you how difficult all this is to learn and execute. It took me over three months to gain these skills and they are just the tiniest tip of the iceberg when it comes to what a good vet tech needs to know. I'm extremely pleased to have my little set of skills though. I was basically tossed into the night shifts at the clinic and I am so thankful that the nurses I worked with were patient and helpful. They deserve a lot of credit for mentoring me so effectively. Look at how much I learned from them! I'm a bit sad to be ending my job in large part because I'll miss working with those caring and dedicated vet techs.
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