wk 9 Fluid Therapy and IV Management in Veterinary Practice

Disconnecting a Patient from an IV Fluid Pump

  • Stopping the Pump:

    • Push 'Stop' or 'Hold' button on the fluid pump.
    • Turn off the pump.

  • Clamping the IV Line:

    • Clamp the IV fluid line both in front of and behind the connection that will be disconnected.
    • Safety Note: Avoid letting fluids run in an open line to prevent hazardous medication additives from flowing too quickly.
    • Examples: KCL (potassium chloride), dextrose, insulin, analgesics.

  • Disconnecting the Line:

    • Disconnect the line and cap or place a needle on the remaining portion connected to the fluid bag to maintain cleanliness.
    • Cap or use a syringe filled with saline on the line connected to the patient.

  • Transporting the Animal:

    • If walking a dog or transporting a cat, tape the disconnected line securely to the patient’s leg if disconnected beyond the t-port.

  • Checking IV Catheter Patency Before Reconnection:

    • Flush the IV catheter to ensure it is patent (able to let fluid flow).
    • If there is difficulty flushing, or if the limb feels swollen, notify a technician.

  • Reconnecting the IV Lines:

    • Once checked, reconnect the fluid lines and unclamp.

  • Restarting the Pump:

    • Turn the power back on and restart the fluid pump.
    • Fluid pumps should restart at the last recorded rate. Always verify the rate against the fluid administration sheet, and report any discrepancies to a technician.

Fluid Therapy in Small Animals: Role of the Veterinary Technician

  • Importance of Fluid Therapy:

    • Administering fluids is critical for optimal veterinary care.
    • Understanding fluid types and administration methods is essential for technicians.

  • Catheter Placement and Care:

    • The veterinarian prescribes fluid type/rate, while technicians carry them out via IV catheters, typically placed in:
    • Cephalic vein (most common).
    • Saphenous vein.
    • Jugular vein.
    • Use the largest diameter catheter possible for quicker fluid administration.

  • Catheter Maintenance:

    • Flush catheters with heparinized saline every four hours if not in use to prevent clotting.
    • Regularly check insertion site for redness, swelling, or discharge.
    • An unattended catheter may cause thrombophlebitis (vein inflammation and clot formation).

  • Fluid Administration Protocols:

    • Swab catheter ports with alcohol before administration.
    • Always cap IV lines and maintain sterility during disconnection.

  • IV Fluid Pumps vs. Drip Lines:

    • IV pumps provide controlled fluid delivery per hour.
    • In absence of pumps, fluids can be administered via IV drip lines (micro-drip: 60 drops/ml; macro-drip: 10 or 15 drops/ml).

  • Monitoring Fluid Administration:

    • Track fluid levels in containers.
    • Patient positioning affects fluid delivery (monitor cat’s position to ensure consistent flow).

  • Signs of Overhydration:

    • Monitor for symptoms:
    • Serous nasal discharge, restlessness, tachycardia, coughing, tachypnea, etc.
    • Weigh patients daily (2.2 lb change = 1 L fluid change).
    • Report any concerning symptoms to a veterinarian.

  • Management of Fluid Overload:

    • Discontinue fluids and may administer diuretics (e.g., furosemide) if necessary.
    • Provide supplemental oxygen for dyspneic patients.

Conclusion

  • Role of Veterinary Technicians:
    • Vital in monitoring and delivering fluid therapy, which is essential for patient survival and proper hydration.
    • Diligence in care and treatment plan execution is paramount for successful outcomes in veterinary patients.