17 Dog Restraint For Cephalic Blood Draw/IV Catheter

There are many methods to restrain and draw blood!  We are reviewing and practicing a few low FAS methods for your toolbox.  As a lifelong learner, you will observe and experience many techniques, and many outcomes.  Please evaluate each in terms of safety-both patient and staff, reduction of FAS of the patient, and quality of the sample.  Be mindful of what worked and didn’t work and how you may add techniques into your own tool box. Remember, communication between handler and drawer/IV catheter placer is vital to success-build a plan together.  As always, gather needed supplies, know what tubes to grab and what order to draw them and be ready! Breathe and be happy! Commonalities in Blood draws

• Lidocaine cream can be placed several minutes prior to blood draw and wiped off before attempt for those patients who are sensitive to needle pricks-can also be used for vaccinations in this way as well!

PRESERVE CEPHALIC VEINS FOR IV CATHETERS IF YOUR PATIENT NEEDS A CATHETER ESPECIALLY IF GOING TO SURGERY AS CEPHALIC VEINS EASIER TO REACH DURING SURGERY VS. LATERAL SAPHENOUS IN MOST CASES. ALSO DO NOT PUT AN IV CATHETER IN AN INJURED LEG!

Dog cephalic blood draw/IV catheter restraint

• Secure/restrain patient: comfortable nonslip footing for patient and handler!  Choice depends on patient temperament, behavior cues and environment.

Sternal recumbency-very stable, dog is fully supported by table or floor, good position for dogs who are weak, or prefer sternal due to injury, breathing difficulty etc…

Sitting-stable even with one front leg lifted, fairly natural for most dogs, may be difficult if dog has vestibular disease or leg injury

Standing-less stable with one front leg lifted, some dogs are fine, others may not have the strength or willingness to stand on 3 legs. Many practitioners prefer standing to draw blood from lateral saphenous using a butterfly catheter.

1. In general, holder positions themselves on opposite side of the leg being drawn from, generally handler on left side of patient, uses right hand to grasp right elbow, and left arm secures head/neck as described below, vice versa for the other leg.

2. Read patient’s behavior cues, be aware of holder’s body position-NOT directly over patient-keep one side open = less FAS for dog. Make sure the Holder position is safe, comfortable and sustainable to keep dog and leg in position

4. Holder holds head/cranial neck of patient in crook of elbow with hand in extension bracing the neck-this position allows for palm on side of face of holder providing added support, comfort and safety for the holder-this method is secure and relatively easy to maintain.

• Protect patient elbow from hard surface with towel on table if needed
• Grasping antebrachium close to the elbow, and stabilize cephalic vein in dorsal/anterior position (on top of the antebrachium) often accomplished by grasping skin of proximal/medial antebrachium, thumb medial, palm down and gently rolling the cephalic vein to the dorsal/anterior aspect of the antebrachium, then bring thumb slightly proximally-this maneuver adds just a bit of tension within the skin which also helps prevent the vein from rolling.

6. Holder and drawer communicate when holder is to let up on vein and cover site of puncture when needle withdrawn. Often this is stated by drawer as “let up please” Then, after vein released, pressure in vein drops, THEN drawer removes needle. With practice this becomes automatic for teams that work together-new teams need to communicate-without trigger words! 🙂 Make sure this makes sense to you!

• Holder or venipuncturist can apply short term bandage (usually small gauze folded on itself with vet wrap) on site if needed-always good to set up prior to blood draw. Many clinics make these in the morning to be ready for the day.
• For IV catheter placement, the Holder restrains as above, holds the vein off and says “I’m ready”,  IV catheter placer, shaves and scrubs area, cleans up shaved hair etc…then starts to place IV catheter, generally saying “I have a flash, advancing just a bit, catheter in, ok now please hold off at end of the catheter” Holder moves thumb or finger to hold off vein at the proximal end of the placed catheter to prevent bleeding (NEVER AT SITE WHERE CATHETER GOES INTO SKIN), while the IV catheter placer puts plug or T-port on the hub end of catheter.  (Some IV catheter placers prefer to hold off vein themselves), Holder continues to hold leg in position while catheter is being taped in.

HOLDER NUTSHELL

• Be safe, comfortable and sustainable in your position
• Holder-hold head/neck in crux of one elbow-brace hand against face
• Hold off vein and position it dorsal on the foreleg-make sure comfortable for you and the dog
• Once blood collected, let off vein, BEFORE the needle removed, still hold onto leg, then cover puncture site when needle out
• Let off vein once IV catheter is in and move to hold off vein at the proximal end of catheter to prevent blood from leaking out until cap or T-port is attached, continue holding the leg.

Link to videos for dog restraint for various blood draws

Link to videos for dog restraint for various exams