16 Dog Restraint For Cephalic Blood Draw
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
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Some hints and tidbits:
- 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 if going to surgery as they are easier to maintain as close to the head and do not place an IV catheter in an injured leg!
- dont draw blood from an injured leg or under infected skin!
Dog cephalic blood draw
Secure/restrain patient: comfortable nonslip footing for patient and handler, several body position options! 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.
Steps of restraint/positioning:
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, so dog doesn’t feel trapped and is 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.
5. Helpful tidbits for finding vein and drawing blood:
- Drawer asks holder “ready?”
- Drawer cradles antebrachium under the leg palm up with non-dominant hand and uses thumb along one side of the vein to steady and can gently pull skin distally to tighten the skin which prevents the vein from rolling.
- Drawer strokes the vein toward the foot a couple times-this causes the vein to stand up a bit, (in human medicine it is common to tap the vein a few times-this is annoying for dogs and cats and we cant tell them why we are doing it stroking is less irritating). Apply a bit of alcohol-sticks to hair makes it easier to see the vein, can part hair to visualize skin.
- Just as in Jugular blood draw, you can rest your syringe hand on your non-dominant hand holding the antebrachium.
- Start distal in case the vein is blown-you can try again more proximally. Bevel up pointing proximally approx 15-20 degrees
- “Poking” (avoid saying “OK” as release word for many dogs! As you enter the skin into the vein-flash (be sure bevel is fully in lumen) draw back gently, and fill syringe or collection tube.
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.
Holder/restrainer 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 with gauze square and can make bandage with vet wrap.
Link to videos for dog restraint for various blood draws
Link to videos for dog restraint for various exams