16 Dog Restraint for Lateral Saphenous Blood Draw/IV Catheter

There are many methods to restrain and draw blood, or place an IV catheter!  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, don’t forget treats if appropriate, know what tubes to grab and what order to draw them and be ready!  Also decide if you have enough room to draw back on a syringe plunger, or if using a butterfly catheter would be easier-the favorite of many blood drawers! 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!

Lateral Saphenous blood draw 2 people generally required to restrain

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

Standing-often preferred by nervous dogs who are hesitant to lie down or sit, or those who do not like activity around their head. Using a basket muzzle and feeding through it is a great option for dogs

Lateral recumbency-helpful for smaller dogs who prefer more body support, dogs who prefer to lie down, but are nervous about front legs being handled (previous poor nail trim experiences etc…), dogs who are weak and unable to stand or sit.

Sternal recumbency in forelimbs with hips and rear legs lateral-helpful for dogs who prefer Sternal recumbency perhaps to breathe properly, or who may be weak, hips rotated laterally for easier access to lateral Saphenous.

1) Head and shoulder restrainer-similar to cephalic vein restraint-head neck in crux of elbow and hand on your face, free hand to manage front legs if needed

2) Hips and rear leg restrainer-prevents dog from sitting when in standing position, or manages hind legs when either in Sternal recumbency with hips lateral, or full lateral recumbency.

• Hips and rear leg handler palm approaches caudal aspect of the hamstring muscles, thumb on lateral aspect of stifle, then gently rolls vein as palm moves against the medial aspect of the stifle.  Similar to cephalic vein restraint, the skin can be slid into position to hold vein steady.  In this way the holders hand is on the medial aspect of the leg allowing the blood drawer to approach from behind or from the side of the dog and have no restrainer hand in the way of the lateral saphenous vein.  Holding off lateral saphenous vein detail video
• The other hand can brace anterior of the knee and support the dog standing, or hold the leg while in lateral recumbency to prevent movement of the leg.
• Please observe closely how individuals have adapted this technique to differing dog anatomy and situations and add to your tool box!

Holder says “I’m ready” when vein held off, Drawer says “poking”, or “I have the vein,” the holder continues to hold off until blood sample is fully drawn up.  Try to avoid saying “ok” as is common release word for dogs!

• 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, I’m ready to remove needle” and then “please hold off puncture site,” and if you are really coordinated you can grab a small folded gauze square to place on the puncture site.
• Holder or venipuncturist can apply short term bandage (usually small gauze 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, cleans up shaved hair, and scrubs area, lets restrainer know when starts to place the IV catheter, generally saying “I have a flash, advancing just a bit, catheter in, ok now please hold off at the proximal 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.
• Watch the video below using technique on a live dog.  Practice this approach on a stuffed dog to get the motion-this will help you build coordination so when you try on live dog you’ll understand this approach.

HOLDER NUTSHELL

• Be safe, comfortable and sustainable in your position
• Holder-hold off vein from caudal/lateral aspect close to stifle
• Slide skin from distal to proximal to put a bit of tension on the vein to prevent it from rolling
• Let off vein, BEFORE needle removed, still hold onto leg, then cover puncture when needle out

Link to videos for dog restraint for various blood draws

Link to videos for dog restraint for various exams