College of Veterinary Medicine

Small Animal DX & Therapeutic Techniques

Placement of a Jugular Catheter


 
jug_caths.jpg (41770 bytes)

There are several types of jugular catheters available. Most catheters are threaded through a needle, therefore, the hole made in the vessel wall by the needle is larger than the diameter of the catheter so for a short time after placement, blood tends to leak back around the catheter. Catheters demonstrated in the slide are Intrafusor (a) which has its own extension set and a separate needle guard, the Venocath (b) that has an attached needle guard and the Intracath (c) that has a detached needle guard.

jug_supplies.jpg (91523 bytes)

jug_pos_sternal.jpg (48345 bytes) jug_hold_vein.jpg (23835 bytes)

A jugular catheter can be placed with the patient in sternal recumbency, with the neck extended upwards.

jug_lat.jpg (22122 bytes) ..or in lateral recumbency. The catheter insertion site should be widely shaved of hair and aseptically prepared using an antiseptic solution such as BetadineTM or Chlorhexadine.

Digital pressure is applied at the thoracic inlet to cause the jugular vein to distend with blood. This is usually done by the person placing the catheter if the dog is in sternal recumbancy, but is done by the holder if the dog is in lateral recumbancy. The jugular vein is clearly visable in this dog.

jug_intracath.jpg (48217 bytes)

The following series of slides will show placement of a jugular catheter using an IntracathTM by Deseret.

jug_puncture.jpg (28708 bytes) Insert the catheter through the skin and through the wall of the vein in one motion, if possible. Make the puncture through skin and vein wall rapidly and forcefully. If you are too delicate and slow when inserting the needle, you will push the vein away from the needle instead of puncturing it. When the vein is punctured, blood will "flash" up the catheter along the blue marker line.
jug_feed_cath.jpg (30210 bytes) Once it is clear that the vein has been punctured, the catheter is threaded (pushed) through the needle by pinching through the plastic behind the catheter which pushes the catheter forward. The green plastic end of the catheter (a) is securely forced into the metal hub of the needle (b). The white plastic cap that still covers the needle hub in this slide will be removed.
jug_intrafusor.jpg (22766 bytes) The Intrafusor is packaged with a rigid plastic cylinder (a) covering the catheter. The white y-shaped part of the catheter (b) is pushed forward until it locks into the yellow hub of the needle (c). This results in the catheter being pushed through the needle. The catheter is the gray "stripe" between c and b. The white plastic cylinder (a) is pulled off and discarded. Other parts of this catheter are the extension tubing (d) and the needle guard (e).
jug_intrafus_tubing.jpg (30692 bytes) When using an Intrafusor style catheter, wait for blood to "flash" back into the extension set (a), to assure a good venipuncture, before pushing the catheter through the needle into the vein.
jug_guard.jpg (20018 bytes)

The needle guard is folded over the needle like a clamshell. Make sure that the needle is in the groove of the guard so that the catheter is not pinched by the needle guard when it is closed. Make sure that the tip of the needle (a) is within the needle guard so the needle does not lacerate the catheter.

jug_syylett.jpg (28035 bytes) The wire stylet (a) is removed. Make sure that the hub of the catheter (b) is firmly locked into the hub of the needle (c) when the stylet is removed or you may remove the entire catheter along with the stylet.
jug_guard_ear.jpg (16151 bytes) An injection cap (a) is attached to the catheter and the catheter is flushed with heparinized saline to assure the catheter is properly placed before it is bandaged. If the catheter is properly placed, you should be able to aspirate blood from the catheter and solutions can be injected without resistance.
jug_ear.jpg (21955 bytes) The external portion of the catheter should be positioned just behind the ear. Notice the small amount of blood leaking around the catheter at the puncture site (arrow). Bleeding around the catheter occurs as the catheter is slightly smaller than the hole made in the vein wall by the catheter needle.
jug_suture.jpg (25874 bytes) Although the needle guard has two holes for suturing (the second hole is under the tape), a butterfly of tape offers better stability in securing the catheter in place.
jug_sut.jpg (40275 bytes) The butterfly wings of tape are sutured to the skin using a 20 gauge hypodermic needle and nonabsorbable suture such as medium weight vetafil.
jug_antibiotc.jpg (27181 bytes) Antiseptic or antibiotic ointment is applied on a gauze square to the site that the catheter penetrates the skin. BetadineTM ointment is being applied in this picture.
jug_gauze.jpg (18934 bytes) A 1/3 to 1/2 inch thick pad of gauze is placed behind the catheter to elevate it away from the neck. This change in position of the external portion of the catheter "pushes" the catheter under the skin at the level of the skin puncture. If a segment of the flexible part of the catheter is visable at the puncture site, that segment of catheter may be bent and thus occluded.
jug_pad.jpg (26223 bytes)
jug_tape.jpg (24987 bytes) One inch tape is placed completely around the neck of the animal on either side of the catheter, catching the butterfly wings and the gauze pad with the antiseptic ointment.
jug_guaze.jpg (23620 bytes) This is followed by a layer of stretchy wrap such as cast padding or cling gauze. The wrap is placed around the neck both in front of, and behind, the external segment of catheter, two to three times on each side. The weave of the gauze can be loosened and placed over the top of the catheter, allowing the catheter to protrude through the gauze.
jug_tape_split.jpg (64270 bytes) A piece of 1 inch tape split lengthwise can be wrapped around the catheter for added security.
jug_vetwrap.jpg (19694 bytes) This is followed by an outer layer of Vet Wrap. This wrap is placed in front of, and behind the catheter. The wrap encircles the neck twice on each side of the catheter. A small hole is cut in the wrap and it is passed over the catheter. The tip of the catheter and injection cap protrude through the hole in the wrap.
jug_xtape.jpg (21330 bytes) Another piece of 1 inch tape (~4 inches long) split lengthwise, is wrapped around the top of the catheter to make it more secure.

Jugular catheters can be used for obtaining blood samples. They are especially useful for repetitive sampling such as occurs when monitoring a diabetic animal. When using an Intrafusor, which has an attached extension set, an extra piece of tape should be applied to the extension set. If the animal pulls on the catheter the chances of it being dislodged are reduced if the catheter is securely taped in place.

 
Last Edited: Feb 02, 2009 1:45 PM   

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