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How to place an intraosseous catheter in a puppy or kitten | VETgirl Veterinary Continuing Education Videos

In today’s VETgirl online veterinary continuing education video, we demonstrate how to place an intraosseous (IO) catheter in a neonate or pediatric veterinary patient. In the critically ill neonatal or pediatric patient, intravenous (IV) access is imperative. This allows for rapid fluid and medication administration (e.g., like life-saving dextrose!). In the event that an IV catheter cannot be placed, placement of an intraosseous catheter is the next recommended life-saving option. Almost all products can be given intraosseously (including crystalloids, colloids, blood transfusion products, medications, dextrose, CPR drugs, etc.), and are rapidly absorbed into the circulatory system. The most common sites for intraosseous access include the trochanteric fossa of the femur, the greater tubercle of the proximal humerus, the wing of the ilium or the crest of the tibia (e.g., tibial tuberosity). The author’s preferred site for IO catheter placement is the proximal femur. Similar to an IV catheter, an IO catheter should be placed in an area that is prepared in a sterile technique – shave, scrub and prepare the area. A small lidocaine bleb can be used, but use caution as this can distort palpation of the site if excessive lidocaine is used. NOTE: A specific IO catheter doesn’t need to be purchased; simply, a 18–22 gauge hypodermic needle can be used. When placing an IO catheter, the needle should be inserted into the bone parallel to the long axis of the bone.

In this VETgirl video, we demonstrate how to place an IO catheter in the trochanteric fossa of the femur. Identify the trochanteric fossa on exam. Use your non-dominant hand to cradle the cranial thigh in the palm and extend the thumb along the lateral aspect of the femur – this will help with restraint of the leg and for better manipulation. Use a firm, but brisk, rotating motion, drive the hypodermic needle carefully into the trochanteric fossa with circular wrist motion. Following placement, attach a 3-mL empty syringe and aspirate back; you often times will see bone marrow spicules or a small amount of blood. Flush with 3-5 mls of saline to assure patency. You should palpate around the IO site and long bone to make sure that a fluid pocket is not palpated (e.g., that the fluid is going into the bone marrow cavity). Flush the IO catheter with saline. Ideally, the IO catheter should be secured with a bandage, suture, or tape preparation and covered to protect the sterile site. The neonate or pediatric patient should be volume resuscitated aggressively (Remember, neonates have a daily maintenance fluid rate of 100-180 ml/kg/day!). Intravenous access should be attempted as soon as possible following IO catheter placement, ideally within 2 hours to reduce the risk of complications from the IO catheter such as infection, inflammation, or even fracture. Radiograph

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  1. Great video, thank you. I’d really appreciate a followup video showing your preferred bandage techniques,

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