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How to Draw Blood from a Jugular Vein on a Dog | VETgirl Veterinary Continuing Education Videos

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In this VETgirl online veterinary continuing education video, Amy Johnson, BS, LVT, RLATG, CVJ, VETgirl’s Manager of Content Development, and Michaela Witcher, MS, CVT, review how to draw blood from a jugular vein on a dog. Phlebotomy is an important and common technique that must be mastered by vet assistants, triage, veterinary technicians, and veterinarians. Venipuncture is an important procedure done every day in veterinary medicine, and must be mastered for patient comfort, patient care, and efficiency in the veterinary clinic.

 

How to Set Up and Hold the Syringe
A couple of things to understand before poking our patient to draw the blood are the syringe, the needle, and how to hold the syringe. First, the needle needs to enter the patient’s skin bevel up. This means you can see the oval-like opening of the needle as it goes into the patient.  Second, we want to break the seal on the syringe. This requires you to pull the plunger back to allow air to enter the syringe and then push it back out. This will break the factory seal on the syringe and allow the plunger to pull back more easily once you have the needle in the patient. Next and probably most important is how to hold the syringe. You need to have a “3-finger grip” on the syringe’s barrel to stabilize the syringe and have a way to pull the plunger back. This requires your thumb and first two fingers at the bottom of the syringe. This then allows for your 3rd and/or pinky finger to pull back on the syringe. You don’t want to hold the syringe like a cigarette or a pencil. These grips don’t give you a good way to pull the plunger back and still stabilize the syringe in the patient’s neck. Also important is choosing the appropriate gauge of needle for your patient. The rule is to go as large as possible in the patient you have. Too small of a needle will cause hemolysis, which can interfere with laboratory testing.

Prior to Poking the Patient
Like most things we do in a veterinary practice, make sure you have your supplies ready before moving straight to the blood draw. Minimally, you will need a couple of syringes and needles, the appropriate blood tubes, and either alcohol wipes or a spray bottle.

Also important is understanding the anatomy of the patient and the jugular vein. The vein runs on either side of the neck from the base of the neck in the jugular groove/furrow towards the back point of the mandible. When you go to hold off the vein for the procedure, you will do so in the thoracic inlet. You will want to ensure that you are holding off on the same side you will draw on. For example, if you are going to draw from the right jugular vein, you will want to hold off in the right thoracic inlet.

The Blood Draw Itself
One of the most important pieces of a blood draw is appropriate restraint. Restraint can make the difference between a smooth, clean blood draw and missing the vein completely.

*For restraint reminders, check out THIS VETgirl Video.

Once your patient is restrained appropriately, you will hold the vein off and feel for the vessel. If you aren’t sure if what you feel is the vein or not, you can release the pressure and then hold it off again to confirm you are feeling the vein rise and fall with the pressure.When it comes time to draw, hold off with the hand that will not be holding the syringe. The vein won’t always be visible, but you should always be able to palpate it before poking with the needle.

Prepping the site for the blood draw will vary based on each individual practice’s protocols, the situation, and the dog. Some practices will require the neck fur to be clipped, while others try to do it without clipping any fur. Whether it is clipped or not, alcohol should be used to wet the fur down and help disinfect the site for the needle poke. Some practices may require more of a disinfection prep on the skin. Also, something that will vary from practice to practice is the requirement to wear gloves for the blood draw.

When you go to draw the blood, make sure you remove the needle cap with your hands, not your mouth, and ensure nothing touches the needle until it goes into the fur/skin of the animal. Insert the needle in the skin bevel up and pull back with gentle pressure on the plunger of the syringe once it is through the skin into where you are feeling the vessel. You will know you hit the vessel when the syringe fills with blood. If you don’t get blood when you first draw back pressure on the syringe plunger, do not remove the needle to start again. Keep the needle in the patient and gently redirect where you are feeling the vessel. Keep back pressure on the plunger as you redirect. Once you have a flash of blood, stop moving the needle and continue to pull pressure on the plunger. Once you have drawn the amount of blood you need, stop pulling on the plunger and remove the needle. The restrainer will apply pressure to the site where the blood was drawn to stop any bleeding and avoid hematoma formation.

Filling the Blood Tubes
If the blood tube has a rubber cap, the needle can be placed through the cap to fill the appropriate amount of blood. But if hemolysis can interfere with the tests being run, it is best to carefully remove the needle from the syringe and the rubber cap on the tube and directly push the blood into the tube. Once the blood is in the tube gently invert it a couple of times to ensure adequate mixing with the anticoagulant or chemical additive in the tube.

*For information on blood tubes and what order to fill them, check out THIS VETgirl Video.

 

 

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