Operator experience and easily identifiable veins predict first-time intravenous catheterization success rates in dogs in an emergency room.

Abstract

OBJECTIVE: To assess factors associated with first-time successful IV catheter (IVC) insertion in dogs presenting to an emergency room and to describe the reasons for IVC insertion failure. METHODS: This prospective study evaluated dogs requiring IVC insertion over a 3-month period. Variables assessed included vein utilized, catheter size, reason for insertion, operator performing the catheterization and their related experience, as well as whether veins were visible or palpable. RESULTS: There were 372 catheters inserted in 359 dogs. Of the catheters where insertion success was documented, 85.6% (309 of 361) were successfully inserted on the first attempt with the greatest number of successful catheters (96%; 298 of 309) inserted in a cephalic vein. Veterinary technicians had the highest first-time success rate (87.6%; 248 of 283), while veterinarians had the lowest (75%; 15 of 20), although this difference was not statistically significant. The first-time insertion success was more likely when the operator had inserted over 500 catheters previously (OR, 3.55; 95% CI, 1.59 to 7.93). Vein visibility (OR, 3.61; 95% CI, 1.55 to 8.37) and palpability (OR, 3.64; 95% CI, 1.39 to 9.53) were also associated with first-time insertion success. Veins resistant to catheter advancement, operator inexperience, and patient hypotension were the most reported reasons by operators for insertion failure. CONCLUSIONS: Greater operator experience and easily identifiable veins (visible and/or palpable) significantly increase the likelihood of first-time insertion in dogs. CLINICAL RELEVANCE: Providing veterinary technicians with more opportunities to perform IV insertion could improve success rates, especially in cases of difficult venous access.