The one lifesaving tip this ER veterinarian wishes more practitioners knew about ...
Dr. Pachtinger is an emergency and critical care clinician at Veterinary Specialty and Emergency Center in Levittown, Pennsylvania, and Philadelphia, Pennsylvania. He is also the chief operating officer for VetGirl.
IO catheters can make a crucial difference for neonate and pediatric patients in emergent situations.
Placing an intravenous catheter can become challenging when the neonate and pediatric patients present sick with inappetence or gastrointestinal losses. In these cases, the patient may also present hypotensive, hypothermic, hypovolemic, or hypoglycemic with very weak pulses. When sick neonate and pediatric patients present such flat pulses, palpating arteries and veins becomes increasingly difficult for veterinarians who are trying to put an IV in.
Garret Pachtinger, VMD, DACVECC, says there's a tremendously valuable lifesaving procedure in both ER and general practices: placing an intraossenous catheter in the patients. Placing an IO catheter in the femur, for example, could provide fluids, dextrose support and a better opportunity to be resuscitated until an IV can be put in later.
According to Pachtinger, not only is this inexpensive, simple and free of fancy equipment, but it is ultimately lifesaving. You can watching him talk about it here:
You might ask, won't placing an IO catheter be painful? While analgesia is very important in veterinary medicine, IO catheters are often placed in extremely debilitated neonatal or pediatric patients where medications such as NSAIDS, opioids or other classes of analgesics may have more risks than benefit. As a result, systemic analgesia may not be the best option for the hypovolemic, hypothermic or otherwise debilitated pediatric or neonatal patient, says Pachtinger.
In these cases, to provide analgesia, Pachtinger says a small bolus of 1% to 2% lidocaine over the insertion site can be considered before the IO placement. And keeping analgesia in mind, it is then recommended to replace the IO catheter with an IV catheter as soon as possible.