Injections and blood collection

Question 1

Angle for IM injection

Answer 1

90

Question 2

Angle for SQ injection

Answer 2

45

Question 3

Angle for IV injections

Answer 3

20-30

Question 4

Angle for ID injections

Answer 4

10-15

Question 5

ID is used for

Answer 5

• Used for skin testing, allergy testing, or to desensitize
  skin with local anesthetic.
• Dogs: allergy testing or for skin desensitizing wherever
  needed.
• Cattle: tuberculosis testing.
• Horses: used for allergy testing on the side of the neck and
  for treatment of sarcoid or nodular skin lesions.

Question 6

Maximum volume injected IM

Answer 6

2ml felin, 3-5ml canine

Question 7

Max volume for ID injection

Answer 7

0.1ml per site

Question 8

Sites for IM injections

Answer 8

• Lumbodorsal muscles
• Back - lateral to dorsal spinous processes of lumbar spine
• not recommended for very thin dogs
• Semimembranosus or semitendinosus muscles
• hind limbs caudal to femur
• Triceps muscles
• front limbs caudal to humerus
• Quadriceps muscles
• Hind limbs cranial to femur
• Neck is never used for intramuscular injection in small
  animals

Question 9

Lumbodorsal IM injection

Answer 9

Palpate the dorsal spinous processes between the 13th rib and iliac crest.
* Insert the needles 2-3 cm off midline into the lumbar muscles at a 90° angle (perpendicular) to the skin

Question 10

Semimembranosus/ Semitendinosus IM injection

Answer 10

• Thumb placed in groove just caudal to the femur
• Insert the needle caudal to femur with tip directed caudally.
• This avoids any risk of damage to the sciatic nerve

Question 11

Triceps IM injection

Answer 11

• Muscle belly is grasped in noninjecting hand with the thumb on the humerus.
• Insert the needle caudal to the humerus and at a 90°angle with the needle tip directed caudally.

Question 12

Quadriceps IM injection

Answer 12

• Thumb of noninjecting hand is placed on lateral femur.
• Needle is inserted cranial to the femur at a 90°angle with the tip directed cranially.

Question 13

Complications with IV injections

Answer 13

• Hemorrhage/hematoma
• Muscle damage
• Nerve damage
• Thrombophlebitis

Question 14

Why IV injection

Answer 14

• Used to administer medications, fluids, blood transfusions, or collect blood samples.
• Medications are absorbed quickly by this route

Question 15

Max volume for SQ injection

Answer 15

30-60ml/site

Question 16

Common problems with venipuncture

Answer 16

• Vein “blows”
• bleeding around puncture site which forms a hematoma (bruise).
• This can lead discomfort for the animal and an inability to collect blood from that vessel until it resolves (days to weeks)
• Blood clots before you can put it into the tube
• Usually from a very slow bleeding/small vein
• If collection is very slow may want to collect blood for one tube and get it into the tube, then do a second poke to collect the rest of your sample
• Get a flash but then unable to collect blood
• This is usually from having to adjust your hand (needle moves out of the vein)

Question 17

Why is accidentally hitting other structures a problem

Answer 17

Accidentally hitting other nearby structures
* This is the biggest safety concern!
* With most veins, there is both an artery and a nerve close by.
* Hitting an artery can cause a large amount of bleeding.
* Hitting a nerve can cause pain and/or nerve damage.
* Biggest concern is with the jugular vein
* Not only do the carotid artery, and a nerve run close, but the trachea is also quite close.
* Good restraint is essential to prevent patient movement
* Know your landmarks and ensure you can palpate the vein before inserting the needle

Question 18

ID needle size for cats and small dogs

Answer 18

25g-30g 5/8”-1/2”

Question 19

SQ needle size for cats and small dogs

Answer 19

Volume < 1mL: 25g 1/2”-1”
Volume > 1mL: 22g 1”

Question 20

IM needle size for cats and small dogs

Answer 20

25g 1/2”-1”

Question 21

IV needle size for cats and small dogs

Answer 21

25g 1/2”-1”

Question 22

ID needle size for med/lg dogs

Answer 22

25g-27g 5/8”-1/2”

Question 23

SQ needle size for med/lg dogs

Answer 23

20g-22g 1”

Question 24

IM needle size for med/lg dogs

Answer 24

22g-25g 1/2”-1”

Question 25

IV needle size for med/lg dogs

Answer 25

22g 1/2”-1”

Question 26

ID equine needle size

Answer 26

25g-27g 1/2”-5/8”

Question 27

SQ equine needle size

Answer 27

20g-25g 1/2”-1”

Question 28

IV equine needle size

Answer 28

18g-20g 1.5”

Question 29

IM equine needle size

Answer 29

18g-20g 1.5”

Question 30

ID bovine needle size

Answer 30

20g-22g 1.5”

Question 31

SQ bovine needle size

Answer 31

16g 2”

Question 32

IM bovine needle size

Answer 32

16g 1.5”

Question 33

IV bovine needle size

Answer 33

Jugular 14g-18g 1.5”-2”
Coccygeal 18g-20g 1.5”