Medication Administration (Large Animals) Flashcards
(168 cards)
1
Q
shorthand for “nothing by mouth”
A
NPO
2
Q
shorthand for medication to be administered orally
A
per os (PO)
3
Q
List 5 methods of oral medication administration in large animals
A
- Syringes
- Drenching
- Balling Guns
- Nasogastric Intubation
- Orogastric Intubation
4
Q
Syringes can be used to deliver what 2 forms of medications?
A
- Pastes
- Tablets
5
Q
PROCEDURE - Administering Medication via Syringe
A
- Restrain the head > using free arm > cradle head + reach around to put hand up over muzzle
- Insert syringe into mouth at lips commissure + near interdental space > between cheeks and teeth
- Advance syringe as far back into mouth as possible
- Admin meds slowly > to avoid aspiration or drooling before syringe can be withdrawn
- Lift head slightly + blow on nose > encourage animal to swallow
6
Q
administering liquid medication or small volumes of fluid onto the tongue using a dose syringe
A
Drenching
7
Q
Do NOT drench sheep or goats with more than ____ mL of liquid
A
30 mL
8
Q
Do NOT drench with _______ because it can be fatal if inhaled
A
mineral oil
9
Q
PROCEDURE - Drenching
A
- Restrain animal > hold nose slightly elevated + pulled toward handler
- Insert tip of dose syringe into interdental space
- Slowly dribble fluid onto the tongue
10
Q
a device used to administer tablet medication deep into the back of livestock mouths to facilitate swallowing
A
Balling Gun (Pilling)
11
Q
What could happen if you use a large balling gun on a small calf, goat or sheep?
A
Could split soft palate or cause phalanx rupture
12
Q
Why should you inspect the balling gun before every use?
A
To ensure no sharp edges have formed
13
Q
PROCEDURE - Using a Balling Gun on Large Livestock (Adult Cattle)
A
- Place patient in head gate > VT stand next to patient’s head + facing same direction
- Open animal’s mouth > using arm nearest to patient > reach over
◊ Grasp mouth at interdental space > press on hard palate
OR
◊ Place finger in 1 nostril + thumb in other nostril > pull nose dorsally - Insert balling gun into mouth > gently work back toward pharynx
- Once thumb rings of gun are at lip commissure > depress plunger
- Keep patient’s head down
- Cattle will lick nostrils once pill is swallowed
14
Q
A
Drenching > using a dosing syringe to administer liquid medication
15
Q
What could happen if the balling gun is NOT inserted far enough into the mouth of calves, sheep, or goats? What could happen if inserted TOO far?
A
If balling gun is not inserted far enough > medication may be chewed and spit out
If balling gun inserted too far > serious damage to pharynx and larynx
16
Q
Give 4 indications for nasogastric intubation in large animals
A
- Large volumes of oral fluid substances must be given
- Relieve gastric distention
- Relieve feed impaction
- Oral fluid therapy or enteral feeding required for extended periods
17
Q
Nasogastric intubation is commonly used for which species? Why?
A
Horses - larger nasal passages than other large animals
18
Q
How do you estimate the length of an NGT? What else should you do for horses?
A
Measure from nostril entrance to rumen (last tib) + mark
Horses > also mark where the tube reaches the pharynx
19
Q
Why is it helpful to also mark an NGT where it reaches the pharynx in horses?
A
When tube reaches pharynx > rotate tube > deflects it into esophagus (rather than into trachea)
20
Q
Give 2 possible complications during NGT removal
A
- Nosebleed
- Aspiration of residual fluid or meds
21
Q
elastic tape wrapped around the muzzle of a patient in order to keep NGT in place without sutures
A
Stay Tape
22
Q
If NGT must remain in place for repeated administrations, how do you keep the NGT in place for:
1. Adult Equines
2. Neonatal Equines
A
Adults = Coil NGT > tape tube to halter > prevent entry of foreign material by using syringe case, tube cap, another adapter
Neonates = Place stay tape around muzzle > coil the tube off to side of the mouth > secure tube at base of nostril with 1” piece of butterflied tape > affix butterflied tape to stay tape
23
Q
PROCEDURE - Nasogastric Intubation (Medication Administration)
A
- Estimate length of NGT from nostril entrance to rumen/stomach > mark tube
- VT stand next to patient’s head + facing same direction > reach over with arm nearest to patient > place finger in 1 nostril + thumb in other nostril > pull nose dorsally
- Pass NGT in ventral matter through nasal meatus + nasopharynx > resistance passing through esophagus > look at neck for movement + to visualize placement
- Continue until NGT in rumen or stomach > check premeasured mark > blow into tube + listen with stethoscope over rumen/stomach for bubbling > confirms proper placement
- Check patient for gastric reflux
◊ If normal amount of gastric fluid noted > use stomach pump/dose syringe/gravity flow > admin meds/fluids/etc.
◊ Neonates - use 60 mL syringe to aspirate - Once admin complete > remove pump from end of tube > hold tube above patient’s head > delivers remaining meds into stomach/rumen > pump small amount of water or air to deliver remaining fluid
- Cover end of tube with thumb + kink > pull out tube with gentle + long motions
- Monitor patient for colic symptoms, bloat, or respiratory problems
24
Q
PROCEDURE - Nasogastric Intubation (Gastric Distention Relief/Gastric Lavage)
A
- Estimate length of NGT from nostril entrance to rumen/stomach > mark tube
- VT stand next to patient’s head + facing same direction > reach over with arm nearest to patient > place finger in 1 nostril + thumb in other nostril > pull nose dorsally
- Pass NGT in ventral matter through nasal meatus + nasopharynx > resistance passing through esophagus > look at neck for movement + to visualize placement
- Continue until NGT in rumen or stomach > check premeasured mark > blow into tube + listen with stethoscope over rumen/stomach for bubbling > confirms proper placement
- Pump a known amount of water into tube > causes a siphon > gastric fluid + contents collected back from tube into a bucket
◊ If a lot of gastric fluid retrieved > secure NGT in place - Once complete > cover end of tube with thumb + kink > pull out tube with gentle + long motions
- Monitor patient for colic symptoms, bloat, or respiratory problems
25
Give 4 indications for orogastric intubation
1. Large volumes of oral fluids must be given
2. Relieve gastric distention
3. Rumen transfaunation
4. Oral fluid therapy or enteral feeding required for extended periods
26
Orogastric intubation is commonly used for which species? Why?
1. Cattle
2. Sheep
3. Goats
4. Pigs
5. Camelids
Nasal passages too small for comfortable NGT
27
How do you estimate the length of an OGT?
Measure from mouth to rumen (last rib)
28
PROCEDURE - Orogastric Intubation (Medication Administration)
1. Estimate length of OGT from mouth to last rib > mark tube
2. VT stand next to patient's head + facing same direction
3. Reach over with arm nearest to patient > place finger in 1 nostril + thumb in other nostril > pull nose dorsally > opens mouth
◊ Or grasp interdental space > press on hard palate
4. Insert speculum over tongue root in middle of mouth > pass OGT into pharynx > resistance passing through esophagus > look at neck for movement + to visualize placement
5. Continue until OGT in rumen > check premeasured mark > blow into tube + listen with stethoscope over rumen/stomach for bubbling > confirms proper placement
6. Check patient for gastric reflux
◊ Neonates - use 60 mL syringe to aspirate
◊ If normal amount of gastric fluid noted > use stomach pump/dose syringe/gravity flow > admin meds/fluids/etc.
7. Once admin complete > remove pump from end of tube > hold tube above patient's head > delivers remaining meds into stomach/rumen > pump small amount of water or air to deliver remaining fluid
8. Cover end of tube with thumb + kink > pull out tube with gentle + long motions
9. Monitor patient for colic symptoms, bloat, or respiratory problems
29
What 3 vessels can be used for equine IV injections? Which is preferred?
1. Jugular > preferred
2. Cephalic Vein
3. Lateral Thoracic Vein
30
What are 3 possible complications of equine IV injections?
1. If meds injected into artery (and not vein) > it goes directly to the brain > can cause serious + violent reaction > can be fatal
2. If some meds injected perivascularly (and not vascularly) > can cause severe necrosis of contacted tissue
3. Mild to severe anaphylaxis
31
Urticaria
hives
32
VT should have prior arrangements with vet regarding amount of ______ to administer if anaphylaxis occurs without vet available
epinephrine
33
How can you tell if a needle is in the vein or the artery?
If needle in vein > dark red blood will steadily drip from needle hub
If needle in artery > bright red blood will forcibly pulse out of needle hub
34
Equine Jugular IV Injection:
Use the _____ jugular and the ______ of the neck
Use the right jugular and the cranial half of the neck
35
Why do you use the right jugular in equine jugular IV injections? And why do you use the cranial half?
The esophagus lies in the left jugular furrow.
The muscle layer in the upper neck protects the carotid artery.
36
Give 3 contraindications for equine jugular IV catheterization
1. Thrombosis in vein
2. Trauma to vein
3. Horse continues to touch catheter
37
If an equine jugular IV catheter is to remain in place for a long time, why should you rotate the type of antibacterial used?
Reduces the chance of drug-resistant staphylococcus
38
Give 2 possible complications of equine jugular IV catheterization
1. Accidental catheterization of carotid artery
2. Drug-resistant Staphylococcus
39
Why is a lidocaine bleb administered over and above the injection site for equine jugular IV catheterization?
To desensitize the area for suturing the catheter in place
40
another name for an intermittent infusion plug
PRN Adaptor
41
PROCEDURE - Jugular Vein Catheterization in Equines
1. Shave + surgically scrub injection site > wipe site with Betadine solution + leave to dry
2. Admin lidocaine bleb over + above injection site
3. Open pack of sterile gloves > aseptically lay cath on the gloves > creates a sterile field > keep all needed items on sterile field or nearby
4. Wearing sterile gloves > grasp cath with dominant hand + apply digital pressure to jugular furrow with other hand
5. Insert cath at 45º angle through the bleb + toward the heart > see flash of blood in cath hub > align cath more perpendicular to vein + advance 1 cm more
6. If cath still in vein > release digital pressure > grasp top of stylet portion of the catheter > simultaneously slide catheter all the way into vessel + remove stylet
7. Recheck vein is still catheterized > apply digital pressure below tip of catheter
8. Once blood drips from hub > attach intermittent infusion plug or T-port > suture cath into place
9. Place neck wrap or stent over catheter > stabilizes it + prevents patient from rubbing it out
10. Always clean injection port with isopropyl alcohol before + after fluid/med administration into catheter
42
What 4 vessels can be used for bovine IV injection? Which is preferred?
1. Jugular - preferred
2. Coccygeal Vein
3. Subcutaneous Abdominal (Mammary) Vein - don't use
4. Auricular Vein
43
the process of stroking a finger over a vein in a downward direction to help make the vein more prominent and assist in visualization
Vessel Ballottement
44
When can you use the coccygeal vein for bovine IV injections?
Up to 5 mL of nonirritating medication
45
What can cause possible complications of coccygeal vein injection in bovines? What are the 2 complications?
Due to administering irritating drugs
1. Vein thrombosis
2. Sloughing of tail
46
PROCEDURE - Coccygeal Vein Injection in Bovines
1. Place patient in chute to restrain
2. Palpate the midline of the ventral surface of the tail > locate 2nd or 3rd coccygeal vertebra
3. Clean site with 70% isopropyl alcohol
4. Introduce needle to skin at 45º angle > look for flash of venous blood in needle hub
5. Attach syringe with medication to needle (if not already attached) > aspirate to reconfirm needle still in vein
6. Administer medication > remove needle + syringe > apply digital pressure to site > prevent hematoma formation
47
When is the auricular vein used for bovine IV injection?
Very small amounts of medications
48
Give 3 vessels used for bovine IV catheterization
1. Jugular - preferred
2. Cephalic - if jugular is inaccessible
3. Caudal Auricular
49
Which 2 vessels are used for camelid IV venipuncture?
1. Jugular - preferred
2. Cephalic
50
Why is the cephalic vein difficult to access in camelids for IV venipuncture?
Due to their tendency to sit in a kushing position
51
Which area(s) of the neck should be used for camelid jugular VP? Why?
Upper or lower 1/3 of the neck
- 1 cm thick skin on neck
- Large transverse processes of cervical vertebrae
52
Which vessels are used for ovine and caprine IV venipuncture?
1. Jugular - preferred
2. Cephalic
53
Which vessels are used for porcine IV venipuncture? And which age should each be used?
1. Lateral Auricular Vein - adult pigs
2. Jugular - piglets
54
Give 4 possible complications of porcine IV venipuncture
1. Phlebitis
2. Thrombophlebitis - can be life-threatening
3. Local Cellulitis
4. Septicemia
55
an infection that occurs when germs get into the bloodstream and spread
Septicemia (Blood Poisoning)
56
PROCEDURE - Auricular Vein Injection in Porcines
1. Properly restrain patient
2. Attach syringe with medication to needle
– Do NOT attach after needle is already in > vessel is delicate
3. Clean ear with alcohol-soaked gauze
4. Apply digital pressure to base of ear > occludes vein
5. Insert needle into vein toward base of ear + at very shallow angle
6. VERY gently aspirate to confirm venous placement
7. Release occlusion > steadily admin meds
8. Remove needle + syringe > apply digital pressure > prevent hematoma
57
PROCEDURE - Auricular Vein Catheterization in Porcines
1. Properly restrain patient
2. Occlude vessel via digital pressure at base of ear OR rubber band tourniquet
3. Surgically prepare dorsal aspect of pinna
4. Insert catheter into vein toward base of ear > release occlusion >
5. Cap catheter with PRN adaptor > secure catheter to ear with glue
6. Place a roll of gauze inside pinna > bend margins of ear around the gauze > secure with adhesive tape
58
IM needle sizes are based on what 3 things?
1. Drug viscosity
2. Volume to be administered
3. Muscle size
59
IM injection sites are based on what 4 things?
1. Drug viscosity
2. Volume to be administered
3. Potential injury to personnel
4. Potential complications for chosen muscle
60
If repeated IM injections are needed, why should you use various sites?
1. Minimizes muscle damage
2. Reduces pain
61
If the needle punctures a vessel during IM injection, you should _______ and _______.
1. Remove needle
2. Restart procedure with a NEW NEEDLE
62
Why is it sometimes helpful to insert the needle without the syringe attached during an IM injection?
If inserting needle with syringe attached > needle may fall out if animal moves due to weight of syringe
63
PROCEDURE - Standard IM Injection of Large Animals
1. Properly restrain patient
2. Select needle size
3. Clean site with 70% isopropyl alcohol
4. Only touching the hub > insert needle without syringe attached perpendicular to muscle
5. Once animal has stopped moving > attach med containing syringe to needle > gently aspirate to confirm placement in muscle > steadily inject meds
6. Remove syringe + needle > apply pressure if any blood at injection site
7. Massage injection site gently > disperses drug
64
Which 4 muscles are used in equine IM injection?
1. Lateral Cervical (Neck) Muscles
2. Semimembranosus / Semitendinosus Muscles
3. Pectoral Muscles
4. Gluteal Muscles - not common
65
Why should the lateral cervical muscles not be used for IM injection in foals?
Soreness from injection may make them reluctant to position themselves to nurse
66
When should you use the lateral cervical muscles for equine IM injections?
Injecting less than 10 mL in adult equines
67
The IM injection site for the lateral cervical muscles is between what 3 landmarks?
1. Nuchal ligament
2. Cervical vertebrae
3. Scapula
68
PROCEDURE - IM Injection of Lateral Cervical Muscle in Equines
1. Properly restrain horse
2. Select needle size > 18-22 gauge
3. Clean site with 70% isopropyl alcohol
4. Using nondominant hand > grasp + pull up skin next to injection site
5. Swiftly insert needle + med filled syringe > gently aspirate to confirm placement in muscle > steadily inject meds > release skin
6. Remove syringe + needle > apply pressure if any blood at injection site
7. Massage injection site gently > disperses drug
69
Why is the "skin pull" method helpful in IM injections?
Results in a needle hole in skin a few inches away from needle hole in muscle > creates barrier to prevent drug leakage when skin released
70
Give 2 possible complications of semimembranosus / semitendinosus muscles in equine IM injection
1. Accidental injection of sciatic nerve > paralysis
2. Excessive distention from injection of large volumes of meds > tissue necrosis
71
What are 3 possible complications from repeated IM injections into equine pectoral muscles? Where does this stem from?
1. Pain
2. Swelling
3. Edema
Due to small size of the muscle
72
What are 3 possible complications due to IM injection into the gluteal muscles of equines?
1. Difficulty detecting inflammation
2. Abscess formation
3. Inadequate drainage in area
73
Why are IM injections highly discouraged in bovines?
1. Possible damage to muscles
2. Most cattle are eventually consumed by humans
74
If absolutely necessary, which muscles are used for bovine IM injection?
Lateral Cervical Muscles
75
Which 3 muscles are used for IM injection in ovines and caprines?
1. Lateral Cervical Muscles - preferred
2. Gluteal - very small volumes only
3. Triceps - very small volumes only
76
Give 3 possible complications of IM injection in ovines and caprines
1. Significant soreness
2. Head drooping
3. Lamb/kid inability to nurse > due to above
77
Which 3 muscles are used in porcine IM injection?
1. Cervical muscles just caudal + ventral to ear > preferred
2. Semimembranosus / Semitendinosus > not for meat animals
3. Gluteal > not for meat animals
78
What is the max volume per IM injection site in adult pigs? Piglets?
5-10 mL > adults
1-2 mL > piglets
79
If absolutely necessary, which muscles can be used in camelid IM injection?
Semimembranosus / Semitendinosus
80
Why is the SC method preferred over IM injection in camelids?
Due to lack of large muscle mass in any one place
81
Where can SC administration be performed in large animals?
Anywhere the skin can be tented
82
Substances that can be SC administered include what 4 things?
1. Vaccines
2. Local anesthetics
3. Small volumes of medication
4. Small volumes of fluid therapy
83
Why is SC administration preferred over IM injection for show animals?
Less chance for adverse reactions
84
Which vaccine do you NOT tent the skin when administering subcutaneously? Why?
Brucella Vaccine - avoid accidental injection of VT
85
Needle size for SC admin is based on what 3 things?
1. Substance viscosity
2. Size of animal
3. Thickness of skin
86
Needle Size SC Admin:
Horses
20-25 gauge x 1"
87
Needle Size SC Admin:
Adult Cattle
16-18 gauge x 1.5"
88
Needle Size SC Admin:
Calves, Sheep, Goats, Pigs
18-22 gauge x 1.5"
89
Preferred Injection Site(s) for SC Admin:
Equines
Base of neck
90
Preferred Injection Site(s) for SC Admin:
Bovines
1. Neck
2. Behind Elbow
3. Eschiorectal fossa
91
Preferred Injection Site(s) for SC Admin:
Camelids
Behind elbow
92
Preferred Injection Site(s) for SC Admin:
Caprines
1. Behind elbow
2. Axillary region
3. Flank fold
93
Preferred Injection Site(s) for SC Admin:
Ovine
1. Axillary region
2. Inguinal area
3. Flank fold
94
Preferred Injection Site(s) for SC Admin:
Porcines
1. Axillary region
2. Inguinal region
3. Caudal to base of ear
95
PROCEDURE - Subcutaneous Injections (Large Animals)
1. Properly restrain patient
2. Select injection site with loose skin
3. Wipe site with 70% isopropyl alcohol
4. Grasp skin + pull away from muscle > insert needle into base of tented skin > gently aspirate to confirm no vessel punctured > steadily inject fluids
- Expect > visible bleb + fluid to eject easily
- If fluid does NOT eject easily > needle may be placed ID > reposition > then continue
5. Remove needle + syringe > gently rub injection site
- Lessens bleb
- Increases circulation > promote absorption
96
ID administration is used for what 4 things?
1. Skin testing
2. Allergen testing
3. Local anesthesia
4. Treat nodules skin lesions and sarcoids
97
a common tumor affecting the skin of horses
Sarcoid
98
Why would the use of antiseptics be contraindicated for ID administration?
May skew test results
Depends on purpose of injection > discuss vet's intentions
99
PROCEDURE - ID Injection (Large Animals)
1. Properly restrain patient
2. Shave + clean > allow to dry
- Use of antiseptic may be contraindicated based on purpose of injection
3. Grasp skin between thumb + forefinger > pull away from body
4. Place needle parallel to site > insert at slight angle > aspirate slightly to confirm no vessels have been hit
5. Steadily inject solution > should feel resistance if correctly in dermis > noticeable bleb should appear as injection is made
- If no bleb visible > needle is too deep
6, Do NOT massage injection site > solution intended to remain localized
100
PROCEDURE - Standard IP Injection for Large Animals Other Than Equines
1. Properly restrain patient
2. Aseptically prepare appropriate injection site
3. Insert needle + solution filled syringe into injection site
4. Gently aspirate to confirm no vessel or organ hit > steadily inject solution
5. Remove needle + syringe
101
PROCEDURE - IP Injection in Equines
1. Vet places abdominal lavage drain system
2. Using five-in-one connector > attach latex tubing to desired fluids + drain system
3. Administer desired amount of fluid + meds
4. Clamp off latex tubing > walk patient > distributes substances
5. Unclamp latex tubing > fluid drains out of abdomen > into original fluid bag
- Amount returned = amount administered (ideally)
102
How much fluid is typically administered during IP injection in adult equines?
10 mL
103
What is the VT responsible for in large animal peritoneal lavage?
VT responsible for aftercare + maintenance > NOT placement
1. Always wear gloves
2. Carefully keep system clean
3. Avoid introducing contaminants during admin
104
Give 2 indications for bovine IP injection
1. IV administration not possible
2. Treating peritonitis
105
What is the preferred site for bovine IP injection?
Paralumbar fossa
106
What are possible complications of bovine IP injection if performed on the LEFT side?
Puncturing rumen
107
What are possible complications of bovine IP injection if performed on the RIGHT side?
Puncturing intestine, dilated organs, or displaced organs
108
Give 2 indications for ovine and caprine IP injection
1. Umbilical infection
2. Hypoglycemia
109
What is the preferred site for IP injection in neonatal kids and lambs?
Just to the left of umbilicus + 1 cm deep
110
What is the benefit of IP administration vs IV administration in porcines?
Fluids can be more easily administered
111
When injecting fluids intraperitoneally, the fluid should be what 3 things?
1. Body temp
2. Nonirritating
3. Isotonic
112
Give 3 possible complications of porcine IP injection
1. Peritonitis
2. Abscess formation
3. Injury to internal organs
113
Intranasal administration can be used for what 3 things?
1. Certain vaccines
2. Local anesthetics before procedures on nasal cavity
3. Oxygen therapy for certain conditions
114
PROCEDURE - Intranasal Administration via Needleless Syringe (Large Animals)
1. Properly restrain patient + stead head with free hand > bring free arm under mandible > reach around + place hand on top of muzzle area
2. Wipe away any nasal discharge with damp gauze sponges
3. Slightly lift head
4. Introduce needleless syringe into nostril
5. Inject substance during inhalation
- Patient may sneeze > VT should take precautions to not get spray on their own mucous membranes
115
PROCEDURE - Intranasal Administration of Oxygen (Large Animals)
1. Properly restrain patient
2. Measure small rubber feeding tube > distance from medial canthus of eye to entrance of nostril > mark
3. Gently insert catheter ventrally into nasal passage to predetermined mark
4. Wrap Elastikon loosely around muzzle + attach piece of butterflied 1" adhesive tape to catheter > connect Elastikon to butterfly via suture material
5. Hook up the end of catheter to oxygen source > administer desired oxygen flow
- Oxygen flow delivered in liters per minute
116
Oxygen flow is delivered in _____ per ______.
liters per minute
117
Intramammary administration is used for what?
Mastitis treatment and control
118
Give a possible complication of intramammary administration
There is a high risk of introducing contaminants like organic debris and yeast
119
PROCEDURE - Intramammary Administration (Large Animals)
1. Properly restrain patient > minimal usually required
- Tail jack needed for some cows
2. Completely milk udder + manually strip
- Residual milk will dilute meds
3. Clean teats with teat dip > thoroughly dry each teat with a separate cloth > wipe each teat with an alcohol-soaked sponge > air dry
- Start with teats on far side > prevent transmissions of contaminants
4. Grasp teat at base > partially insert (up to 4mm) a sterile teat cannula OR disposable mammary infusion cannula on an antibiotic syringe > slowly inject antibiotic into canal > occlude end of teat > massage teat + udders to distribute meds
- Start with teats on near side
5. Repeat with new cannula + syringe on next teat
6. Reapply teat dip > air dry
- If temp is 32º F > do NOT move animal outside until udders are dry
120
Topical ophthalmic administration is used to treat ocular diseases or conditions such as:
1.
2.
3.
4.
1. Ulcers
2. Abrasions
3. Lacerations
4. Keratitis
121
PROCEDURE - Ophthalmic Ointment Application (Large Animals)
Method 1:
1. Properly restrain head
2. Slightly pull down the lower eyelid of the eye that needs medication
3. Apply a small amount of ointment directly to eye
- Do NOT touch surface of eye with applicator
4. Release eyelid > blinking distributes the medication
Method 2:
1. Properly restrain head
2. Place small ribbon of ointment on gloved finger
3. Slightly pull down the lower eyelid of the eye that needs medication
4. Apply ointment directly to eye
- Eliminates risk of scratching eye with applicator
5. Release eyelid > blinking distributes the medication
122
PROCEDURE - Ophthalmic Solution Application (Large Animals)
1. Properly restrain head
2. Slightly pull down the lower eyelid of the eye that needs medication
3. Place a few drops into lower conjunctival sac
4. Release eyelid > blinking distributes the medication
123
What are ophthalmic lavage systems used for?
Treatments that require repeated applications into the eye
SOLUTIONS ONLY
124
List the 2 types of ophthalmic lavage systems
1. Subpalpebral Lavage System
2. Nasolacrimal Lavage System
125
a device used to protect the eyes of large animals from sunlight, prevent the animal from rubbing the eye, and keep the eye free of debris while healing
Guardian Mask
126
PROCEDURE - Ophthalmic Solution Administration via Subpalpebral Lavage System (Large Animals)
1. Properly restrain head
2. Incision(s) made into upper or lower eyelids (by vet?)
3. Insert narrow rubber tubing through incision(s) > to open directly in the conjunctival sac + away from cornea
4. Secure system to skin above the eye > attach IV extension tubing > extend tubing system over the poll
5. Attach PRN adaptor to the end of the system
- Change every 24 hours OR more often if PRN becomes friable
6. Very slowly deliver slightly warmed medication > admin a very slow air bolus (1-2mL) to clear the line
- If resistance felt during solution injection > alert vet
127
PROCEDURE - Ophthalmic Solution Administration via Nasolacrimal Lavage System (Large Animals)
1. Properly restrain head
2. Small stab incision made into nasal punctum (by vet?)
3. Insert narrow rubber tubing through incision
4. Secure tubing to the skin > attach IV extension tubing > extend tubing system over the poll
- Prevents tubing from moving inside nostril or patient rubbing it out
5. Attach PRN adaptor to the end of the system
- Change every 24 hours OR more often if PRN becomes friable
6. Very slowly deliver slightly warmed medication > admin a very slow air bolus (1-2mL) to clear the line
- If resistance felt during solution injection > alert vet
128
Epidurals are used for what 3 things?
1. Deposit drugs into the epidural space
2. Provide anesthesia
3. Control pain
129
List 4 medications commonly administered via epidural
1. Lidocaine
2. Carbocaine
3. Xylazine
4. Morphine
130
List the 2 epidural locations that can be chosen by the vet based on the desired effect
1. Cranial Epidural (between L6 + S1)
2. Caudal Epidural (between S5 + Cy1 OR Cy1 + Cy2)
131
Cranial Epidurals are given between which vertebra?
Between L6 + S1 (aka lumbosacral junction)
132
Caudal Epidurals are given between which vertebra?
S5 + Cy1
OR
Cy1 + Cy2
133
Cranial Epidurals are typically used for which species?
1. Porcines
134
Caudal Epidurals are typically used for which species?
1. Equines
2. Bovines
3. Camelids
4. Ovines
5. Caprines
135
Handing sterile syringe to the vet:
1. Open plastic syringe casing
2. Gently slide syringe into sterile gloved hand of vet
- Do NOT touch outer casing to the glove
136
Handing the sterile needle to the vet:
1. Remove the needle cap
2. Hold needle cover tightly
3. Point hub toward vet > vet pulls needle from cover
137
Epidural Needle Size:
Equines
19 gauge x 1.5"
OR
18 gauge epidural catheter + stylet
138
Epidural Needle Size:
Bovines
18 gauge x 1.5-3"
139
Epidural Needle Size:
Camelids
20 gauge x 1.5"
140
Epidural Needle Size:
Ovine + Caprine
18-21 gauge x 1-1.5"
141
Epidural Needle Size:
Porcine
18-20 gauge x variable"
Length depends on size of animal
142
Why is it important to always wear gloves while delivering medications transdermally?
To avoid accidentally medicating yourself
143
List 4 medications commonly given transdermally via a patch
1. Fentanyl
2. Scopolamine
3. Nitroglycerin
4. Estrogen
144
PROCEDURE - Transdermal Administration (Large Animals)
1. Properly restrain patient
2. Shave + clean site with alcohol > allow to dry fully
3. Wear gloves > avoid accidentally self-medication
4. Apply medication > patch/ointment/solution/cream
5. Cover with bandage
- Optional for many ointments/solutions/creams
6. Wear gloves > remove patch + excess product
7. Dispose of patch
- Fentanyl has strict legal disposal requirements
145
Intrasynovial administration is used to administer:
1.
2.
1. High drug levels localized in the joint
2. Joint lavage
146
Intrasynovial administration is common for which species?
Horses
147
The VT is responsible for what 3 things during intrasynovial administration?
1. Prepare joint
2. Assist with procedure
3. Postprocedural care
148
After intrasynovial administration, the VT should monitor the joint for:
1.
2.
3.
1. Pain
2. Heat
3. Swelling
149
General Procedure - Intrasynovial Lavage
1. Two needles placed at different sites on affected joint capsule
2. Sterile flush forced through one needle + exits through other
3. Exit needle removed > inject intrasynovial antibiotics
150
Joint lavage is performed on animals with what type of restraint?
Under general anesthesia
151
Give 2 indications for rectal administration
1. Deliver medication if patient cannot tolerate oral medication due to ileus or regurgitation
2. Deliver enema to patient with constipation
152
Rectal tearing is a possible complication due to what 4 things?
1. Sharp nails
2. Jewelry/watches
3. Rough tubing
4. Forcible pumping of fluid into tubing
153
Rectal tubes sizes are based on what?
Size of the patient
154
What type of tube(s) is used for rectal fluid administration in adult large animals, foals, and calves?
1. Harris enema tube (24-Fr)
2. Fenestrated tube
155
What type of tube(s) is used for rectal fluid administration in lambs, kids, and crias?
Small diameter soft rubber tube
156
PROCEDURE - Intrarectal Medication Administration (Large Animals)
1. Properly restrain patient > stand to side to avoid getting kicked
2. Dissolve medication in water or other solution in a catheter tip syringe
3. Vet may admin 2% lidocaine to rectum via rubber tubing or IV extension tubing
- Reduce patient straining
4. Well lubricate a rectal sleeve > VT gently insert hand short distance into rectum > gently remove obvious feces
5. Select appropriate size tube > lubricate distal end with water-soluble solution > insert tube 1-12 inches into rectum
- Distance based on size of animal
6. Gently inject medication into tube > inject small amount of water or air
- Fully clears the tube
7. Gently remove tube
157
Enema Admin: The size and condition of the animal dictates the:
1.
2.
3.
1. Tube used
2. Volume of fluid
3. Composition of fluid
158
Enema fluids should be:
1.
2.
1. Nonirritating
2. Warmed to room temp but NOT above body temp
159
Cold enema solutions can lead to ______ in young patients
hypothermia
160
Prepackaged human enemas are commonly used on ______ to ______.
newborn foals to facilitate the passage of meconium
160
What 2 types of enemas can be used in neonates?
1. Prepackaged human enemas
2. Gravity flow enemas
161
Gravity Flow Enemas can contain:
1.
2.
3.
4.
1. Warm water
2. Gentle soap
3. Mineral oil
4. Other lubricants
162
a procedure in which fluid is held in the colon for a predetermined amount of time in order to give it time to work
Retention Enema
163
Retention enemas are routinely used for ________.
Hospitalized neonates
164
Why is it important to always be aware of patient size when administering retention enemas?
Excessive enema volume + repeated enemas can be harmful to neonate
165
PROCEDURE - Retention Enema (Large Animals)
1. Properly restrain patient
2. Lubricate the distal end of a Foley catheter with a balloon
3. Insert the tube 2-4" into rectum > inflate the balloon via syringe containing air or water
4. Gravity flow solution into tube OR very gently admin solution via syringe > clamp catheter with a hemostat for at least 15 min
5. Remove hemostat > deflate balloon > remove catheter
166
an instrument used to prevent the flow of blood from an open vessel by compressing that vessel
Hemostat
167
PROCEDURE - Enema Administration to Adult Patients (Large Animals)
1. VT make a disposable coverall using a trash bag
- Just in case of rapid projectile expulsion of fluid and feces
2. Properly restrain patient > VT stand to side of patient
3. Lubricate the distal end of an NGT
4. Insert the tube into the rectum
5. Deliver solution
6. Gently remove tube
