IV line management

  1. Use either fluid from the bag or pre-made Hep-flush (water and heparin solution) found in the top-left cupboard above the needles in the prep room. Draw up 1–2 ml.
  2. Use spirit to swab the port on the T-connector or drip line of choice before inserting the needle.
  3. Clamp the line above the port where you are flushing (using the clamp or pinching the line with your fingers).
  4. Insert the needle and flush at a steady pace.
  5. Unclamp the line and check if the fluid is now running.

  • Step 1: Remove any dressing around the IV site, if present.
  • Step 2: Inspect the site just above where the IV is placed: does it look swollen or indicate peri-vascular fluid leakage?
    • No: Try flushing closer to the catheter site i.e. the port right at the base of the T-connector.
    • No improvement: Remove the T-connector and flush directly into the catheter.
    • Yes: Remove the tape while attempting to leave the IV in place to check placement. If it appears displaced, the IV will likely need removal, though care should be taken to confirm before removal.

  1. Apply Easeoff spray to the tape holding the catheter to dissolve the adhesive. Alternatively, use spirit (pink solution in squeeze bottles).
  2. Once the IV is removed, place a small piece of cotton wool or Soffban over the site to stem any bleeding.
  3. Wrap a small length of Petflex (colored bandage) around the leg to hold it in place and apply slight pressure to prevent hematoma formation.
  4. This bandage can be removed in 15–30 minutes. If swelling persists, it may be left on longer as needed.

  1. If the patient is on a drip pump, press STOP and open the door to release the line.
  2. Clamp the line using the small white clamp attached to the line.
  3. Clamp the T-connector using the small white or blue clamp attached to it.
  4. Disconnect the line from the T-connector by unscrewing it.
  5. Use the bungs provided with the line (stored in the black drawers in the kennels or on the blue tray on the prep table anaesthetic trolley) to cap the open ends. Ensure these are screwed in placed before walking patients out to prevent contamination of the line entering the vascular system.

  1. Reverse the disconnection steps above, flushing the line if needed.
  2. Ensure the drip pump START button is pressed. If you’ve forgotten to unclamp a section, the pump will alert you with an “occlusion” or “air bubble” error.

  • Swollen feet in cats are often caused by restricted circulation due to overly tight tape rather than peri-vascular fluids.
  • For mild cases (or if the line cannot be removed):
    1. Remove the dressing around the IV.
    2. Once at the tape layer, use scissors to carefully cut the tape at the back of the leg (away from the IV site). One or two cuts should create a small square; but if you can only get one in for a fizzy cat that is fine!
    3. Replace the bandage with a looser fit – I personally exclude the foot from the bandage to allow gentle massage throughout the day to disperse fluid. However, if the cat won’t tolerate this or if the vet prefers the foot included, this is also fine.

Drip pump operations

There are 5 errors the drip pumps might shout about:

  1. AC Fail: This means that the pump isn’t plugged in. They have a 4 hour battery life so do not need to be plugged in at all times – if you press silence this will stop the warning and use the battery until the battery becomes low (drip pump 3, Lorraine, doesn’t do this – she insists on being plugged in at all times or she will keep screaming at you)
  2. Low Battery: Self explanatory – please plug in and let it charge – they can be left plugged in also so don’t worry about disconnecting once full again
  3. Door Open: Again, self explanatory – close the door
  4. Air Bubble: They are highly sensitive so even small air bubbles in the chamber can trigger this error.
    • Remove the line from the pump and let it run through.
    • Flick the line to remove bubbles, ensuring none remain in the section that enters the pump. As long as they are not large don’t obsess over getting them all out, as long as they are not at the section of line that goes into the pump itself it should be okay.
    • It can often be that there is no bubble but instead when placing the line into the pump the small yellow lever isn’t sitting on top of the line or the line just isn’t fully placed into the slot – an indicator that it is happy – once the line is pushed in fully the light should go green
  5. Occlusion: Fluid isn’t flowing through the line. Check for clamped sections and flush the line. If the problem persists, replace the line.

  • Solid green: Ready to start but not running.
  • Flashing green: Running.
  • Amber: On but not ready to go.
  • Flashing red + beeping: Error detected.

Laboratory procedures

Getting the Lab Back Online

  1. Go to All Programs > IDEXX > Interlink on the lab computer.
  2. Repeat this process twice if needed.

Write the patient’s name and date on every sample taken.

Running Samples

  • Any lab requests entered on a patient’s account will appear automatically on the lab computer.
  • Tap the touchscreen to select the patient sample you want to run followed by the machine(s) you want to use – these are along the bottom of the screen
  • ProCyte: Haematology.
  • Catalyst One: Biochemistry, electrolytes, and T4.
  • SnapShot: Snap tests for CPL.
  • Once you have selected what machine you need press “run” this will prepare the machine

  • The drawer opens automatically; if not, press the small “Start” symbol.
  • Invert the sample 10 times and place it in the holder with the lid off.
  • Press the large grey button on the front to start.

  • Biochemistry needs to be spun down – ensure it is balanced in the centrifuge, close the lid, ensure it is set at “2” and press start – this will take 4 minutes.
  • Once spun, open the lid and draw off the top layer of the sample using the blue pipette tips and grey plunger and place it into a sample cup.
  • Open the sample drawer of the catalyst (large drawer) where there will be space for the sample cup and the slides.
  • Depending on the sample you’re running, place the required slides into the machine (Examples: Chem. 17 for full biochemistry, Lyte 4 for electrolytes, Chem. 10 for pre-anaesthetic bloods.)
  • Once slides and sample are loaded, close the drawer and press the square grey button to start.

  • Once you have selected the Snapshot machine the following on-screen instructions will appear (you may need to tap the screen to wake it up).
  • Follow the instructions.
  • Failing this, each box of Snaps has a booklet of instructions inside which you can follow to use the Snaps manually instead of the machine reader.

  • This small blue machine and the attached printer sit on the draining board in the lab.
  • These require the strips in the blue and white tubes in the top drawer.
    1. Tap the screen to wake it up. Ensure the correct patient type is selected (“dog” or “cat”) and that the setting is EU14 not 10.
    2. Enter the patient’s name using the touch screen keypad – use the straight arrow to enter, the curved arrow will delete all that you’ve typed!
    3. Press the test tube symbol to start the run.
    4. Follow the on-screen instructions to apply urine to each window and then place it in the sample tray.
    5. It will automatically run and print out results – please type or scan these onto patient account and ensure it is charged.
    6. Once ran, dispose of strips in clinical waste and ensure the sample drawer is cleaned with Trigene spray (it can be removed and replaced for easy cleaning).
    7. We have normal dipstick strips in the black tubs if all else fails!

Facility & equipment maintenance

There are 2 washing machines

  • Machine 1: Located at the end of the corridor for bedding, towels, scrubs, etc. Instructions are on the machine.
    • Add 1 capful of softener to the first tray (lift the lid) and 1 scoop of powder to the second tray.
    • Use the quick wash setting for normal levels of soiled bedding
  • Tumble Dryer: Next to the window.
    • Suitable for all bedding but not waterproofs or plastic items.
    • Once full, set the dial to 60 minutes, close the door, and push to start. You can stop the machine anytime by opening the door.
  • Machine 2: Located in the large animal store for waterproofs and heavily soiled towels from farm use.
    • Use a synthetics wash with 1 scoop of powder (no softener).
    • Hang waterproofs to dry on the indoor laundry rail using coat hangers.
    • Any towels that are very dirty can also be thrown out if you think appropriate – there is a large supply of them in the loft upstairs – please throw out any holy ones you may come across!

For putting away vet beds the wards are colour coded for ease:

  • Green: Dog Ward.
  • Blue: Cat Ward (small sizes only, large are for prep).
  • Pink: Isolation Ward.

Towel Storage:

  • Low cupboards: Dog ward (under sink) and Cat ward (under cages).
  • Prep room: Small and large towels, plus blankets, are on top of the oxygen kennel.

If unsure, leave folded laundry in kennels for morning staff.

A task list is posted by the sink for out-of-hours (OOH) setups.

The oxygen store is at the end of the corridor through the locked door and immediately on your right.

  • There are two canisters; only one is needed at any given time. Push the wrench away from you to open the valve.
  • There is also NO₂ if needed. Use the turn dial (anticlockwise) to open.
  • There are switches on the wall by the hoover in prep for the low oxygen alarm.

For swabs use cotton wool with hibitane (pump bottle by sinks), followed by spirit/hibi solution (squeeze bottles in prep and theatre).

For wounds we use diluted iodine with water.

  1. All surgical kits are cleaned with a 1:100 dilution of trigene (this is in the large pump bottle by the sink):
    • 1 pump (30ml) of trigene into 3L of water (it should be a very pale green colour).
    • Scrub instruments with a nail brush and rinse under water.
  2. There is an ultrasonic bath by the autoclave. Place instruments in here unclamped and set for 5 minutes on the dial. Rinse and dry after.
  3. Packaging:
    • Instruments are placed in the middle of the blue drapes (located under the radio) and folded into parcels.
    • Seal with autoclave tape and label with the kit name/number e.g. SA1 red (a list can be found by the radio for these)
  4. Autoclave:
    • Turn on with the small square button near the bottom. Use the 147 cycle (except suction tubing/lap cables, which require 121).
    • If water is needed, use the purifier next to the autoclave and pour into the top hole.
    • To start just shut the door and it should start on its own.