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Tech Tips: Tips and Tricks of the Trade Presented By: Kristin Loy, CVT

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Tech Tips: Tips and Tricks of the Trade Presented By: Kristin Loy, CVT Tech Tips: Tips and Tricks of the Trade Presented by: Kristin Loy, CVT Forbidden Phrases: Never use the following phrases or ones similar if you want your coworkers to still like you o “Look at that vein!” or “That’s a nice vein.” o “It’s been pretty slow today.” o “I need to get out on time today because I have plans right after work.” Must Haves: These are must have items for every technician on the job. o On your person at all times a tech should have a stethoscope, black pen, highlighter, sharpie (I like the ones that are two ended so I can use the fine tip for writing on blood tubes), bandage scissors, calculator, and a notebook. Notebooks are great for whipping out and jotting down notes about a patient or directions for a medication your vet is hollering out of the room while you are restraining that fractious cat. o An extra set of scrubs, shoes, and socks (I also keep an extra set of underwear) in your car or locker. o Moisture wicking long sleeve shirts: For people who get cold or who break out with certain types of fur, these are great to wear under your scrubs. They keep you at a comfortable temp and also protects against those pesky nails during nail trims, blood draws, etc. o Spandex shorts: Your coworkers will thank you. No one wants to see your exposed partial moon! And if you haven’t had a pair of scrubs rip yet, just wait, your day will come but you’ll be good because you got this awesome advice! o Comfortable shoes: Your feet will thank you. We are on our feet all day long every day. Find what works best for you and not what is the cutest or the most in style. Add some arch supports or extra padding if you need to extend the life of your shoes. Ideally buy new every 6mths or so. o Compression socks: I don’t personally use these but other techs swear by them. They help with circulation and I’ve heard keep your feet from falling asleep when you are in the same restraint position for what feels like hours. Restraint Go-Tos o Cat harness: Use a slip lead and place it around the neck. Then wrap it under the chest and feed the loose end through the loop (picture in PowerPoint). Great for having good control of a feline patient or small dog without applying too much pressure to the trachea. o Hard plastic muzzles: Way better than those cloth muzzles that cats always slip out of. Also provides a great handle for jugular blood collection. www.vetsol.com o Snacks, snacks, and more snacks! These work wonders with many patients and are a great distraction during procedures. Use basket muzzles with dogs if need be and smear peanut butter on the front. Cheese whiz is great with cats. Physical Exam Techniques: o Examining the nictitating membrane can be very difficult in dogs and cats. Gently press on the lateral canthus exposing the membrane. Do not touch the eye itself and do not perform if there is concern of glaucoma. o When palpating the abdomen of a small dog it can be difficult to feel the cranial organs. Prop them up on their hind legs, allowing the cranial organs to fall caudally, and continue with the abdominal exam. Tech Tips: Tips and Tricks of the Trade Presented by: Kristin Loy, CVT Catheter tricks: o Pull the tape longer than you think you will need. Then tear access off. Better to be too long than too short. o Always grab multiple catheters and 2 different sizes. This way you won’t have to go back to get another if you miss the first shot. (I also believe it’s bad luck if you only have one ) o Go big or go home! Maybe this is the ER tech in me talking but nothing is more frustrating than needing to bolus a patient with fluids and only having a 22g catheter in a 90# lab. Use the appropriate size catheter in every patient to ease administration of fluids and medications. o Fold over the very end of each piece of tape to make a tab. This makes removal of the tape much easier. Your coworkers will thank you! o Hold the sides of the catheter when placing to allow for visualization of the flash. Once you get the flash, decrease your catheter angle and advance the catheter (and stylet) another 2-3mm. This verifies you are fully seeded in the vein and will increase the chance of your catheter advancing smoothly. o Valves are a vet techs nemesis! If you hit one try the following: . Stop advancing, back up your catheter ever so slightly, and let the vein and valve relax. The valve may spasm during placement and may just need a 5-10 seconds to relax. Then try advancing once again. Pulse saline through the catheter while gently trying to advance the catheter. Be aware that this may also blow the vein if not careful so always make sure you start distal when placing the catheter. Syringe Handling Tips o Train your hand by using an empty syringe and pressing it against your hand. Pull back on the plunger without readjusting your hand. You will get resistance from the suction on your hand. o Never recap with your mouth or hand. You risk poking yourself. Always use the scoop technique or do not recap at all. Just discard immediately. o Angle the bevel of the needle against the port of the vaccine vial while pulling back on plunger and pulling needle out slowly to get every drop. Injectable Medication Administration o Use the 5 Rights when administering any injection: right patient, right medication, right route, right amount, and right time. o Rubbing the site of injection after administration of a burning/stinging medication can amplify the discomfort (Cerenia). o Always tighten the needle on the syringe and break the seal of the plunger before drawing blood or administering an injection to avoid struggling during blood collection or loosing injectable out of the syringe around the needle. o Mix thick medications with sterile water or saline to thin out and make injections easier to administer (i.e. Euthanasia solution) Blood Collection Help o Pull skin taunt around the leg and slightly distal to stabilize the saphenous vein. Tech Tips: Tips and Tricks of the Trade Presented by: Kristin Loy, CVT o Access amounts of alcohol during blood collection can affect blood chemistries if any alcohol is pulled into the syringe. o Stabilize the vessel by placing your thumb alongside the vein. o Use of a butterfly catheter can be helpful when drawing blood from a feline saphenous. o If blood stops flowing, release negative pressure and squeeze/pump paw. They vein may collapse during collection and may just need time to refill. Fluid Hacks o When dosing a canine patient for shock fluids at 88ml/kg, a quick calculation to administer ¼ dose in the first 15 minutes is add a “0” to the patient’s weight (lbs). Example: 67# dog, administer 670ml fluid bolus IV in the first 15 minutes then reassess the patient. Shock calculation would be 67# = 30.45kg x 88 ml/kg = 2,680ml ÷ 4 = 670ml in first 15 minutes. o When setting up a drip set and fluid bag for a manual drip (not using a pump). “Burp” the fluid bag to remove all air out of the bag. This avoids getting air in the line when the bag empties. Spike the bag upside down without clamping the fluid line. While bag is still upside down, squeeze all of the air out of the fluid bag. Clamp fluid line and hang bag. Prime the drip reservoir and prime line as normal. o If needing to administer fluids quickly (i.e. SQ fluids) and a pressure bag is unavailable, a BP cuff can be used to speed up administration. Bandaging Tips o Apply bandage layers in opposite directions to help secure the bandage and to keep the bandage from slipping. o Draw a symbol on the bandage over the site of injury to avoid damaging the wound when removing the bandage. o When applying a tail bandage, cut the tip end off a syringe case and slide the syringe case over the tail and bandage material (before applying Elasticon®) leaving ¼ of the casing end passed the tip of the tail. Secure casing and bandage to the tail with Elasticon®. Basic Nursing Tricks o Assign each roll/position for the techs an emergency roll so each person knows their job should an emergency come in. Example: Room tech 1- oxygen/respiratory tech, Room tech 2- circulation/compression tech, Room tech 3- catheter tech, Lab tech- medication tech, etc. o Record vitals and drugs on gloves or on a metal table with a Sharpie® marker. Isopropyl alcohol takes Sharpie® right off of metal tables. o If short-handed and need to administer oxygen to a patient while also placing a catheter, drawing blood, etc. Use a loose muzzle to loosely hold oxygen mask onto muzzle of the patient. o If your clinic uses the Fluorescein strips, while wearing gloves, cut the stain tip of the strip off and place in the barrel of a 3cc syringe. Place plunger back in syringe and draw up 3cc of saline. This makes a useable stain that is good for 24 hours. Apply a couple drops into the eye in question and continue with diagnostic testing.
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