Operator experience and easily identifiable veins predict first-time intravenous catheterization success rates in...

To assess factors associated with first-time successful IV catheter (IVC) insertion in dogs presenting to an emergency room and to describe the reasons for IVC insertion failure.

This prospective study evaluated dogs requiring IVC insertion over a 3-month period. Variables assessed included vein utilized, catheter size, reason for insertion, operator performing the catheterization and their related experience, as well as whether veins were visible or palpable.

There were 372 catheters inserted in 359 dogs. Of the catheters where insertion success was documented, 85.6% (309 of 361) were successfully inserted on the first attempt with the greatest number of successful catheters (96%; 298 of 309) inserted in a cephalic vein. Veterinary technicians had the highest first-time success rate (87.6%; 248 of 283), while veterinarians had the lowest (75%; 15 of 20), although this difference was not statistically significant. The first-time insertion success was more likely when the operator had inserted over 500 catheters previously (OR, 3.55; 95% CI, 1.59 to 7.93). Vein visibility (OR, 3.61; 95% CI, 1.55 to 8.37) and palpability (OR, 3.64; 95% CI, 1.39 to 9.53) were also associated with first-time insertion success. Veins resistant to catheter advancement, operator inexperience, and patient hypotension were the most reported reasons by operators for insertion failure.

Greater operator experience and easily identifiable veins (visible and/or palpable) significantly increase the likelihood of first-time insertion in dogs.

Providing veterinary technicians with more opportunities to perform IV insertion could improve success rates, especially in cases of difficult venous access.