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3 Halloweenish but Preventable Horror Stories

Some scary things can happen in your practice. Avoid them with these tips.

Don't forget to remove the IV catheter!

Courtesy Dr. Phil Zeltzman

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Around Halloween or not, some pretty scary things can occur in your practice. Here are ways to avoid them.

1. Sending a pet home with an IV catheter!

Ms. Monster called the clinic to ask when her puppy, Eddie, was supposed to have a follow up appointment to have this “plastic thing” removed from his front leg.

Surprised by that strange question, Carrie the receptionist asked Mrs. Monster to hold for a moment.  She relayed the question to a technician and the doctor. Initially confused, they all suddenly remembered that Eddie was castrated four days ago. To their horror, they realize that Eddie must have gone home with his IV catheter still in place!

Ms. Monster brought Eddie in and the staff removed the forgotten catheter.

How embarrassing!

One creative system to be sure every staff member, without exception, knows that a patient still has an IV catheter in place, is to use a simple color code. All catheters, once taped in, can be covered with a red bandage. Once the catheter is removed, before a patient is discharged, the area can be covered with a green bandage. This way, all team members, from the “front” to the “back” can easily spot a forgotten catheter.

If this concept prevents your team from forgetting only one catheter each year, it will be well worth it. Simply remember: Green means go, red means stop.

2. Forgetting the pop-off valve in a closed position!

Scar had just hooked up her patient Cruella to the anesthesia machine and turned her attention to the monitoring equipment.  One by one, she connected the pulse oximeter, the ECG, the blood pressure cuff and the rectal thermometer.

By the time she turned her attention back to the patient, to her horror she noticed that she was not breathing!

Then Scar realized, flabbergasted, that the breathing bag looked like a giant balloon about to explode. Quick to react, she did the only thing to do: she ripped the bag off the anesthesia machine, deflated it, reattached it and then opened the pop-off valve as quickly as possible.

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Somebody had forgotten it in the closed position … and, pressed for time, she hadn’t checked the anesthesia machine before connecting her patient.

Fortunately, Scar avoided a serious disaster to occur (a ruptured lung and pneumothorax). The main reason a pop-off valve should be closed is to test the anesthesia machine for leaks (every morning, and arguably before any anesthesia episode).

The technician checking the machine should never walk away from the machine until all connections, hoses and bags have been checked and the pop-off valve has been opened.

It also is closed if you need to “give a breath.” A wonderful way to avoid having to ever close the pop off valve is an inexpensive, easy-to-install “pop-off occlusion valve” or “restrictor.” This is a simple button that is depressed and held down while giving a breath … which suddenly becomes quicker and much easier.

3. Chewed out IV catheters

After placing an IV catheter and beautifully taping it, Sabrina places her patient Elvira in her cage. Five minutes later, Sabrina walks past the cage and horror, she notices that Elvira and her cage are covered in blood: Elvira chewed out her catheter.

Now it takes twice as much time for two technicians to clean Elvira up, replace the IV catheter and clean up the cage.

All of this could have been avoided if Sabrina had placed an e-collar on Elvira. Alternatively, "no-chew" bandage material or spray might be enough to deter a patient from chewing a catheter out. Another option is to place an IV catheter guard over the catheter. It will more than pay for itself very quickly.

Murphy's Law says that the harder it is to place an IV catheter, the more likely the patient is to remove said catheter. A corollary to that law: the patient is very likely to have white, long hair. Corollary to the corollary: the client will ask to visit her beloved pet in the next 2 minutes.

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Kelly Serfas, a Certified Veterinary Technician in Bethlehem, PA, contributed to this article.

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