Comparison of the modified Seldinger and through‐the‐needle jugular catheter placement techniques in the dog

Abstract Objectives: To compare the ease of placement of central intravenous catheters in the dog using 2 techniques: the modified Seldinger jugular catheter placement technique and the through‐the‐needle jugular catheter placement technique. To evaluate the ease and effectivness of teaching the 2 jugular catheter placement techniques. To determine the utility of a synthetic vascular access model for teaching the 2 techniques to veterinary students. Design: Students were taught 2 jugular catheter placement techniques using a synthetic jugular venipuncture model and were then observed placing catheters using each technique in live dogs enrolled in a terminal surgery laboratory. Time taken for catheter placement, success or failure of catheter insertion, indicators of catheter viability (time required for blood to be collected through the catheter and for fluid to flow through the catheter), and complications associated with catheter insertion (hematoma presence/size post‐mortem) were objectively evaluated by the authors, and ease of catheter placement was subjectively evaluated by the students. Setting: Surgical techniques laboratory in a veterinary teaching hospital. Animals: Dogs destined for a terminal student surgery laboratory (n=35). Intervention: Jugular catheterization. Measurements and main results: Catheter placement was successful for 27/35 (77.1%) first attempts on a live dog with the modified Seldinger technique, and for 26/35 (74.3%) first attempts on a live dog with the through‐the‐needle technique. The modified Seldinger technique took significantly longer (mean 452 seconds) than the through‐the‐needle technique (mean 273 seconds). There was no significant difference in time taken to aspirate 5 mL of blood through catheters placed by either technique. Time required to flow 25 mL of fluid through the catheter was slightly longer for the modified Seldinger technique (mean 133 seconds) than for the through‐the‐needle technique (mean 113 seconds). Post‐mortem hematomas were detected at 26/26 (100%) of through‐the‐needle insertion sites and at 24/27 (89%) of modified Seldinger insertion sites. Hematoma diameter at the through‐the‐needle insertion site (mean 2.2 cm) was significantly greater than at the modified Seldinger insertion site (mean 1.1 cm). Student assessments of the comparable difficulties of the 2 jugular catheter placement techniques were not significantly different, and both techniques were assessed to be only slightly more difficult than placement of a cephalic catheter. Conclusions: Jugular catheter placement by either the modified Seldinger or through‐the‐needle technique can be relatively easily mastered by entry‐level veterinarians. Hematoma formation is common with both techniques. The teaching of jugular catheter placement is facilitated by the use of a synthetic jugular venipuncture model.