DVM Q&A: Any Advice for Helping Our Veterinary Technicians Gain Confidence with Dosing?

Note: This month’s ERDVM Q&A covers our Tech Tip of the Month too.

Here are essential tips for technicians to enhance accuracy and safety when dosing: 

1. Mastering drug calculations

• Understand the basics: The fundamental formula for calculating dosages is: Volume (mL) = (Weight (kg) × Dose (mg/kg)) ÷ Concentration (mg/mL).
• Unit conversion: Be comfortable converting between different units (e.g., pounds to kilograms by dividing by 2.2, mcg to mg by dividing by 1000, and g to mg by multiplying by 1000).
• Practice makes perfect: Regularly review and practice calculations to build confidence and accuracy.
• Double-check: Always double-check your calculations, especially for crucial medications or controlled substances. 

2. The 5 rights of medication administration

This framework is crucial for preventing medication errors:

• Right Patient: Always verify the patient’s identity using neck bands, cage cards, and other identification methods.
• Right Medication: Double-check the medication name and label against the treatment sheet or prescription, advises VETgirl. Watch out for sound-alike and look-alike drugs.
• Right Dose: Verify the calculated dosage and ensure consistency in units (pounds or kilograms).
• Right Route: Confirm the intended administration route (e.g., oral, intravenous, subcutaneous) and any specific considerations (e.g., NPO status).
• Right Time: Ensure the medication is given according to the prescribed frequency and interval, and document the administration time. 

3. Syringe preparation and administration

• Choose the right size: Select a syringe that accommodates the required volume accurately.
• Handle carefully: Ensure the needle is securely attached to the syringe, and break the plunger’s seal before drawing up the medication.
• Minimize bubbles: Expel air bubbles from the syringe to prevent inaccurate dosing.
• Mix appropriately: Invert the syringe multiple times for proper mixing, especially with suspensions.
• Proper technique: Administer injections following the appropriate technique for the chosen route (e.g., subcutaneous injection technique described by Summit Animal Hospital involves tenting the skin, inserting the needle at a 45-degree angle, and administering the medication slowly).
• Aspirate (where appropriate): Always aspirate to check for blood before injecting medication, particularly for nerve blocks.

4. Addressing common challenges

• Distractions: Minimize interruptions when handling medications. Studies in human medicine have shown that wearing an orange vest can reduce interruptions and improve medication error rates, according to The Veterinary Idealist.
• Difficult patients: Approach anxious or fearful pets calmly and with positive reinforcement. Consider alternative forms of medication if oral administration is difficult.
• Look-alike/sound-alike drugs: Separate these medications in the clinic’s inventory and use tall man lettering and warning labels to differentiate them. 

5. Documentation and communication

• Accurate records: Meticulously document all aspects of medication administration, including the drug name, dose, route, time, and your initials.
• Clear communication: Communicate effectively with veterinarians and clients regarding medication orders, potential side effects, and recheck schedules.
• Utilize client handouts: Provide clients with clear, concise instructions on medication administration and storage, such as those provided by Plumb’s™ drug handouts, according to Plumb’s.

6. Safety precautions

• Protect yourself: Wash your hands before and after handling medications, and wear gloves if necessary.
• Proper storage: Store medications securely and away from pets and children, following recommended temperature and humidity guidelines, advises the FDA.
• Safe disposal: Properly dispose of expired or unwanted medications by following FDA guidelines or using drug take-back programs. 

By consistently implementing these tips, veterinary technicians can contribute significantly to patient safety and positive treatment outcomes.