California RVTs get OK for catheter procedure

SACRAMENTO, CALIF. — Registered veterinary technicians in California are chalking up another task to their approved list — creating a relief hole — despite some opponents classifying the procedure as "surgery" and an infringement on the practice of veterinary medicine.

The results of an RVT job validity and analysis study sponsored by the California Veterinary Medical Board (CVMB), along with two years of testimony from the profession at public meetings, highlighted the need to amend the RVT task list to include creating a relief hole — a nick incision in the neck to create an entry point for a jugular catheter. At press time, the new regulation was slated for implementation in early June after more than two years of debate and discussion.

Catheter use is "very common" when administering fluids for large animals and performing critical care on small animals, says Teri Raffel, CVT, and president of the National Association of Veterinary Technicians in America (NAVTA). Typically half the diameter of a pencil, newer catheters are larger than designs used in the past and require a larger entryway through the skin.

"It is really very logical. There is less trauma, less anxiety and easier placement because there is a big enough opening for the catheter to get fed through," Raffel says of the relief hole. "From a nursing perspective, whether it is a dog, cat or cow, we are in favor of any invasive procedure like this that can be done as easily and with as much comfort for the patient."

The regulation hit resistance from the California Veterinary Medical Association (CVMA) because of the procedure's scope. "The CVMA believes the relief hole is surgery because it involves incising tissue. Therefore, it infringes on the practice of veterinary medicine as included in the state practice act," says Valerie Fenstermaker, CVMA executive director. "According to the practice act, surgery is to be done only by veterinarians."

No legal definition for surgery exists in the state of California, so CVMB was not bound to consider the task surgery simply because a scalpel is used. CVMA is reviewing the process for requesting the creation of a legal surgery definition, "because of the many reasons to define it. Only veterinarians are trained to do surgery. In this case, RVTs are not trained, so it crosses over into veterinary medicine," says Fenstermaker.

Countering CVMA's opinion, Raffel says NAVTA does not consider the relief hole surgery because it is not curative for the animal. "It is part of the nursing process that we provide for the animals. It is not in any way intended to have technicians encroaching on veterinary medicine. It is a very good step in the right direction with the best intentions and comfort of the animal in mind."

The regulation also amends exam guidelines for patients administered anesthesia and clarifies suture provisions, among other minor changes