Daily Nursing Care

I. Intravenous Catheters

(See Placement and Management of Intravascular Catheters)

1. Placement of catheters should be sterile and aseptic
2. Change dressing, clean and inspect site and catheter daily.
3. Change catheter depending on the catheter type

1. Teflon catheters may be used up to 48-72 hours
2. Polyurethane catheters may last up to 2-3 weeks
3. Silicone catheters can be used for up to a month

II. Fluid Administration Sets and Fluids

1. Change administration sets daily if glucose-containing fluids are given or if IV line must be broken frequently, change every 48 hours if line remains intact.
2. For ambulatory foals use a coiled extension set and secure it to the fluid harness.
3. Change all fluid containers (including PN) hanging longer than 24 hours.

III. Oxygen Administration Equipment

1. Change O2 insufflation lines and humidifiers every 24-48 hours.
2. Change or inspect nasal insufflation catheter 2-3 times daily to see if holes are plugged.
3. Check frequently for fluid accumulation in the lines which may occlude O2 flow.
4. Monitor pressure if using a cylinder.

IV. Body Position and Exercise

1. Sternal or semi-sternal position with thorax upright allows best ventilation and perfusion of the lungs.
2. Body position should be changed every 2-4 hours. If possible, assist the foal to stand for about 5 minutes as often as possible, but at least turn and stand the foal every 4 hours.
3. In term foals, passive range-of-motion exercises performed several times each day may help to stimulate circulation and prevent tendon contractures.
4. Premature foals with incomplete ossification of the cuboidal bones (carpus, tarsus) should not be encouraged to stand in the first several days.
5. Recumbent foals with fractured ribs should be moved very carefully with the assistance of two people.
6. "Sling assisted outdoor experience" appears beneficial. This is taking the foal "for a walk" but essentially exposes the foal to the outdoor environment. Subjectively appears to improve foal demeanor and mentation.

V. Bedding

1. Foals with their dams should be bedded on straw rather than shavings which get into the eyes, nose and mouth.
2. Critical foals (usually removed from the mare) should be placed on a soft mattress with a readily cleaned surface. Ideally the mattress should be contoured so that urine and other fluids pool away from the foal. Warm, dry, clean blankets should be used under the foal as well as on top of the foal.
3. If the foal has limb problems, have minimal bedding to allow foot support on flat surface.

VI. Umbilicus

1. Treat umbilical stump with (0.5%) chlorhexidine solution 3-4 times during the first three days of life.
2. Inspect stump daily for signs of infection or patent urachus.
3. Ultrasound if any concern.

VII. Eyes

1. Inspect frequently for evidence of corneal abrasion from trauma or entropion. A head protector may be used to reduce trauma to the eyes in struggling patients.
2. Use artificial tears, Lacrilube ointment® or antibiotic ointment at least 4-6 times daily to prevent corneal desiccation

VIII. Perineum and Sheath

1. Clean and apply petroleum jelly or Desitin® ointment as necessary to prevent scalding from urine and diarrhea
2. Urinary catheters should be used only when medically necessary. Human colostomy bags may be modified for urine collection without catheterization.

IX. Rest - Don't Forget to Allow Quiet Time for Foals to Sleep!