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    Urinary Catheter Insertion

    Uploaded by

    Angel Samonte
    This document provides instructions for urinary catheter insertion. It begins with an introduction describing catheter sizes and types. Universal precautions for infection control are outlined. Indications for catheterization include urinary retention, drainage for diagnosis, and monitoring output. Contraindications include suspected urethral trauma. The procedure is described in 21 steps, and complications include infection and tissue trauma if left in long term.

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    Urinary Catheter Insertion

    Uploaded by

    Angel Samonte
    369 views4 pages
    This document provides instructions for urinary catheter insertion. It begins with an introduction describing catheter sizes and types. Universal precautions for infection control are outlined. Indications for catheterization include urinary retention, drainage for diagnosis, and monitoring output. Contraindications include suspected urethral trauma. The procedure is described in 21 steps, and complications include infection and tissue trauma if left in long term.

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    This document provides instructions for urinary catheter insertion. It begins with an introduction describing catheter sizes and types. Universal precautions for infection control are outlined. Indications for catheterization include urinary retention, drainage for diagnosis, and monitoring output. Contraindications include suspected urethral trauma. The procedure is described in 21 steps, and complications include infection and tissue trauma if left in long term.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    369 views4 pages

    Urinary Catheter Insertion

    Uploaded by

    Angel Samonte
    This document provides instructions for urinary catheter insertion. It begins with an introduction describing catheter sizes and types. Universal precautions for infection control are outlined. Indications for catheterization include urinary retention, drainage for diagnosis, and monitoring output. Contraindications include suspected urethral trauma. The procedure is described in 21 steps, and complications include infection and tissue trauma if left in long term.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 4

    Urinary Catheter Insertion

    Introduction
    The ability to insert a urinary catheter is an essential skill in medicine.
    Catheters are sized in units called French, where one French equals 1/3 of 1 mm. Catheters
    vary from 12 (small) FR to 48 (large) FR (3-16mm) in size.

    They also come in different varieties including ones without a bladder balloon, and ones with
    different sized balloons - you should check how much the balloon is made to hold when
    inflating the balloon with water!

    Universal precautions

    The potential for contact with a patient's blood/body fluids while starting a catheter is present
    and increases with the inexperience of the operator. Gloves must be worn while starting the
    Foley, not only to protect the user, but also to prevent infection in the patient. Trauma protocol
    calls for all team members to wear gloves, face and eye protection and gowns.

    Indications Procedure
    Contraindications Complications
    Equipment

    Indications

    By inserting a Foley catheter, you are gaining access to the bladder and its contents. Thus
    enabling you to drain bladder contents, decompress the bladder, obtain a specimen, and
    introduce a passage into the GU tract. This will allow you to treat urinary retention, and bladder
    outlet obstruction.

    Urinary output is also a sensitive indicator of volume status and renal perfusion (and thus
    tissue perfusion also).

    In the emergency department, catheters can be used to aid in the diagnosis of GU bleeding.

    In some cases, as in urethral stricture or prostatic hypertrophy, insertion will be difficult and
    early consultation with urology is essential.

    Contraindications
    Foley catheters are contraindicated in the presence of urethral trauma. Urethral injuries may
    occur in patients with multisystem injuries and pelvic factures, as well as straddle impacts. If
    this is suspected, one must perform a genital and rectal exam first. If one finds blood at the
    meatus of the urethra, a scrotal hematoma, a pelvic fracture, or a high riding prostate then a
    high suspicion of urethral tear is present. One must then perform retrograde urethrography
    (injecting 20 cc of contrast into the urethra).

    Equipment

    Sterile gloves - consider Universal Precautions


    Sterile drapes
    Cleansing solution e.g. Savlon
    Cotton swabs
    Forceps
    Sterile water (usually 10 cc)
    Foley catheter (usually 16-18 French)
    Syringe (usually 10 cc)
    Lubricant (water based jelly or xylocaine jelly)
    Collection bag and tubing

    Procedure

    Insertion of an urinary catheter Insertion of an urinary catheter


    in a female in a male

    Review the female anatomy Review the male anatomy


    in more detail in more detail
    1. Gather equipment.
    2. Explain procedure to the patient
    3. Assist patient into supine position with legs spread and feet together
    4. Open catheterization kit and catheter
    5. Prepare sterile field, apply sterile gloves
    6. Check balloon for patency.
    7. Generously coat the distal portion (2-5 cm) of the catheter with lubricant
    8. Apply sterile drape

    9. If female, separate labia using non-dominant hand. If male, hold the penis
    with the non-dominant hand. Maintain hand position until preparing to
    inflate balloon.
    10. Using dominant hand to handle forceps, cleanse peri-urethral mucosa with
    cleansing solution. Cleanse anterior to posterior, inner to outer, one swipe
    per swab, discard swab away from sterile field.

    11. Pick up catheter with gloved (and still sterile) dominant hand. Hold end of
    catheter loosely coiled in palm of dominant hand.

    12. In the male, lift the penis to a position perpendicular to patient's body and
    apply light upward traction (with non-dominant hand)

    13. Identify the urinary meatus and gently insert until 1 to 2 inches beyond
    where urine is noted

    14. Inflate balloon, using correct amount of sterile liquid (usually 10 cc but
    check actual balloon size)

    15. Gently pull catheter until inflation balloon is snug against bladder neck
    16. Connect catheter to drainage system

    17. Secure catheter to abdomen or thigh, without tension on tubing

    18. Place drainage bag below level of bladder

    19. Evaluate catheter function and amount, color, odor, and quality of urine

    20. Remove gloves, dispose of equipment appropriately, wash hands

    21. Document size of catheter inserted, amount of water in balloon, patient's


    response to procedure, and assessment of urine

    Complications

    The main complications are tissue trauma and infection. After 48 hours of catheterization, most
    catheters are colonized with bacteria, thus leading to possible bacteruria and its complications.
    Catheters can also cause renal inflammation, nephro-cysto-lithiasis, and pyelonephritis if left in
    for prolonged periods.

    The most common short term complications are inability to insert catheter, and causation of
    tissue trauma during the insertion.

    The alternatives to urethral catheterization include suprapubic catheterization and external


    condom catheters for longer durations

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