CATHETERISATION.
Ursula A Wood.
Clinical Educator.
Bradford Teaching Hospitals.
Indications for catheterisation.
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Monitoring of acutely/ critically ill patients
Relief of retention
To relieve intractable urinary incontinence
To allow bladder irrigation
To allow bladder investigation
To allow intravesical drug instillation
To obtain uncontaminated urine sample
To measure residual urine
Spinal Injury
Following Epidural anaesthesia
Fasting patients who need a full bladder
Contraindications.
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Urethral injury/trauma
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Acute prostatitis
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None consenting
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Caution with confused/agitated patients
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Allergy to Latex
Complications.
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Urinary Tract Infection
Urethritis
Haematuria
Abscess formation
Pressure ulcers
Encrustation
Bladder shrinkage
Bypassing
Traumatic removal
False passages / urethral strictures
Allergic reaction
Don’t Forget !
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To introduce yourself
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Explain procedure & check understanding
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Obtain verbal consent
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Use of a chaperone
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Ensure privacy, dignity & comfort at all times
Equipment Required.
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Catheter / dressing pack
Sterile foley catheter – size 12 (woman) 14 (man)
Please select appropriate length for the patient (20-26cms for
females and 40-45cms for male)
Sterile water
Cleansing solution
10ml sterile syringe
2 Pairs of sterile gloves
Catheter drainage system
Instillagel / Lignocaine Gel
Blanket
Dressing trolley
Preparation.
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Position patient
Position yourself
Open catheter pack
onto trolley
Open catheter pack –
maintaining sterility
Open both pairs of
sterile gloves and put
them on, maintaining
sterility
In your catheter pack you will
find:
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Sterile towel
Cotton wool
Gallipots
Sterile gauze
Sterile forceps
Sterile kidney dish
You will need to add to your
sterile field:
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Sterile catheter
Instillagel
Cleaning solution
Water for injection
Sterile syringe
Drainage system
Important!
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After arranging the equipment
and exposing the patient.
Remove top pair of gloves.
Procedure. (male)
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Draw up the water, into the syringe
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From this point onwards you must adopt the clean hand / dirty hand
technique
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Apply dressing towels
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Hold the shaft of the penis, using gauze
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Retract the foreskin if present
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Clean the urethral meatus
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Do not put used swabs back on the sterile field
Uncircumcised Penis
Circumcised Penis
Procedure. (male)
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Introduce Instillagel and hold the penis at 90 degrees for 3
minutes
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If there is a blue fenestrated drape, use it at this point
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Pick up catheter with ‘clean’ hand and insert into urethra
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When urine drains advance the catheter a further 5cm
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Slowly inflate the balloon with syringe of sterile water
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Gently pull back the catheter to anchor it in the bladder neck
Patient comfort
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Replace the foreskin
Attach drainage system & send
specimen if required
Ensure patient is left clean, dry &
comfortable
Give explanation & reassurance to the
patient
Female catheterisation
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Place the two white drapes, one over
each thigh.
Drape the thigh furthest away first.
Separate the labia with two fingers
using gauze and the non dominant
hand, in an upward direction.
Identify the urethral opening anterior to
the vaginal orifice.
Female catheterisation.
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Clean the urethral orifice.
Wipe in a downwards direction towards
the anus.
Use a clean piece of cotton wool for
each wipe.
Female anatomy.
On completion
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Remove gloves & wash hands
Document the date, type, size and
batch number of catheter
Document the date due for changing
Document any trauma sustained
Document the amount of residual urine
Document balloon size
AND NOW IT IS YOUR TURN
!!