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Catheterisation and

Catheter Care

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Catheterisation

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Indications forcatheterisation

Retention of urine

Monitor urine output / acutely ill patient

Pre/peri/post-operatively

Assessment and investigations

Treatment (e.g. to instil chemotherapy

Irrigation of !ladder

"ypass an o!struction

Management of incontinence (as a lastresort

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Reasons for #emale $rinaryRetention

%arge &!roids

Pregnancy

Post partum- epidural/spinal $rine infection

Post pelvic surgery

Post !ladder surgery-T'T anteriorand posterior repair colposuspension

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Reasons for #emale $rinaryRetention

Constipation

Medication- anticholinergics

antihistamines morphineanaesthetic agents (atropine !oto)alcohol

*enital herpes infection

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Mode of catheterisation

Choices to !e made+

Clean intermittent self

catheterisation,uprapu!ic catheterisation

$rethral catheterisation

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Catheter ,election

Points to consider

,ie

"alloon sie

0ml for routine drainage 10 ml for someurology procedures only

%ength

#emale 2 34cm paediatric 2 10 cm

standard length 2 50cm Charriere sie (Ch 2 0.1mm

Material (consider late) allergy

6rainage system (closed / lin7 system

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Catheter Materials

,hort-term materials

May stay in up to 1/83

%ate)

PT#9 coated late)

,iliconised late)

P'C

%ong-term materials

May stay in up to 1/3

,ilicone elastomer(silastic

:ydrogel coatedlate)

,ilver coated late)

00; silicone

00; silicone ho are

!ed!ound or !ed tochair only

The !ag attachesdirectly to the catheter

and stays there for 4days

6on?t !rea7/open thesystem@

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%in7 drainage system

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%in7 system

$sed for am!ulant patients

%eg !ag stays attached to catheter for 4days and don?t open this connection

Attach overnight 3 litre !ag to end of leg!ag and open tap at night

Remove overnight !ag in the morning

empty and dispose of =vernight !ags are never to !e re-used

the follo>ing night@

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Catheter valves

o !ag attached to catheter

"ladder &lls and stores urine lifting!ladder tissue oB catheter tip

6iscrete

"ut+

Patient needs good manual de)terity Patient needs good cognitive a!ility to

remem!er to empty the !ladder

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Procedure

Patient preparation

- information

- consent

Aseptic techniue

- to prevent the transmission of micro-organisms either directly or indirectly

thus reducing ris7 of infection

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9uipment

Catheter pac7

T>o pairs sterile gloves

,achet of normasol (to clean round

urethral meatus 0ml syringe

Ampoule of sterile >ater for inDections (ifnot in pac7 >ith catheter

%u!ricant e.g. instillagel Eml for females and ml for males

An appropriate catheter

6rainage system

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6ocumentation

6ate inserted Fdate due to !e

changed Rationale for

catheterisation

Any pro!lems

encountered

,ie inserted

"atch / lot num!er

9)piry date

#luid used in !alloonType F volume

'olume of urinedrained

6rainage systemused

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Ris7 of infection + CA$TI

9)traluminal contamination

on insertion opportunistic

Intraluminal contaminationreGu)

"acteria H !io&lm H al7aline urine Hcrystalliation H encrustation

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Care

Meatal hygiene

Minimise handling

Maintain asepsis 6o not allo> !ag to !ecome too full

eep drainage !ag !elo> level of

!ladder