Presentation on theme: "CATHETERISATION. Ursula A Wood. Clinical Educator. Bradford Teaching Hospitals."— Presentation transcript:
CATHETERISATION. Ursula A Wood. Clinical Educator. Bradford Teaching Hospitals.
Indications for catheterisation. 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. Urethral injury/trauma Acute prostatitis None consenting Caution with confused/agitated patients Allergy to Latex
Don’t Forget ! To introduce yourself Explain procedure & check understanding Obtain verbal consent Use of a chaperone Ensure privacy, dignity & comfort at all times
Equipment Required. 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. 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: Sterile towel Cotton wool Gallipots Sterile gauze Sterile forceps Sterile kidney dish
You will need to add to your sterile field: Sterile catheter Instillagel Cleaning solution Water for injection Sterile syringe Drainage system
Important! After arranging the equipment and exposing the patient. Remove top pair of gloves.
Procedure. (male) Draw up the water, into the syringe From this point onwards you must adopt the clean hand / dirty hand technique Apply dressing towels Hold the shaft of the penis, using gauze Retract the foreskin if present Clean the urethral meatus Do not put used swabs back on the sterile field
Procedure. (male) Introduce Instillagel and hold the penis at 90 degrees for 3 minutes If there is a blue fenestrated drape, use it at this point Pick up catheter with ‘clean’ hand and insert into urethra When urine drains advance the catheter a further 5cm Slowly inflate the balloon with syringe of sterile water Gently pull back the catheter to anchor it in the bladder neck
Patient comfort 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 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. Clean the urethral orifice. Wipe in a downwards direction towards the anus. Use a clean piece of cotton wool for each wipe.
On completion 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