Inserting a catheter

Video: INSERTING A FOLEY CATHETER ON A FEMALE PATIENT/SKILL DEMO

Content

To step
Part 1 of 2: Preparing for insertion
Part 2 of 2: Inserting the catheter into the bladder
Tips
Warnings
Necessities

A catheter is a medical device made up of a long, thin tube. This tube can be equipped with different attachments and can therefore be used for multiple purposes. Catheter insertion is part of several medical treatments. For example, they are used to diagnose urogenital bleeding, monitor intracranial pressure, and even to administer certain medications. When it comes to “inserting a catheter”, one usually speaks of a bladder catheter that is inserted through the urethra for the purpose of passing urine. As with any other medical treatment, catheter insertion requires proper medical training and strict adherence to safety and hygiene protocols. Go to Step 1 to get started.

To step

Part 1 of 2: Preparing for insertion

Before starting, explain the process to the patient. Most people are not used to inserting objects, let alone a long tube, into the urethra. Although the treatment is not always described as “painful”, most patients describe the treatment as “uncomfortable” —often even as “extremely uncomfortable”. Out of respect for the patient, you should explain the steps of the procedure before starting it.
- By explaining what the steps are and what to expect, the patient will be able to relax better and be less anxious.
Ask the patient to lie on his / her back. The patient's legs should be spread and feet should be together. The bladder and urethra relax when the patient is supine, making insertion of the catheter easier. A strained urethra can compress the catheter, resisting insertion. This can cause pain and sometimes damage the surrounding tissue of the urethra. In severe cases it can cause bleeding.
- Help the patient lie back if necessary.
Wash your hands and put on sterile gloves. Gloves are an important part of the personal protective equipment that medical personnel use to protect themselves and the patient during medical treatment. When inserting catheters, sterile gloves prevent bacteria from entering the urethra and the patient's bodily fluids from coming into contact with your hands.
Open the outer packaging of the catheter. Single-use catheters are contained in a sterile, sealed package. Before opening it, make sure that this catheter is suitable for your purposes. You will need to use a catheter that is sized for your patient. Catheters come in different sizes. These sizes are indicated by the unit charrière (1 charrière is 1/3 mm) and are available from size 12 (small) to size 45 (large). Smaller catheters are often better for patient comfort, but thick urine requires larger catheters to keep the catheter in place.
- Some catheters have specialized tips that allow them to perform different functions. For example, there is the Foley catheter: it is usually used to drain urine, because it is a so-called indwelling catheter with a balloon. The balloon can be inflated to secure the catheter behind the bladder neck.
- Also collect medical disinfectant, cotton swabs, surgical drapes, lubricant, water, a drainage collection bag, tubes, and tape. All supplies should be properly cleaned and / or sterilized.
Sterilize and prepare the patient's pubic area. Scrub the patient's pubic area with cotton swabs soaked in disinfectant. Then rinse or scrub the area with sterile water or alcohol to remove any debris. Repeat if necessary. When you're done, place the drapes around the genitals - leave room for access to the penis or vagina.
- In female patients, make sure that the labia and the meatus urethrae (the outside of the opening of the urethra just above the vagina) are properly cleaned. In men, the opening of the urethra in the penis should be properly cleaned.
- Cleaning should take place from the inside out, so that the urethra cannot be contaminated. In other words, start at the opening of the urethra and gradually work your way out in a circular motion.

Part 2 of 2: Inserting the catheter into the bladder

Apply some lubricant to the end of the catheter. Apply a generous amount of lubricant to the distal portion of the catheter (the top 2-5 cm section). This is the end that is inserted into the urinary hole. If you are using a balloon catheter, make sure to lubricate the piece with the balloon as well.
In female patients, keep the labia aside and insert the catheter into the meatus urethrae. Hold the catheter in your dominant hand and use your non-dominant hand to spread the labia so that you can see the pee hole. Gently insert the end of the catheter into the urethra.
For male patients, hold the penis and insert the catheter into the urethra. Hold the penis in your non-dominant hand and gently pull it upward until the penis is perpendicular to the patient's body. Insert the tip of the catheter into the patient's urethra with the dominant hand.
Keep pushing until the catheter is in the bladder. Gently insert the catheter further into the urethra until it reaches the bladder and urine is visible. When the urine begins to flow, push the catheter an additional two inches so that the catheter rests against the bladder neck.
If you are using a balloon catheter, you should inflate the balloon with sterile water. Use a water-filled syringe to inflate the balloon through the sterile tubing attached to the catheter. The inflated balloon acts as an anchor so that the catheter does not slip when moving. Once inflated, you can gently pull on the catheter so that the balloon is firmly against the bladder neck.
- The amount of sterile water you should use to inflate the balloon depends on the size of the balloon. In general, this requires 10 cc of sterile water, but check the size of the balloon to be sure.
Connect the catheter to the drainage collection bag. Use sterile medical tubing to route the drained urine to the collection bag. Tape the catheter to the patient's thigh or abdomen.
- Make sure your collection bag is lower than the patient's bladder. Catheters work by means of gravity; the urine cannot flow “uphill”.
- In a medical setting, a catheter can remain in place for up to 12 weeks without having to be replaced. However, they are usually replaced a lot earlier. For example, some catheters are replaced immediately after the urine flow has stopped.

Tips

Catheters are made from a variety of materials, including latex, silicone, and Teflon. They are available with or without a balloon, and the size of the balloon can also vary.
Most medical professionals take universal precautions when inserting catheters, including wearing gloves, face and / or eye protection, and a gown.
Empty the drainage collection bag every eight hours.
Assess the amount, odor, and color of the urine that collects in the drainage collection bag.

Warnings

Look out for the following complications: strong odor, cloudy urine, fever, or bleeding.
Some patients may be allergic to latex. Pay close attention to allergic reactions.
The catheter may have been inserted incorrectly if there are leaks, or if little or no urine is entering the drainage bag.