Female Catheterisation Study Materials

Female Catheterisation Anatomy of the Urinary System Urinary Catheter • • • • • • Flexible tube that is usually latex. Used to drain urine. Balloon located at the end of the catheter. - Usually inflated with sterile water to prevent the catheter from slipping out. Measure in French units. - Ranges from 10F – 28F. - Each unit of French gauge is 0.33 mm. So, a 16F gauge catheter has an external diameter of 5.8 mm which will pass along most urethras into the bladder. 15cm in length. Held in the balder by means of a balloon at the tip which is inflated with sterile water. - Allows the catheter to securely remain in the bladder. - Does not cause pain or discomfort. - Comes in 5cc and 10cc. - If over inflated -> distort the catheter tip and cause problems for the drainage of the urine or can cause rupture. - If under inflated -> catheter can become dislodged from the bladder and fall out. Types of Catheters Indications • • • • • • • • • Urinary retention When urine output needs to determine such as in clinical situations and determine accurate urinary output during and following a major surgery. Surgeries where the bladder needs to be decompressed. Prolonged operations or cases where urine output monitoring is required. E.g., cardiac bypass surgeries and ICU patients. When the bladder loses control. Determine residual urine volume. To allow urodynamic studies to performed to confirm bladder function. To manage vesico-rectal fistula. To introduce cytotoxic or immunotherapy drugs in the treatment of carcinoma of the bladder. Contraindications • • • • Bladder or urethral trauma. Severe coagulopathy or thrombocytopenia (low platelet count) Paediatric and adolescent population All the above require senior medical review. Procedure 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Set up the equipment and wash hands. Prepare the patient and explain why this procedure needs to be done. Obtain consent. Ensure privacy throughout. Place the patient in a supine position. Place disposable protective under pad under the patient. Prep a sterile field. Lubricate catheter and water based lubricating gel. Clean the patient’s vulvua with aqueous 0.5% chlorhexidine-soaked gauze. Always cleaning anteriorly to posteriorly. Separate the labia and clean the area directly around the urethral orifice specifically. Insert the catheter into the bladder and urine should drain spontaneously. If none appears then gently press on the lower abdomen (suprapubic area). If this does not result in any urine flow through the catheter, then try aspirating the bladder via the end of the catheter with a syringe. If this still does not produce urine, it usually means that the catheter is in the incorrect position, and you need to begin again and to insert another catheter. Aspirate urine if it doesn’t drain spontaneously. If you are in doubt about the position of the catheter, it is advisable to begin again and insert another catheter. Inflate the balloon with sterile water. DO NOT inflate the balloon until you are sure you are in the bladder. If in doubt, insert the catheter slightly further than should be required, inflate the balloon and gently withdraw. If it does not withdraw feely, it may be in the urethra, so deflate the balloon and repeat the procedure. Prevent tension on the catheter by taping it to the patient’s thigh. Clean up the equipment. Following the insertion of urinary catheter • Ensure daily fluid intake of 2-3 litres for adults on fluid restriction. - High urine flow reduces encrustation and infection.