Catheterisation.

The procedure for entering the urethra and bladder with a tube for the instilling or evacuation of fluids.
Only performed under medical advice. Using an aseptic technique.
The Underwater Centre Tasmania

 To monitor fluid balance. Establish a flow of urine in retention. Used in some neurological decompression illness.Indications.   The Underwater Centre Tasmania .

The Underwater Centre Tasmania    . Inner layer made of smooth muscle.  18 – 25 centimetres long. Outer layer covered in mucus membrane.Male Urethra. Continuous with the bladder.

Male Urethra and Bladder. The Underwater Centre Tasmania .

Drainage bag. Instilagel 10 mls. Normal saline. Sterile water.Equipment Required.         Appropriate size catheter. Syringe. The Underwater Centre Tasmania . Swabs. 2 pairs surgical gloves.

Catheter Size. The Underwater Centre Tasmania .  The correct size of catheter is the one that provides the best drainage. 14 – 16 charrier.   5 or 10 ml balloon.

Instilagel or Equivalent.  Must be used prior to catheterisation.   The Underwater Centre Tasmania . Provides lubrication. Provides anaesthetic.

clean the urethral meatus using normal saline.  Inject and leave to work for 3-4 minutes.  Use a sterile swab to hold the penis upright.  Retract the foreskin.  Remove the first pair of gloves. Put on both pairs of gloves.Procedure.  Check for known allergies prior to injecting instilagel.  The Underwater Centre Tasmania .

Using non dominant hand.  Grasp the shaft of the penis.  Making catheterisation easier.  The Underwater Centre Tasmania .Procedure Cont’d.  Raise until almost totally extended.  This straightens the urethra.

The Underwater Centre Tasmania .

Use free hand to insert catheter into urethra.Procedure Cont’d.  Gently withdraw the catheter until it stops.  Urine should start to flow.  About 15-25 cms.  Inflate the balloon with the correct amount of sterile water.  The Underwater Centre Tasmania .  Advance almost to the bifurcation. (Not saline).

  This applies to any complications.  If resistance is felt at the prostate apply steady but gentle pressure to the catheter. If this is unsuccessful stop and seek advice.Procedure Cont’d. The Underwater Centre Tasmania .

Procedure Cont’d. Make the patient comfortable. Attach a suitable drainage bag.   The Underwater Centre Tasmania .  Obtain a sample if required.

Including: Date of insertion.  Volume of water in the balloon.  Gel and cleansing fluid.  Any problems encountered.  Size and type of catheter.Update Your Notes.  The Underwater Centre Tasmania .  Sign.

Remove debris around the catheter tube.  Check catheter is draining freely.Daily Catheter Care.  Replace the foreskin after cleansing.  Check drainage bag is positioned below level of bladder and not on the chamber floor.  Ensure the patient is comfortable.  The Underwater Centre Tasmania .

 2 pairs of gloves.  Saline.  Requires:  Dressing pack.Removal of the Catheter.  The Underwater Centre Tasmania .  Syringe. Dependent on medical advice.

 Frequency.Removal Cont’d.  The Underwater Centre Tasmania .  Symptoms normally resolve within 24-48 hrs.  Urgency.  Post catheter symptoms include.  Discomfort. Carefully explain the removal procedure.

 Deflate balloon using syringe.  The Underwater Centre Tasmania .Removal Cont’d. Wash hands and put on gloves.  Clean the meatus and catheter.  Check notes for volume of water in balloon.  Change your gloves.  Swab away from the urethral opening.

then out.  Clean meatus and lock out equipment.Removal Cont’d.  Ask the patient to breathe in.  Make the patient comfortable. Remind patient of discomfort as the catheter passes through the prostate.  As patient exhales gently. but quickly remove catheter.  The Underwater Centre Tasmania .

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