Male Catheterisation

WIPERNA

Hello________
My name is_______________
I'm a doctor
How are you feeling?

I was wondering whether I could catheterise you? Do you know what a catheter is?
We insert a small plastic tube to reach your bladder through your penis, so we can collect the urine into a bag. It helps us monitor how you are doing, and means you won't have to get up to go to the loo. We'll use local anaesthetic so it won't be painful, but it might be uncomfortable at first. Any concerns? Okay - so you're happy with us to go ahead?


I'll just go get my equipment ready

Equipment
Catheter pack
Foley catheter 16/18 - smallest cath poss

Catheter bag

Trolley
Sterile gloves x2
Lignocaine gel 2%
Sterile water/saline
Syringe x2
Bin

Prepare Trolley
Wash hands - 7 stage
Put on apron
Clean trolley - top & bottom
Open cath pack and slide onto trolley, preparing sterile field

Place equipment into sterile field

Attach yellow disposable bag onto side of trolley/move bin nearby

Pour sterile water into small bowl with swabs

Fill syringe with 10mls and place outside sterile field if not already within pack

Put on sterile gloves

Put on disposable gloves

WH/Ap/CT/CP/SF/SW/GL/GL

Prepare Patient
Expose + reposition
Make hole in drape and place onto pt - 2nd sterile field
Wrap gauze around shaft and keep in sling, with left hand raised
Retract foreskin
Clean penis - holding swabs in right hand/with forceps and wipe out from meatus x2
Dispose
Warn anaesthetic
Insert LA (lignocaine 2%) - squeeze 5ml into urethra
Hold for 3-5mins to give time for the anesthetic to work
Discard top gloves

E+R/SF/SL/FSK/x2Cl/LA/Wait/xGl

Catheter
Place receiver dish inbetween legs/attach catheter to bag
Open catheter
Insert catheter into urethra - ANTT
 - touch plastic only
 - massage out and into urethra
 - if necess when negotiating prostate, lower penis
 - if resistance ask pt to breathe deeply
 - move till bifurcation
 - by now urine should start emptying into plastic/kidney dish
Inflate balloon - 1ml of sterile water
Any pain?
Continue to fill with remaining 9ml
Withdraw catheter to make sure balloon becomes lodged into neck of bladder
Attach catheter bag if not yet attached

Dish/Cath/Ball/WD/Bag

Finishing Off
Restore foreskin/ask pt to (avoid paraphimosis)
Thank pt

Cover them up

Throw away remaining waste

Document:
A) date & time
B) size and type of catheter
C) amount of water in balloon
D) ?problems

E) residual volume of urine intially collected

Tests - dipstick & MSU
10ml from sampling port

Fsk!!/TY/Cov/Cl/DocRV/Ix