URINARY FOLEY’S CATHETERISATION
• 
Wash hands and wear sterile gloves.
• 
Ask someone to put lignocaine jelly at the back of your left palm.
• Don’t touch any sterile field with your left hand.
• As the bulb of the penis is reached it should be gently rotated down in line with the patient’s body and catheter should be further advanced till the Y of catheter is at the level of urethral meatus.
• Wait for urine to drain.
If no urine is draining:
a) Gently press supra-pubic region)
b) Aspirate via the urobag port using a sterile syringe.
c) Disconnect and reconnect the urobag and foley's catheter.
• After visualization of urine return, inflate the distal balloon by injecting 20-30 ml of normal saline through the cuff inflation port. (Distilled water is preferred).
• Gently withdraw the catheter from the urethra until resistance is met (else excessive intravesical length of foley’s can cause it’s knotting and failure of removal).
• Reduce the foreskin (else paraphimosis can occur).
*For females, do not insert the whole length of foley’s as female urethral length is only around 4 cm.
• Keep the catheter and collecting tube free from kinking.
• Keep the collecting bag below the level of the bladder at all times. Do not rest the bag on the floor.
URINE SAMPLE COLLECTION FROM A CATHETERISED PATIENT
I) If a small volume of fresh urine is needed for examination (i.e., urinalysis or culture), clamp the catheter for sometime so that urine is collected in the catheter tube.
Disinfect the site of collection.
Remove the clamp
II) Obtain large volumes of urine for special analyses (not culture) aseptically from the drainage bag.
URETHRAL CATHETER REMOVAL
Use a syringe to empty the balloon, and then apply gentle traction.
Written by our guest author - Anveshi Nayan
Illustrations by Anveshi Nayan
#Ae(ONE)INTERN
1) its not just glans which is cleaned with povidone ,its whole perineum ( though books say till mid thigh)
ReplyDelete2) while holding the penis , hold in a c format ..dont hold the penis in a circle bcz corpora spongiosa containing the penile urethra is below (ventrally) and if we hold 360 degree the jelly wont go and come out
3) what to do if urine doesnt come out even after inserting it fully( aspirate with a 2 ml syringe ,only 2 ml.. if u use others ntg will come)
4) what if paraphimosis has happened ..mgt can be added
5) what if foleys isnt going further after 5-6 cm ? Stricture
6) what if foleys isnt gng further after 10-14 cm ...? Prostatic enlargement
7) "also read" ..sizes of foleys and color coding
Types of foleys
Coaxial dilatation
Spc
8) jelly isnt put on palm ..its injected via 10 ml syringe
9) its not 5-10 ml normal saline its 10-30 ml (the volume is written over d catheter read and use)
10 its not ns its distilled water which is to be used bcz ns contains salt which can crystallise and then itll be difficult to remove
11 whats a three way foleys
12 where to fix the foleys ..in males its said to be in upward direction
In females it shud be fixed on thigh bcz upwards clitoris is there and the pipe will rub against it causing discomfort...
7)