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FOLEY urinarybladder CATHETERISATION.pptx
- 1. FOLEY CATHETERISATION DR. BHAVYA DNBRESIDENT GENERAL SURGERY HINDU RAO HOSPITAL
- 2. Urinary catheterization oCatheterization ofthe urinary bladder is the insertion of a hollow tube through the urethra into the bladder for removing urine. oIt is an aseptic procedure for which sterile equipment is required. oIs a procedure that involves putting a catheter in the urethra up into the bladder to drain out the urine.
- 3. Urinary Catheter A urinarycatheter is a hollow, partially flexible tube that collects urine from the bladder and leads to a drainage bag. They can be made of rubber, plastic (PVC) & silicone Catheters may be necessary in cases when the patients can’t empty their bladder.
- 4. Purposes of UrinaryCatheterization • Relieve urinary retention • Measure residual urine • Empty the bladder before, during, or after surgery • Allows accurate measurement of urine output
- 5. Indication Perioperative use inselected surgeries Acute urinary retention or obstruction comfort care/palliative care Accurate measurement of urinary output in critically ill patients Required strict immobilization for trauma or surgery Assistance in healing of severe perineal and sacral wounds in incontinent patients
- 6. Urinary Catheter Sizes TheFrench scale (Fr.) is used to denote the size of catheters. Each unit is roughly equivalent to 0.33 mm in diameter (that is, 18 Fr. indicates a diameter of 6 mm). The smaller the number, the smaller the catheter.
- 7. Types of catheters SIMPLERUBBER CATHETER This catheter is made of India rubber The tip is smooth and rounded and there is an opening at the side near the tip
- 8. FOLEY’S BALLOON CATHETER 2way foleys • the side channel is used to inflate the balloon so that it is kept indwelling • There is a valve in the side channel • The main channel is for drainage of urine
- 9. FOLEY’S BALLOON CATHETER •3 ways foley’s Additional third channel for either irrigation or drainage
- 10. MALECOT CATHETER • typeof self retaining catheter • it is retained after its introduction by its dilated winged end • The dilated winged end made straight by introducing a Malaecot catheter introducer or by inserting a hemostatic forceps into the dilated end
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- 12. K 90 CATHETER •Made of PVC • Short term catheterisation
- 13. URETHRAL CATHETERISATION • procedureexplained with benefits, risks, complications, and alternatives to the patient or the patient's representative. • patient positioned supine, in bed, and uncover the genitalia. • position the female patient in a dorsal recumbent position with the knees flexed and the feet about two feet apart. • catheter tray opened and place in between the patient’s legs
- 14. URETHRAL CATHETERISATION • Thoroughhand wash, donning sterile gloves • the nondominant hand used to hold the penis and the foreskin retracted (if present) • genitalia cleaned using soapy antiseptic
- 15. • Using asyringe with no needle, instill 10 mL of lidocaine gel 2% into the urethra • The jelly should be massaged posteriorly in an attempt to anaesthetise the sphincter region • Place a penile clamp for few minutes to ensure that sufficient time is given to allow the anaesthetic to work before the catheter is inserted
- 16. URETHRAL CATHETERISATION • Holdthe catheter with the sterile hand • Apply a generous amount of the lubricant to the catheter • Hold penis at approximately 90° to the bed and stretch upward to straighten out the penile urethra • Slowly and gently introduce the catheter into the urethra • Continue to advance the catheter until the proximal Y-shaped ports are at the meatus
- 17. URETHRAL CATHETERISATION • Waitfor urine to drain from the larger port to ensure that the distal end of the catheter is in the urethra • If no spontaneous return of urine occurs, try to aspirate urine using a syringe • If urine return is still not visible, withdraw the catheter and reattempt the procedure
- 18. URINARY CATHETERISATION • Aftervisualization of urine return inflate the distal balloon by injecting 10-15 mL (or a/c to balloon capacity of the catheter)of 0.9% NaCl (normal saline) through the cuff inflation port • Gently withdraw the catheter from the urethra until resistance is met • Secure the catheter to the patient's thigh with a wide tape • If the patient is uncircumcised - reduce the foreskin as failure to do so can cause paraphimosis • connect the catheter with drainage bag
- 19. Inserting the Foleycatheter in a Female patient Cleanse the genital and perineal areas with antiseptic Open the sterile catheterization kit, using sterile technique. Put on the sterile gloves. Open the sterile drape and place on the patient Apply sterile lubricant liberally to the catheter tip. Lubricate at least six inches of the catheter. Leave the lubricated catheter on the sterile field. Place the thumb and forefinger of non-dominant hand between the labia minora, spread and separate upward Keeping the labia separated, cleanse each side of the meatus . Insert the lubricated catheter into the urethral meatus Angle the catheter upward as it is advanced. If the catheter will not advance, instruct the patient to inhale and exhale slowly. This may relax the sphincter muscle.
- 20. URINARY CATHETERISATION When urinestarts to flow, insert the catheter approximately one inch further. Inflate balloon, using correct amount of sterile liquid (usually 10 cc but check actual balloon size) Gently pull catheter until inflation balloon is snug against bladder neck. Connect catheter to drainage system Evaluate catheter function and amount, color, odor, and quality of urine.
- 21. Complication • Allergic rxnto material of catheter • Infections- urethritis, cystitis, pyelonephritis • paraphimosis caused by failure to reduce the foreskin after catheterization • Creation of false passages • Urethral perforation • Bleeding • Bladder spasm, pain
- 22. REFERENCE • Bailey andLove Short Practice of Surgery Textbook • Thomsen TW, Setnik GS. Videos in clinical medicine. Male urethral catheterization. N Engl J Med. 2006 May 25. 354(21):e22