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A catheter is a medical device consisting of a long, thin tube which can be fitted with a variety of different tips to serve a range of functions. Catheters are inserted into the body as part of many different medical procedures; for instance, they are used to diagnose genitourinary (GU) tract bleeding, to monitor intracranial pressure, and even administer certain medicines. In common usage, "inserting a catheter" usually refers to the common practice of inserting a urinary catheter into the bladder via a patient's urethra for the purpose of draining urine. Like all medical procedures, even this common one, proper medical training and strict adherence to safety and sanitation procedures are a must. [1] X Research source
Steps
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Explain the process to the patient before beginning. Most patients are not used to inserting any object, let alone a long tube, into their urethra. Though this isn't always described as "painful," it is often described as "uncomfortable," even intensely so. Out of respect for the patient, explain the steps of the procedure to him or her before beginning. [2] X Research source- Explaining the steps and what to expect can also help the patient relax and avoid anxiety.
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Ask the patient to lie on on their back. The patient's legs should be spread and their feet should be together. Lying in a supine position relaxes the bladder and urethra, facilitating easier catheter insertion. A tense urethra compresses the catheter, which results in resistance during insertion, causing pain and sometimes even damage to the underlying tissue of the urethra. In severe cases, this may cause bleeding. [3] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source- Assist the patient in getting into the supine position if necessary.
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Wash your hands and put on sterile gloves. Gloves are an important part of the PPE (Personal Protective Equipment) health care workers use to protect themselves and the patient during medical procedures. In the case of catheter insertion, sterile gloves help ensure that bacteria are not introduced into the urethra and that the patient's bodily fluids do not come into contact with your hands. [4] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source -
Open the catheter assembly. Single-use catheters come in sealed, sterile kits. Before opening the kit, ensure you have the correct catheter for your purposes. You will need a catheter that is the correct size for your patient. Catheters are rated for size in units called French (1 French = 1/3 mm) and are available in sizes from 12 (small) to 48 (large) French. [5] X Trustworthy Source Cleveland Clinic Educational website from one of the world's leading hospitals Go to source- Smaller catheters are usually better for the patient's comfort, but larger catheters may be necessary to drain thick urine or to ensure the catheter stays in place.
- Some catheters also have specialized tips that allow them to serve different functions. For instance, a type of catheter called a Foley catheter is usually used for draining urine because it includes a balloon attachment which can be inflated to secure the catheter behind the bladder neck.
- Gather medical-grade disinfectant, cotton swabs, surgical drapes, lubricant, water, tubing, a drainage bag, and tape. All items should be properly cleaned and/or sterilized.
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Sterilize and prepare the patient's genital area. Scrub the patient's genital area with disinfectant-soaked cotton swabs. Rinse or scrub the area with sterile water or alcohol to remove any debris. Repeat as needed. When finished, lay down surgical drapes around the genitals, leaving a space for access to the penis or vagina. [6] X Trustworthy Source State of Indiana Official site for state-approved sources related to life in Indiana, including laws, services, and culture Go to source- For female patients, be sure to clean the labia and urethral meatus (the outside of the opening of the urethra located above the vagina). For men, clean the urethral opening on the penis.
- Cleaning should be done from inside to outside so as not to contaminate the urethra. In other words, start at the urethral opening and gently work your way outward in a circular fashion.
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Apply lubricant to the tip of the catheter. Coat the distal portion of the catheter (the 0.78-1.97 in (2-5 cm) portion at the tip) with a generous amount of lubricant. This is the end you will insert into the urethral opening. If using a balloon catheter, be sure to lubricate the balloon portion at the tip as well. [7] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source -
If the patient is female, hold the labia open and insert the catheter into the urethral meatus. Hold the catheter in your dominant hand and use your non-dominant hand to spread the patient's labia so that you are able to see the urethral opening. Gently insert the tip of the catheter into the urethra. [8] X Research source -
If the patient is male, hold the penis and insert the catheter into the urethral opening. Hold the penis in your non-dominant hand and gently pull upward, perpendicular to the patient's body. Insert the tip of the catheter into the patient's urethra with your dominant hand. [9] X Research source -
Continue pushing until the catheter sits in the bladder. The length of the catheter should be gently fed through the urethra and into the bladder until urine is observed. After urine begins to flow, continue to push the catheter into the bladder another 2 inches (5.08 cm) to make sure the catheter is against the neck of the bladder. -
If using a balloon catheter, inflate the balloon with sterile water. Use a water-filled syringe to inflate the balloon via sterile tubing connected to the catheter. The inflated balloon serves as an anchor so as not to displace the catheter when moving. Once inflated, pull gently on the catheter to ensure the balloon is seated snugly against the neck of the bladder. [10] X Research source- The amount of sterile water you use to inflate the balloon depends on the size of the balloon on the catheter. Usually, about 10 cc of water is required, but check the size of your balloon to be sure.
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Connect the catheter to the drainage bag. Use sterile medical tubing to allow urine to drain into a drainage bag. Secure the catheter to the patient's thigh or abdomen with tape. [11] X Trustworthy Source Cleveland Clinic Educational website from one of the world's leading hospitals Go to source- Make sure you place the drainage bag lower than the patient's bladder. Catheters work via gravity - urine cannot drain "uphill."
- In a medical environment, catheters can be left in for as long as 12 weeks before being changed, though they are often removed much earlier. Some catheters, such as a straight or intermittent catheter, for instance, are removed immediately after urine stops flowing.
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Expert Q&A
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QuestionDo you inflate the balloon inside the bladder?Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.The balloon is inflated once the catheter is advanced into the bladder. The balloon holds the catheter in place inside the bladder.
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QuestionHow often do you change the Foley catheter?Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous (IV) therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.An indwelling catheter, such as a Foleycatheter may stay in place for up to 12 weeks. It is imperative to monitor for infection. If signs or symptoms of infection or irritation are present the catheter needs removed and replaced under the direction of a health-care provider.
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Tips
- Catheters come in a variety of materials including latex, silicone and Teflon. They are also available without balloons or with different size balloons.Thanks
- Empty the drainage bag on an 8 hour cycle.Thanks
- Most health care workers follow universal precautions and use a sterile technique, which includes wearing sterile gloves, face and/or eye protection, and sterile gowns as well as working in a sterile environment when inserting a catheter.Thanks
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Warnings
- Some patients may be allergic to latex. Watch for reactions.Thanks
- The catheter may be inserted incorrectly if it leaks or little or no urine empties into the drainage bag.Thanks
- Watch for the following complications: strong odor, cloudy urine, fever, or bleeding.Thanks
- Foley catheters should only be inserted by medical professionals, or with their supervision. Improper insertion of a Foley catheter can cause catastrophic urethral trauma.Thanks
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Things You'll Need
- Gloves (sterile)
- Drapes (sterile)
- Solution for cleaning the skin
- Cotton swabs
- Sterile water
- Lubricant
- Tubing
- Drainage bag
- Tape
- Sterile water
- Syringe
References
- ↑ https://www.healthywa.wa.gov.au/Articles/U_Z/What-is-a-catheter
- ↑ https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Indwelling_urinary_catheter_insertion_and_ongoing_care/
- ↑ https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cardiac-catheterization
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/
- ↑ https://my.clevelandclinic.org/health/treatments/foley-catheter
- ↑ https://www.in.gov/isdh/files/Tab_1_Resource_CD.pdf
- ↑ https://www.cdc.gov/infectioncontrol/pdf/strive/CAUTI104-508.pdf
- ↑ https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Indwelling_urinary_catheter_insertion_and_ongoing_care/
- ↑ https://meds.queensu.ca/central/assets/modules/ts-urinary-catheterization/steps_in_male_catheterization.html
About This Article
Article Summary
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To insert a catheter, have the patient lie on their back with their legs spread and feet together. After you've washed your hands and put on gloves, sterilize the patient's genital area with disinfectant-soaked cotton swabs to decrease the likelihood of infection. Next, coat the tip of the catheter with lubricant and insert it into the urethral opening. Depending on the patient, you'll either need to hold the labia open or hold the penis while you push the catheter into the bladder. When urine begins flowing, push the catheter in 2 more inches to make sure it's against the neck of the bladder. Then, if you're using a balloon catheter, inflate the balloon with sterile water. Otherwise, connect the catheter to the drainage bag and secure it to the patient's thigh with tape. For more tips from our Medical co-author, like how to choose the right catheter size, read on.
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Reader Success Stories
- "The information in the article was very helpful. The last time I was in the hospital, I was given no warning about how painful the process might be. Because of this, I believe I was tense and probably brought more pain to the process than was necessary. I have had other experiences which have been much more successful because the nurses took their time when inserting the pulley and used adequate lubrication so that there was much less pain in the insertion process." ..." more
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"The information in the article was very helpful. The last time I was in the hospital, I was given no warning about how painful the process might be. Because of this, I believe I was tense and probably brought more pain to the process than was necessary. I have had other experiences which have been much more successful because the nurses took their time when inserting the pulley and used adequate lubrication so that there was much less pain in the insertion process."
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"I am a diabetic, and have urinary incontinence occasionally. Being diabetic, when the urge to urinate is strong, I find I do not have enough time to find a loo, which has resulted in some embarrassment. So I am keen to learn about catheterization, for occasional use. I feel this will be a better solution for me."
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"All of it was really helpful, as I am frightened of anything being inserted there. Because I get frequent UTIs, the day will surely come when I need catheterizing in an emergency, but if I can learn to do it myself, this won't happen. Thank you."
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"My dad is 86, and after an operation to remove water around his heart, apparently the anesthesia is making It impossible for him to urinate on his own. This is giving me a clearer explanation of what he has to do to wear the catheter."
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"What helped me most was learning how to inflate the balloon on the Foley catheter. To be perfectly honest, I enjoyed reading all of the article and found it very informative. Obviously, the pictures helped a great deal also."
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