A catheter is a medical device that consists of a long, thin tube. This tube can be equipped with different attachments and can therefore be used for multiple purposes. Insertion of a catheter is part of several medical treatments. For example, they are used to diagnose urogenital bleeding, monitor intracranial pressure and even administer certain medications. When it comes to “inserting a catheter”, one usually speaks of a bladder catheter that is inserted through the urethra for the purpose of draining urine. As with all medical treatments, catheter insertion requires proper medical training and strict adherence to safety and hygiene protocols. Go to Step 1 to get started.
Steps
Part 1 of 2: Preparing for insertion
Step 1. Explain the process to the patient before you begin
Most people are not used to inserting objects, let alone a long tube, into the urethra. Although the treatment is not always described as "painful", most patients describe the treatment as "uncomfortable" - often even as "extremely uncomfortable". Out of respect for the patient, you should explain the steps of the procedure before starting it.
By explaining the steps and what to expect, the patient will be more relaxed and less anxious
Step 2. Ask the patient to lie on his/her back
The patient's legs should be spread and feet should be together. The bladder and urethra relax when the patient is supine, making it easier to insert the catheter. A strained urethra can compress the catheter, resisting insertion. This can cause pain and sometimes damage the surrounding tissue of the urethra. In severe cases, this can cause bleeding.
Help the patient to lie back if necessary
Step 3. Wash your hands and put on sterile gloves
Gloves are an important part of the personal protective equipment that medical personnel use to protect themselves and the patient during medical treatment. When inserting catheters, sterile gloves prevent bacteria from entering the urethra and the patient's body fluids from coming into contact with your hands.
Step 4. Open the catheter outer packaging
Single-use catheters come in a sterile, sealed package. Before opening it, make sure that this catheter is suitable for your purposes. You will need to use a catheter that is sized appropriately for your patient. Catheters come in different sizes. These sizes are indicated with the unit charriere (1 charriere is 1/3 mm) and are available from size 12 (small) to size 45 (large). Smaller catheters are often better for patient comfort, but thicker urine will require larger catheters to ensure the catheter stays in place.
- Some catheters have specialized tips that allow them to perform different functions. For example, there is the Foley catheter: this is usually used to drain urine, because it is a so-called indwelling catheter with a balloon. The balloon can be inflated to secure the catheter behind the bladder neck.
- Also collect medical disinfectant, cotton swabs, OR drapes, lubricant, water, a drainage collection bag, tubes and tape. All supplies must be properly cleaned and/or sterilized.
Step 5. Sterilize and prepare the patient's pubic area
Scrub the patient's pubic area with cotton swabs soaked in disinfectant. Then rinse or scrub the area with sterile water or alcohol to remove any debris. Repeat if necessary. When you're done, place the drapes around the genitals-leave room for access to the penis or vagina.
- In female patients, you should make sure that the labia and the meatus urethrae (the outside of the opening of the urethra just above the vagina) are well cleaned. In men, the opening of the urethra in the penis should be well cleaned.
- The cleaning should take place from the inside out, so that the urethra cannot be contaminated. In other words, start at the opening of the urethra and gradually work your way out in a circular motion.
Part 2 of 2: Inserting the catheter into the bladder
Step 1. Apply some lubricant to the tip of the catheter
Apply a liberal amount of lubricant to the distal portion of the catheter (2-5 cm top portion). This is the end that is inserted into the pee hole. Also, if you are using a balloon catheter, make sure to lubricate the part containing the balloon.
Step 2. In female patients, hold the labia aside and insert the catheter into the urethral meatus
Hold the catheter in your dominant hand and use your non-dominant hand to spread the labia so you can see the pee hole. Carefully insert the end of the catheter into the urethra.
Step 3. In male patients, hold the penis and insert the catheter into the urethra
Hold the penis in your non-dominant hand and gently pull it up until the penis is perpendicular to the patient's body. Insert the tip of the catheter into the patient's urethra with the dominant hand.
Step 4. Keep pushing until the catheter is in the bladder
Gently advance the catheter further into the urethra until the bladder is reached and urine is visible. When the urine begins to flow, push the catheter an additional 5 centimeters so that the catheter rests against the bladder neck.
Step 5. If you are using a balloon catheter, inflate the balloon with sterile water
Use a water-filled syringe to inflate the balloon through the sterile tubing attached to the catheter. The inflated balloon acts as an anchor so that the catheter does not shift when moved. Once inflated, you can gently pull on the catheter so that the balloon is firmly against the bladder neck.
The amount of sterile water you need to use to inflate the balloon depends on the size of the balloon. In general, this requires 10 cc of sterile water, but check the size of the balloon just to be sure
Step 6. Connect the catheter to the drainage collection bag
Use sterile medical tubing to guide the drained urine to the collection bag. Tape the catheter to the patient's thigh or abdomen.
- Make sure your collection bag hangs lower than the patient's bladder. Catheters work by gravity; the urine cannot flow “uphill”.
- In a medical setting, a catheter can be left in place for up to 12 weeks without having to be replaced. However, they are usually replaced a lot sooner. For example, some catheters are replaced immediately after the flow of urine stops.
Tips
- Catheters are made from a variety of materials, including latex, silicone, and Teflon. They are available with or without a balloon, and the size of the balloon may also vary.
- Most medical professionals take universal precautions when inserting catheters, including wearing gloves, face and/or eye protection, and a surgical gown.
- Empty the drainage collection bag every eight hours.
- Assess the amount, odor and color of the urine that collects in the drainage collection bag.
Warnings
- Watch out for the following complications: strong odor, cloudy urine, fever, or bleeding.
- Some patients may be allergic to latex. Watch out for allergic reactions.
- The catheter may be incorrectly inserted if there is a leak, or if there is little or no urine entering the drainage collection bag.