Urinary Catheterisation (ASAN002/21) Flashcards
Urinary Catheterisation
Have everything prepared before catheterisation.\nLessens the chance of contamination during procedure.\nEquipment varies depending on reason for catheterisation & if indwelling or not.
Catheterisation Equipment:
Generally Includes:\nClippers (if long hair on prepuce)\nDilute Chlorhex flush (or similar prep)\nSwabs\nGloves\nCatheter (correct size)\nStylet / wire guide (if needed)\nSterile lubricant (check compatability with chosen catheter)\n3–way–tap (if needed)\nKidney dish\nSterile urine sample pot
Extra Equipment for Indwelling Catheter placement:
Saline filled syringe for inflation of balloon\nClosed collection system (if needed)\nConnector
Catheter Selection
Catheter should be measured against patient PRIOR to unpacking:\nEnsures correct length is selected.\nShould comfortably fit from bladder to exterior of penis.\nToo short catheters may result in urethral trauma from trying to inflate balloon prior to bladder placement.\nToo long catheter may bend, kink, re–enter bladder or damage bladder wall.
General Guide to \nCatheter Size Selection for Male dog:
<5kg = 3.5 – 5 fr\n5 – 25kg = 8 fr\n>25kg = 10 – 12 fr
Patient Preparation – Sedation
Sedation is not generally required when placing urinary catheter in a male dog.
Factors to consider regarding the need for sedation:
Patient temperament\nReason for placing catheter – patient may have a condition where catheterisation may cause further pain.\nIndwelling or sample collection – placing indwelling caths may take longer and sedation would be helpful.
Patient Positioning
Lateral recumbency (often preferred)\nCan also be placed whilst standing\nPatient position must not be uncomfortable or painful for the dog.\nMake sure you are at a comfortable working height.
Placing the Urinary Catheter – Indwelling
Procedure must be performed aseptically.\nCheck & ensure area is prepared.\nWash hands & apply gloves. Non–sterile gloves ok as cath will be fed from packaging without touching the catheter.\nExtrude penis – may need assistant for this.\nClean prepuce once more.\nRemove catheter from outer wrapping.\nCut a ‘feeding’ sleeve from inner sterile packaging.\nFeed guide wire up the centre of the catheter.\nLubricate catheter (ideally sterile lube)\nInsert tip into urethra & advance.\nOnce urine flows back – remove wire guide & discard.\nInflate balloon with correct amt of saline.\nAttach closed collection system if required.
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Complications associated with Urinary Catheterisation
Infection\nTruama\n\nInfection is most common, therefore aseptic techniques are important when placing urinary catheters.
Infection
When placing catheter, any bacteria in the urethra will be pushed into the bladder. \nUsually quickly eliminated.\nCan cause a UTI.
The risk of infection is increased when:
A preputial or vaginal discharge is present.\nThe bladder is traumatised.\nThe patient is immunosuppressed.\nIndwelling catheters are being used.\nRepeated catheterisation.\nAseptic techniques not used.
Trauma
Trauma may occur to the urethra or bladder if catheterisation technique is not done correctly.
Catheterisation mistakes leading to Trauma
Force applied during catheterisation (esp. when passing around ischial arch in male dogs).\nInadequate lubrication of catheter.\nCatheter too large & force applied.\nBalloon inflated when catheter in urethra not bladder. \nCatheter too long & bends back on itself, or sits on bladder wall causing truama.
