URINARY CATHETER TROUBLESHOOTING

• what is a urinary catheter?


  catheters that can be used for short-term or permanent drainage of urine
• what prevents the IDC from falling out?

  a balloon is inflated
• what can an IDC blockage be from?

  • mechanical dysfunction
  • blocked tubing
  • encrustation by mineral salts
• when should troubleshooting be used?

  when the catheter cannot be replaced in the next few hours
• when should troubleshooting not be done?

  surgery on rectal tract or prostate within the last 4 weeks and signs of sepsis
• what does a check involve?

  • make sure the drainage bag is not full
  • ensure the bag is below the pubic height
  • tubing is not kinked or blocked
  • tubing does not contain a one-way valve that has been incorrectly inserted
• what is the second step of troubleshooting?

  examine the patient for signs of sepsis
• what is the third step for trouble shooting?

  arrange for a catheter reinsertion within the next few hours if a trained person is available
• what is the fourth step of troubleshooting?

  • if the catheter cannot be replaced in the next few hours use the clean technique
  • draw up 50-100ml of 0.9% NaCl solution or sterile water using a catheter tip syringe and warm under a tap.
  • detach the drainage tubing from the catheter and attach the syringe
  • flush the catheter firmly over 5-10 seconds, stop if severe pain is felt
  • if possible, use syringe to remove fluid
  • reattach the draining tube and ensure urine is flowing into the drainage bag
  • document intervention and outcome on ePRF
• what are some complications from troubleshooting?

  • discomfort/pain due to incorrect flushing technique (too much solution or cold solution)
  • urethral injury due to inappropriate handling and excessive movement of the catheter
  • bleeding due to trauma from flushing
  • allergic reactions to materials used
  • catheter-associated urinary tract infection (CAUTI) from unclean flushing technique
  • psychological discomfort/trauma
• what to do if flushing is successful?

  • arrange for the catheter to be replaced ASAP
  • patient to remain home and drink plenty of water
• what to do if the flushing is unsuccessful?

  • make a firm recommendation for transport to a medical facility for replacement
  • use clinical judgement for transport options