indwelling urinary cathether maintenance
TRANSCRIPT
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INDWELLING URINARY CATHETHER MAINTENANCE
Nikki Arana-Oquendo, NREMT-P. I/C
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Universal Precautions
• Hand washing is the single most important thing you can do to protect your patient and yourself.
• If soap and water are not accessible, it is acceptable to use waterless hand gel.
• Waterless hand gel is not recommended/ effective for patients +Cdiff.
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Anatomy of the Catheter
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Correct Placement
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Possible Complications
• Obstruction within the catheter• Kink of the catheter / obstruction• Leak around the catheter• Leak of the catheter or collection bag• Infection• Accidental extraction of catheter with the
balloon inflated
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Obstruction Within the Catheter
• Usually clots, sometimes blood• Irrigation recommended• Not within EMS scope of practice• Obstructions are common in post surgical,
urological patients• Excessive bleeding is not common• Transport time >4 hours
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Kink of the catheter / obstruction
• Check the catheter /tubing during transport• Check the connection between the catheter
and the urine collection system• Check the site where the foley is secured to
the patient
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Leak around the catheterMost Common Causes
• Excessive strain• Leak in the balloon• Aged foley• Inappropriate solution used in balloon causing
balloon breakdown• Apply chux to patient, if >2 hour transport
contact receiving facility for direction• Keep the patient clean and dry
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Leak of the catheter or collection bag
• Prior to leaving facility for transport, check the integrity of the catheter connection and collection bag
• If there is an issue have the staff address it before you leave, unless the transfer is a medical emergency (stat transfer).
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Infection
• Common• Not to be addressed in the field setting, only
noted in the chart• Amount of urine, appearance of urine and
patient tolerance of catheter
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Accidental extraction of catheter with the balloon inflated
• AMS• Expect bleeding• Contact receiving facility• Monitor blood loss• Do not attempt to replace foley unless advised
to do so• Extended transport times
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Monitoring the Foley Catheter
• New Foley placement sometimes causes bladder spasm, pain, irritation
• Monitor output, >1000cc out clamp to prevent spasm
• Check foley securing device or secure the foley to the patient to prevent pulling of the catheter
• Make sure the urine collection area is clamped
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Questions?