- Aseptic procedure
- Check for latex allergy
- Tell person that inserting catheter will cause some discomfort
What you need
- PPE — mask, goggles, non-sterile gloves, plastic apron
- Blueys
- Sterile catheterisation or dressing pack
- Sterile gloves x 2 pair
- Normal saline for cleaning
- Urinary catheters x 2 with balloon or in/out catheters
- Smaller the urethra the smaller the catheter
- 12G or 14G for adults, 6–12G for younger girls
- Kelly Forceps or similar (ones in dressing pack usually too small)
- For indwelling catheter — 10mL syringe filled with sterile water and catheter drainage
bag
- Sterile anaesthetic gel or water-based lubricant
- Clean dish to catch urine
- Sterile specimen jar if needed
What you do
- Lie woman on bed and put blueys under bottom. Keep upper body covered and ensure privacy
- For obese women — a pillow under the buttocks will lift the pelvis
- Ensure good light — to be able to visualise the urethral meatus (opening) some loosely
rolled gauze in the vagina will help distinguish it from the urethra
- Put on PPE, unsterile gloves, mask, goggles, plastic apron
- Lay out dressing pack and prepare equipment using non-touch technique
- Open catheter outer packet, drop catheter onto sterile area. Do not open inner plastic covering yet
- Ask woman to bend knees, feet together and let knees fall apart (support knees/legs
for comfort if needed with pillows or assistant)
- Put clean dish between the legs
- Remove gloves, wash hands, put on sterile gloves
- Hold labia apart with hand 1
- With hand 2, clean genitals with cotton balls soaked in normal saline. Sweep down each side, repeat as needed using new cotton ball each time
- Drape inner thighs and above pubic bone with sterile towels
- Open end of inner plastic cover to expose tip of catheter. Do not touch tip
- Hold catheter by plastic cover, dip tip into gel or lubricant
- Hold labia apart with hand 1 so you can see opening of urethra
- With hand 2, hold catheter in forceps or by plastic cover so you don’t touch it. Put
into urethra — Figure 6.22
- Gently push catheter in until urine flows into collection dish
- Push catheter in a further 2–4cm to make sure balloon is past urethra
- Let about 500mL urine flow into dish, then clamp or kink catheter
- After 5–10 minutes release and let flow finish
- Collect urine specimen if needed, do U/A
- If catheter indwelling (to stay in)
- Fill balloon with sterile water from syringe (amount needed is written on side of
catheter)
- Withdraw catheter slightly until resistance felt
- Connect urine drainage bag
- Secure catheter — check it is not stretched tight when person moves
- Monitor and report abnormal urinary output — aim for 0.5mL/kg/hr