🚄 Male and Female Cath

Step-by-step, male (1):

1. Clean the trolley, assemble equipment and check expiry dates. Hand hygiene, apron, introductions, consent, chaperone.
2. Patient supine and exposed only as needed. Open the pack, add equipment to the field, pour saline over cotton balls in the gallipot. Hand hygiene and put on first sterile gloves. Place a drape under the genitals.
3. Retract the foreskin with gauze (non-dominant hand). Clean the glans with single strokes away from the meatus, using a new cotton ball each time. Remove gloves, wash hands, re-glove, apply the fenestrated drape.
4. Hold the penis vertical and slowly instil all of the lidocaine gel into the urethra; warn that it may sting. Wait about 3-5 minutes.
5. Open the catheter wrapper tip only, hold the penis with gauze, warn the patient and insert the catheter slowly, peeling the wrapper back as you advance. Mild resistance at the prostate is common; if marked, stop and seek help instead of forcing.
6. Advance to the hilt of the catheter (the bifurcation) and watch for urine.
7. Inflate the balloon with 10 mL sterile water, asking the patient to say if it hurts; stop immediately if painful (tip may still be in the urethra). Then gently withdraw until it holds.
8. Attach the drainage bag below bladder level, note residual volume and urine appearance, and replace the foreskin to prevent paraphimosis.
9. Clean up, cover the patient, dispose of waste, hand hygiene, fix the catheter.

Step-by-step, female (2): same steps, but part the labia with the non-dominant hand and clean the meatus and surrounding area with single downward strokes (front to back), insert the catheter a few centimetres until urine drains (the female urethra is short), then advance a little more before inflating the balloon. No need to reposition a foreskin.

Your checklists (kept)

Female Catheterisation

1. Introduction (You and Pt name, DOB)
2. Due to low urine output to measure it, have you had one before
3. Minor procedure, small plastic tube that we insert where you pass urine, into your bladder and we hook it to a bag to measure your output. It might be a bit uncomfortable
4. There are always risks with procedures like infection and very rare risk that the tube can make a small hole in the urinary tract
5. Do you have any questions? Would you like a chaperone? Do you give me consent
6. Wash hands, underwear removed, waterproof sheet, frogged-leg position and cover
7. Wash hands, gather equipment in cleaned trolley
8. Prep bin, apron, eye wear and open pack and empty + catheter + gloves
9. Sterile water in one tray for balloon and sterile saline on swabs for cleaning, gel for lubrication
10. Glove up, sterile water in syringe and second glove
11. Place drape on and clean area using sterile swab anterior posterior and remove blue gloves
12. Open catheter and lube up and insert it where you pass urine until end
13. Empty syringe of water into balloon and pull till resist
14. Connect to drainage bag and clean up the area of lube
15. Remove drape cover and clean
16. Tape catheter to leg
17. Please let someone know if anything feels uncomfortable and ill let you rest now
18. Clean hands
19. Documentation (in-patient notes record, date, time, procedure, size of catheter, reason for insertion and plan, name and sig)

Male Catheterisation

1. Introduce yourself and patient confirmation
2. I heard you are having trouble passing urine and it is getting uncomfortable and I have been told to insert a urinary catheter into your bladder to drain it to make you feel better
3. Have you ever had a catheter in before? Urinary catheter is a small plastic tube that we insert through the penis into the bladder that allows us to drain the urine into the bag. it is a minor procedure and there are always risks associated to it like infection (we try minimise the risk by using sterile equipment ). Rarely a small hole can be made in the urethra when we insert it and we have to mention it however rare it is. It may feel discomfort and it is common so we can provide panadol. There can be some blood in the urine which is quite common. Do you have any questions? Can I put the catheter in?
4. Wash hands, underwear removed, waterproof sheet, supine position
5. Have you had any recent infections, strictures, operations down there? Any allergies to local anaesthetic
6. Wash hands, gather equipment in cleaned trolley
7. Prep bin, apron, eye wear and open pack and empty + catheter + gloves + leg tape
8. Sterile water in one tray for balloon and sterile saline on swabs for cleaning, local anaesthetic gel for lubrication
9. Glove up + syringe water + double glove + drape over
10. Clean around penis using saline (+ retract foreskin)
11. Ask for allergies then add gel into penis + usually wait 2-3 mins for LA to work
12. Insert catheter slowly, then blow balloon up and pull down catheter + pull down foreskin
13. Connect to drainage bag so bladder can empty and clean up area
14. Remove drape cover and clean
15. Tape catheter to leg
16. Please let someone know if anything feels uncomfortable (pain, discomfort, bleeding) and ill let you rest now
17. Clean hands
18. Documentation (in-patient notes record, date, time, procedure, size of catheter, reason for insertion and plan, name and sig)