[tm2400]

Hi traumaRus, thanks for the advice on cathing female infants. Have you ever used a papoose board? I only have one assistance and the parent who is no help.

[Pedi-ER-RN]

We don't papoose. We have the parents stand at the head of the bed and hold the childs hands (and love on the kid) and another person holds the legs. It goes pretty well this way. Holding the legs in a lithotomy position works best for little girls. Hope this helps.

[tm2400]

Hello to all who posted advice for me,

A GREAT BIG THANKS TO ALL TOO!!! I used the techniques you all suggested on Friday Sept 8th and it worked . I was so happy with myself (have to brag a little because doc sure didn't). It was a bad day in the office Friday and everyone was rushing around and then this female pedi cath came up. I felt like finding somewhere to hide but I went in the room and remembered all the great advice I'd received from you all and cathed the baby and got my sterile specimen; I then felt much better the rest of the day!

Thanks again!!

[janfrn]

Originally Posted by traumaRUs

Jan - you don't use kits?? In our ER, we had pre-packaged peds cath kits which included the sterile gloves, sterile draps, betadine, lube, and catheter already connected to the specimen bottle. Very easy and also easy to ensure you got at least 6cc which was the minimum amount to do a UA.

No, Judi, we don't use kits. As I said, we don't have kits for most things. We have a disposable cath tray, a disposable irrigation tray and disposable dressing trays and of course, CSR supplies/trays. EVERYTHING else is assemble-it-yourself. It's very frustrating to work in a place that fancies itself as state-of-the-art, centre-of-excellence, world-class, but is too cheap to ensure we have suction canisters on a long weekend (the whole health region has been completely out since Tuesday), monitors that are reliably going to work, adequate numbers of pumps... even our Pyxis kakked at 0330 today and we couldn't access anything in it. Good thing we have two code carts, cuz if we'd've had a code, we would have needed the contents of both!

tm2400 Congratulations!!! :hatparty: I'm so glad the tips we gave you worked for you!! Now the confidence success has given you will make it easier next time, and the time after, and one day you'll wonder what the problem was. Way to go. Brag all you want! You earned it.

[rnsrgr8t]

Congrats! tm2400! I used to work in a Pediatric office and I am now a PNP in Urology so we have to catheterize a lot! A couple of hints, we use those cath kits a lot. If it is a teeny baby, use the 5fr catheter. Second, slightly loosen the cap on the collection tube.. sometimes it creates a vacuum and the urine will not drain by gravity unless you loosen it. You need a good helper to help hold. Have the parents up by the head and gently hold the hands. Have your help hold each leg, bend them at the knee and bring them up to the chest (so their thighs are up against their stomache). You want their bottoms up just a little off the table, this helps them not to wiggle so much. When you are cleaning with the betadine, watch for the meatus to "wink" at you (as described above) it always will. It may not be exactly where you think. When you are inserting the catheter you may sometimes hit some resitance when you hit the sphincter, especially if they are crying. Hold gentle, constant pressure and you should be able to glide past. If you keep pulling back and "poking" the spincter, it will tighten up even more. Sometimes you cannot visualize the meatus because they may have labial adhesions. If you are not sure, I would ask the MD to look. In those girls, you will never be able to see it unless the adhesions are released. If you accidently go into the vagina, leave the catheter there so you know where not to go the next time. When I was first learning, I used to go in everytime someone needed to be catheterized and help hold. I used to always see if I could visualize the meatus before they were catheterized. It gave me a lot of practice and now I almost never have a problem. BTW, sometimes people use the little NG feeding tubes. That is fine to do but be careful. Once you obtain urine, stop advancing (this is true for boys and girls). We have had a couple of them get advanced way too far and then knot on themselves (b/c they are so soft) and then could not be removed. Good Luck and congrats on the great job! With practice, you will get confidence!