Straight Cath over 1000ml

  1. Hi,

    New nurse here. I'm on a Med/Surg floor with I/O. When straight catching a patient with urine >1000ml how do you maintain sterile technique, when the sterile tray included in the cath kit holds <1000ml. I tried manually pinching with my left (non-sterile hand) then pouring the tray into a urinal with my right (sterile hand), but process seems risky (mess wise), and then I'm breaking sterile techniques with my left hand. There has got to be a better way.

    Thanks!
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  2. 14 Comments

  3. by   ___Mimi__
    When I worked med/surg some years ago, we hadn't gotten a bladder scanner yet (small community hospital with limited budget and slow to jump on advancements).

    If I thought that I might be getting a big volume, I would use a regular Foley kit with a 2000ml bag. I know it's not as cost effective, but it was easier to collect those larger volumes.

    Using a graduate cylinder can be done, but having everything in easy reach or using a second set of hands definitely helps.
  4. by   LovingLife123
    Our bags hold much more than 1000mL. I got 1600mL out of a patient once.
  5. by   amoLucia
    Quote from LovingLife123
    Our bags hold much more than 1000mL. I got 1600mL out of a patient once.
    I'm guessing OP is talking about a red rubber straight cath tray (without any bag).

    Like PP mimi, I used a foley and bag whenever there was a retention issue. I'm from 'the old school' when we would temporarily stop drainage of a very large volume of urine. So I would clamp on & off, on & off, etc.
  6. by   KelRN215
    I never saw one of these kits that you speak of in pediatrics. We simply had the straight catheters and then grabbed castile soap towelettes or betadine swabs separately for cleaning. The drainage end of the straight cath drained into whatever we had- urinals, bedpans, diapers, the toilet.
  7. by   nursej22
    I vote for using a foley kit too. that way you can inflate the balloon, let it drain, and then remove. It can take a loooong time to drain a bladder, depending on the size of the catheter. And this would also allow you to drape your patient for privacy, allow a woman to straighten her legs for comfort, or raise the head of the bed for someone with orthopnea.
  8. by   gpsrn
    I always had a urinal or another container close by to use if necessary. I like the idea of putting in a foley instead and allowing it to drain then taking it out especially if they have a full bladder.
  9. by   brillohead
    Once I've inserted the catheter, I don't worry about the "sterile zone" anymore -- the invasive/sterile part of the procedure has already been completed once urine is flowing.

    I always keep a urinal handy when straight cathing -- if we're getting toward the top of the pan, I'll just grab a urinal and drain the rest into that. Or if I have a patient that I can't trust to not move around, I don't even drain into the pan at all -- I use a urinal right from the beginning, as it's less likely to tip/spill if jostled.
  10. by   Ambersmom
    On my unit we have to use a regular closed system foley kit, no more open straight caths. It also allows to leave the catheter in if over 500mls. On a side note: I once cathed someone and got 3000mls from him, I called him iron bladder (in my head) we were amazed that his bladder didn't rupture. Thank God for transitional cells, lol.
  11. by   seaofclouds21
    Quote from Ambersmom
    On my unit we have to use a regular closed system foley kit, no more open straight caths. It also allows to leave the catheter in if over 500mls. On a side note: I once cathed someone and got 3000mls from him, I called him iron bladder (in my head) we were amazed that his bladder didn't rupture. Thank God for transitional cells, lol.
    So your unit always leaves the catheter in if the patient has over 500mLs?
  12. by   Ambersmom
    usually we do, we have a specific protocol to follow.
  13. by   diana1234
    Thank you all for the input, I can see there are many different ways to accomplish this. I'm glad the point was made that once the straight catheter is in it is no longer sterile technique. That does free up your options here, for pinching on & off the tube with your left (non-sterile hand) while switching out containers with your right sterile hand (which then is no longer sterile).
  14. by   applewhitern
    Our protocol is if a patient has not voided for >10 hours, we perform a cath and if we get back 300cc or more, we leave the catheter in. Yes, you can indeed contaminate the patient by having an open-ended catheter. We use the kit with the bag.

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