condom catheters

[84RN]

Give me your best tips for getting condom caths to stay put. I work in home health and have a patient that had a foley, but kept pulling it out. The physician said ok to try a condom cath, but after putting it on this morning, the caregiver called to say it already came off.

I made sure the member was dry (difficult because he urinates frequently), and used skin prep before applying the catheter. He has advanced Parkinson's plus dementia and is very active in his bed, so this is going to be a challenge---but I really want to try because he hates the foley so much. When the caregiver told him I was removing the foley this morning, he looked at me and said "God bless you!"

[Delicate Flower]

Yeah, weighing diapers is pretty much a NICU/peds thing. I've never seen it done in adults.

[TU RN, DNP, CRNA]

Staple gun.

[duskyjewel]

Staple gun.

I have seriously considered it a couple times!

[blondy2061h, MSN, RN]

1 gram = 1mL of fluid. Strict I&O can quite easily be calculated for an incontinent person by weighing the soiled brief and subtracting that value from the weight of a dry brief.

Sorry, you can get an estimate of output doing this, but this is not "strict" I&O.

[blondy2061h, MSN, RN]

I have seriously considered it a couple times!

I had a patient come in from an outside ER with a foley that they couldn't advance past the prostate, so they put it in as far as possible then sutured it. Not kidding.

[duskyjewel]

I had a patient come in from an outside ER with a foley that they couldn't advance past the prostate, so they put it in as far as possible then sutured it. Not kidding.

What the.....?! First, did they never hear of a coudé? And second....um, they couldn't put him in a brief until they got a consult for a suprapubic, or decided whatever other course of action? What a disgusting thing to do to someone. I sometimes really wonder if we don't have some full on sociopaths practicing medicine....

[blondy2061h, MSN, RN]

What the.....?! First, did they never hear of a coudé? And second....um, they couldn't put him in a brief until they got a consult for a suprapubic, or decided whatever other course of action? What a disgusting thing to do to someone. I sometimes really wonder if we don't have some full on sociopaths practicing medicine....

I have no idea what their thinking was. The man was actively dying. He was flighted to my hospital's ICU where he died the next day. It was a small, country hospital that did it. Between the time he got to us and the time he died, we managed to get a coude in- no urologist required.

[annie.rn]

I had a patient come in from an outside ER with a foley that they couldn't advance past the prostate, so they put it in as far as possible then sutured it. Not kidding.

Oh My Goodness! That doc should lose his license. What a barbaric thing to do. It makes me hurt just thinking about it.

[Paws2people]

Sizing is everything. Always go smaller than you think. You take 3-4 adhesive preps and apply everywhere, than take them and squeeze the excess over the member letting it drip onto it. Next you put the condom cath on, and slide it as far down to the base as you can while pulling the string. (Make sure no pubic hairs are caught) Lastly, take a used prep and "paint" the outside of the condom to the base. This makes it stick better.

Kind of hard to explain online... This is one of those things where demonstrating works better. Also some people just aren't candidates for condom caths. Their anatomy just does not work

[toomuchbaloney]

And some people are just not candidates because they are NOT going to leave the catheter alone and in place, especially in their home setting.

[KRVRN, BSN, RN]

In a confused pt could you use a condom cath and then put a brief on to discourage grabbing the cath?

[duskyjewel]

Sure you can. And confused, agitated people tear them off.