Foley Catheter Insertion Tips

[Spritenurse1210]

Hello all. Can anyone offer me some tips/tricks for inserting a foley catheter in either a male or female?

[ShelleyERgirl, LPN]

Light, lots of light.:) Also, like the tip about leaving cath in lady parts if you miss urethra, learned that one the hard way.

[Spritenurse1210, BSN, RN]

oh, that's easy.

just have your doc do what our doc did...

RAM IT THROUGH UNTIL IT BLEEDS.

yep, doc had the gall to get ticked off at me because the darned thing just wouldn't budge.

so he persisted and persisted (while pt is SCREAMING in pain) til it eventually passed.

pt had to go to er r/t profuse bleeding.

doc has lost privileges at our facility.

leslie

HOLY CRAP!!!:angryfire

Methinks he's lost his bedside manner.

[gentlegiver, ASN, LPN, RN]

Good tips! Another question, along the lines of the OP. I've cathed men before and felt the catheter curling in the member....how do I prevent this?

I have run into this a time or two. What I always did was to help guide the cath down the lenght by using one hand to "hold" the cath straight. If I find a blockage, I will pull back slightly and insert again moving the cath to a new position. I would try this twice, making a total of 3 times trying to cath. If I am unable to insert past the blockage or the patient is in pain, I stop and report to the Dr. Then it's his job to cath the patient.

[leslie :-D]

I have run into this a time or two. What I always did was to help guide the cath down the lenght by using one hand to "hold" the cath straight. If I find a blockage, I will pull back slightly and insert again moving the cath to a new position. I would try this twice, making a total of 3 times trying to cath. If I am unable to insert past the blockage or the patient is in pain, I stop and report to the Dr. Then it's his job to cath the patient.

i keep a few caths in the utility freezer.

when cath'ing, it won't curl, and also serves as a better anesthetic for the pt.

leslie

[Sandbeacher]

Good lighting is essential in female cath. Put a flashlight or penlight pointing right on the area. If the pt is conscious and coherent ask them to cough. This actually will open the meatus slightly. If your pt is elderly you may even have leakage. Works great!

[saintplatypus]

when i cath a female i usually have better luck if I position her on her side. This also tends to be less embarassing for her as well. By using this position you have virtually no contact with the labia which can often times be very slick and moist, which makes separating them to visualize the urethra very difficult. The urethra will usually be easily seen, although not always. I always have someone assist me and hold a flashlight right at the area because room lighting many times just is inadequate for me to see well.

If you still don't see the urethra try her on her back, and if you can't see it still, lift up slightly on the skin just above the lady parts. Sometimes urethras are located just inside the lady parts. I have seen some women have more than one urethra, actually there is only one true urethra and the others are false openings. You won't know which one to use in this case, trial and error.

As far as cathing a man, well there's only one way in and it's obvious. But sometimes he may have prostatic hypertrophy making it difficult to insert. I don't have any answer other than try repositioning. My experience has been that just being persistant, while reassuring your patient all the while, iis what works best.

Good Luck

[nurselori001]

when I cath a male pt and feel resistance I give the catheter a little twirl. I believe it curls the tip like a coude and the catheter has never failed to pass the obstruction (yet!)

[Dave RNFA]

I have found that using routinely a coude tip on male patients and filling the urethra with lube does the trick on a majority of the cases. If a catheter is kinking in the urethra, it is too small. Routine use of an 18fr in a male used to be the old standard. I have never deviated and had little problems. Also, holding and slight traction on the member to a 90 degree angle, almost forming the letter "J" with the urethra helps.

If it is too difficult,stop and defer to a urologist for insertion.

[Nomadnurse, L.P.N.]

When inserting a cath into a male, be sure to insert it ALL THE WAY TO THE "Y'. (The inflator for the saline bulb). That way you are SURE you aren't inflating it in the urethra.

[MinnieMomRN]

For a woman, place an upside down bedpan under her buttocks so that her pelvis is tilted for you to see better.