Foley Catheter issues - yikes!

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In clinicals yesterday in the ED, I had opportunity to insert 4 foleys. They were all on ladies who were older 70s. Finding the darn urethra was quite a chore - even for the nurse with me. Anyone have any good tips to locate? We kept getting into the lady parts and it would curl back out ! Holy Ike !

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i know that when the nurses on my floor accidently get it into the lady parts they leave that foley cathether in. they get a new it and insert it in the urethra and then precede to take out the one they accidently inserted in the lady parts. this way they cant make the same mistake twice! not sure if that helps!

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Specializes in Med Surg - Renal.
this way they cant make the same mistake twice! not sure if that helps!

Oh, you can make that mistake twice...

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Oh, you can make that mistake twice...

lol - Depending on various factors, you could make that mistake MANY times.

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One of my clincial instructors said she always asks the woman to give a little cough when your trying to find it and while she's coughing you can usually find it, not sure what happens as I didn't get the opportunity do to another foley after she had told me that. Maybe a drop of urine comes out???? If you get a chance to try it out, let me know!! Good luck!!

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the best tip to avoid this problem i learned from an old nurse about mumblemumble years ago, probably decades before you were born.

when you are doing the prep, tuck the last betadine-soaked cotton ball into the introitus. not so deep you'll have to go dig for it, just enough to block the way. then even if you slip around a little bit trying to find the urethral meatus, all you'll hit will be sterile cotton ball and betadine, and you will not have to go get another catheter and start over. retrieve the cotton ball before you leave. :D

dontcha just love it? i never cathed a lady parts again after i learned that, never. tell all your friends.

you're welcome!

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Specializes in PICU, Sedation/Radiology, PACU.

The coughing trick works well for older ladies. Ask your patient to take a deep breath and cough. 9 times out of 10 you will see a drop of urine appear during the cough. Older women (especially those who had children) are notorious for rather poor bladder control while coughing/sneezing, etc. So have them cough and watch for the drop of urine. Then aim for the spot right where the drop appeared.

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Specializes in Reproductive & Public Health.

I use the coughing/bearing down trick and have never once seen a drop of urine- a little cough just makes the urethral meatus wink into view. Granted, my population was younger women so it is probably different in older patients.

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Specializes in Trauma SICU.

A nurse who used to do labor and delivery back in day when LPNs could still work it, passed on to me that the hole may look like the lady parts but aim above that one and the urethra is there. So, you're kinda going in blind but 99& of the time it's between the privy parts and the lady parts so aim for the empty space. The coughing tip works well, because when a lady coughs the urethra opens a little. Kinda coughs like a little mouth. :lol:

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Specializes in Critical Care, Emergency Medicine, Flight.

i picked up this trick from a nurse, bend one of the legs up Left or Right (depending on ur dominant hand) use your arm/elbow to hold that leg up (Right leg for me) when doing that... use your left hand to open the labias up. as much as u can.. i usually do this first with clean gloves on so i know what im getting into

after i set up and put the sterile gloves on, i go in, sometime i have the nurse or another tech help hold the other leg open, then aim high, bc the urethera is a bit upwards, but every female is different so it gets a little tricky.

repition is the only way to really get good at it.

just be happy u didn have to straight cath a guy with a d*ck piercing in...that was tricky... LOl

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

All great suggestions.

Turn a fracture pan upside down with the narrow part points towards the back. It will help barely tip the pelvis to gain better access and view.! I ahve encounterd the occasional peri-area that has left me stummped.....you know it HAS to be there....but you sure can't find it

And yes, Some body piercings do present their own brand of challenge and difficulty.:lol2:

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Specializes in being a Credible Source.

Just keep thinking "anterior, anterior."

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