foley catheters

[troy09boston]

For some reason I have difficulty placing foley catheters; I have been a nurse for 5 years and work on a floor that most of the patient come up from the ED with one placed. When I dod need to place one I seem to have a problem; which makes me feel inadequate; does anyone have any litlle tricks or suggestions thanks so much for your input

[helper T cell]

For the female insertion I recon the meatus. Before I open up the sterile stuff I get the pt ready and in position. I do a good peri care or if she/he can I ask them to. Next for the female I just say I am going to make sure I have the right area to insert the foley and use a flashlight to get a visual on the meatus and get help if need be. Evere since I take the time for the visual no problems.

On another note I had to do an insertion on a pt with foreskin the other night. Make sure to gently get the head of the member out before you attempt. I know this sounds remedial but for some reason I forgot the other night and had to get a second cath. Definatly worth it to bring two in as previously mentioned.

[tewdles, RN]

I love the term "recon" the meatus....LOLTCCOMN (lol til coffee came out my nose)

[Virgo_RN, BSN, RN]

Practice. As someone else said, let the other nurses on your shift know you'd like to brush up on your skills. I'm sure they'd be more than happy to oblige. The urinary meatus is not too hard to find, once you know what you're looking for. Of course, there are some with anatomy that makes it more of a challenge, but as suggested, if you take a helper with you, have a second cath kit available, use bright lights, trendelenburg, etc., you'll find it.

[HmarieD]

For the female insertion I recon the meatus. Before I open up the sterile stuff I get the pt ready and in position. I do a good peri care or if she/he can I ask them to. Next for the female I just say I am going to make sure I have the right area to insert the foley and use a flashlight to get a visual on the meatus and get help if need be. Evere since I take the time for the visual no problems.

On another note I had to do an insertion on a pt with foreskin the other night. Make sure to gently get the head of the member out before you attempt. I know this sounds remedial but for some reason I forgot the other night and had to get a second cath. Definatly worth it to bring two in as previously mentioned.

Recon - HAHAHAHAHA!!!

Regarding the foreskin, always remember to put it back where you found it. If you don't, the head of the member can swell and make it impossible to reposition the foreskin, and is very painful (so I've heard). I have never actually seen this is practice, and I could be wrong about this part, but I seem to remember hearing that has to be surgically corrected. Anyone know more?

Also, someone suggested aiming for the bellybutton. This technique has worked really well for me in the past, especially if you have a really obese female and can't see the meatus (recon mission failed!).

[pennyaline]

oh my gosh, your post reminded me of when i was a new grad in hospice, and a pt had a new onset of vag or rectal bleeding...

i didn't know the source, so i inserted my (gloved) finger into her lady parts, and it came back bloody.

when the nm found out what i had done, she flipped on me, saying how inappropriate it was to use my finger.

Sounds like your NM was just a prude. What did she want you to do, not investigate the source of the bleeding? What would have been appropriate to use, if not a finger

[Guitar_Heroine]

I always take someone in to help with positioning for women, but we have a LOT of bariatric and respiratory patients which makes positioning difficult. I like to grab a couple sterile gauze 2x2s to help hold the labia open because it helps me "grip" when there's betadine and moisture making things slippery. Sometimes it helps to think of "aiming up" with the catheter tip when going in.

With men it can take some manuevering to get around the prostate - sometimes you have to pull back a little and try changing your angle, twisting slightly or having the patient take a deep breath and cough.

[lesrn2005]

If the meatus is tricky to find, I turn them on their left side (I am right handed) and go in from behind with a silicone catheter. The silicone is firmer and does not move around.

[chelynn]

At the job I am at now I was told "aim high" for the women.

[thehipcrip]

If the meatus is tricky to find, I turn them on their left side (I am right handed) and go in from behind with a silicone catheter. The silicone is firmer and does not move around.

That same firmness that can make insertion easier can also make removal more uncomfortable. With 100 percent silicone catheters, the deflated balloons tend to not collapse as completely and are more rigid than silicone-coated latex caths.

The sterile lidocaine can make insertion almost discomfort free, but only if the lidocaine is applied to the meatus at least five minutes before insertion of the catheter. For best results, you should both apply some lidocaine to the patient in advance of the procedure so it has time to work, and mix some in with the sterile lube.

I have been taught that by using your finger to locate the correct insertion site, you risk contaminating the meatus with bacteria from the lady parts and increasing the possibility of infection -- especially if you then hold your finger there as a guide.

[Music in My Heart]

My only comment is that, rather than a flashlight, I use a small LED headlamp that I keep in my gig bag. That way I can keep the lighting good, use one hand for visualization, and the other for the insertion.

[Super_RN, BSN, RN]

My only comment is that rather than a flashlight, I use a small LED headlamp that I keep in my gig bag. That way I can keep the lighting good, use one hand for visualization, and the other for the insertion.[/quote']

The first thing that came to mind is mining for gold

[leslie :-D]

The first thing that came to mind is mining for gold

i thought of construction worker.:redbeathe

leslie:devil: