Foley insertion.. best techniques???

YOu are not stupid! Let me tell you, not everyone is normal. Things are not always were they should be....at least that is my experience working with the elderly. LOL.

My tips.....bring an extra set of hands or two if you can, sometimes a flashlight helps, if the parts are visible...look for the winking eye, sometimes elevating the female pts hips help (stick a bed pan under them)..I've also had sucess cathing some women from the back....have them turn on their sides.....always have an extra foley if you can bring one with you. Ummmm let me think of a few more...

Foley insertion 101. easy patients, piece of cake. difficult patients..here are some of my suggestions.

women who you will never visualize, clean, hold open with one hand, stretch the opening downward a little bit, focus the foley upward toward the front of the lady parts and slide it down that wall, in a short distance you will just fall into the urethra. Obese cannot even consider visualizing, roll her on her side if she can tolerate that and enter from the back you can visualize that way with most.

Men, edema and member is not visible. get an assistant, one will glove and find, the other will cleanse and insert. You can identify the head of the member in the edema and then capture it with one or two hands gently displace edema and bring the head to the surface to expose the opening and the assistant can clean and insert easily. Be quick, they do squirm a bit.

and you said you already got an inservice on foreskin retraction.

good luck

One of my favorite tricks for interting male foleys is this: When having difficulty passing the catheter past the prostate tell the man to bear down like he is urinating, this opens up the urethra allowing easier passage of the catheter. It is also less uncomfortable for the patient.

For women I find that the labia is sometimes easier to part with the index and middle finger in an upside down "V", rather than the traditional middle and thumb. Not sure why this gives better visualization (and it doesn't always).

The surest way to increase your success is to do as many as possible. Tell your coworkers that you will trade their foley insertion for your IV med push or something.. trust me, they'll jump at the chance!

i don't have any problem w/cathing women: i just bring 2 catheters w/me knowing that every female has only 2 meatuses.

betadine increases visability.

and most people don't think there would be a problem w/catheterizing men.

wrong. even w/1 meatus they have that problematic prostate that gets in the way so many times. it still obstructs the urethra even after asking the pt. to cough or bear down.

with both sexes, i have learned not to panic when i don't automatically get a positive urine return; i monitor closely once i know the catheter is where it should be.

leslie

thanks for all the good tips and advice:)

Yeah, after my difficulty today, I became the "foley" lackey. So, needless to say, I'll be doing ALL foleys that come through the ED for the next few weeks I'm sure!

I'll let you know how it goes:p

I have been an LPN for 8 years and have worked in Geriatrics the entire time. I have never had a problem with foleys in geriatric women but I am now precepting in the ED in my last semester of ADN and have had problems visualizing the ureatha in younger women. My preceptor has shown me to have them place the bottoms of their feet together and then relax the leg and hip, kinda froggy style. This has really helped in visualizing the ureatha.

Always ask for a urojet if it is available at your facility. When you explain that you are going to "numb" the area, the patients become much less anxious and squirmy.

:)hello why does a foley drain lying down and not sitting up''''anyone