Urinary i/o cath difficulty

[Gampopa]

OK so I've floated last week and again this week. I am assigned a 8yr old male spina bifida pt in for IV abx. He's ordered to be i/o cathed Q4. Both times, once last week, and once this week, I get no urine out. I'm using a 10F which the day nurse used with result. I haven't cathed many pts. Am I just not going far enough? Obviously, I don't want to cause trauma so I'm not going to force the cath in. I am a traveller and the floor I'm on isn't all that friendly so I'm really hesitant to ask for help. Any ideas? Looking at his chart he's been successfully cathed in the past. Don't know what I'm doing wrong.... I can feel the cath in the scrotum and it's not stright in. It's got a bend in it although it's not looping.

[NotReady4PrimeTime, RN]

You're going to need to have that catheter in almost its entire length to get urine, and there's probably no tone in the kid's bladder so you'll have to express the urine through the catheter anyway. I used to straight cath a four year old with a spinal cord injury q4h and prn and there's a bit of a trick to it. Insert the catheter with the member parallel to the bed until you start feeling resistance then raise it up perpendicular to the bed. The catheter should slide in further at that point. If it doesn't, adjust the angle in either direction, a little at a time until you feel the catheter start to move again. Keep threading it in until you get a flow of urine then advance it another inch or so. Then using your nondominant hand, gently press on the bladder until the flow of urine stops. Try it and see if it makes a difference.

[gofast!]

how about trying a coude tip catheter?