Types of Catheters

• Non-retaining or self-retaining (e.g., Foley catheter with inflatable balloon).
• Metallic and non-metallic (e.g., plastic, rubber, silicone).
• Rubber catheters.
• Plastic catheters. Catheter sizes are according to the French (Fr) scale. Sizes include 8 to 10 Fr for children, 14 to 16 Fr for adult females, and 18 to 20 Fr for adult males. Generally, sizes range from 8 to 24 Fr. The smallest effective size should be used to minimize trauma.

Indications for Catheterization

• To obtain a sterile specimen of urine for examination or investigations (e.g., when a clean catch midstream sample is not possible).
• To relieve urinary retention when other nursing measures have failed (e.g., after surgery, due to obstruction, or neurogenic bladder).
• To ensure that the bladder is empty before (pre-operatively), during, and after pelvic or abdominal surgeries to prevent injuries to the bladder.
• To measure the amount of residual urine after voiding (post-void residual). It is done when partial obstruction of the bladder outlet is suspected (e.g., in BPH, VVF patients, patients on bladder training).
• Emptying the bladder before giving a bladder irrigation or installation of medication.
• Splinting the urethra following urethral surgery or trauma.
• In cases of incontinence of urine to prevent bed sores which may occur in diseases of the nervous system, trauma, and other conditions requiring strict intake and output monitoring.
• Monitoring accurate hourly urine output in critically ill patients.

Requirements

Trolley (Top Shelf)

• A sterile catheterization pack containing: Sterile towels (2), Drape (1), Sterile receiver (2), Gauze swabs, Cotton wool swabs.
• Sterile Foley catheter (appropriate size, have a spare)
• Sterile KY Jelly or Lubricant (water-soluble)
• Antiseptic solution (e.g., Povidone-iodine or Chlorhexidine solution) in a gallipot
• A 10 ml syringe (for inflating the balloon)
• Sterile water (or normal saline) for inflating the balloon (amount specified on catheter)
• Specimen bottle(s) with labels (if specimen is required)
• Spigot or clamp
• Drainage bag and tubing (if inserting an indwelling catheter)
• Dressing mackintosh and towel
• Sterile gloves (at least 2 pairs)
• Non-sterile gloves (for initial preparation)

Bedside:

• Hand washing equipment (access to sink, soap, water, towel)
• Screens (for privacy)
• Adequate lighting (e.g., torch or lamp)
• Waste receptacle
• Urine collection container (if not using a drainage bag, e.g., receiver or measuring jug)
• Patient’s chart and Fluid balance chart (if monitoring output)