Bard Catheters

The most important thing when inserting a urinary catheter into a person’s bladder is the plan to take it out as soon as possible in order so as to prevent any complications; Complications can include things such as urinary infections, encrustation and/or damage to the bladder neck.

As a patient, one needs to know the reason for removal of their catheter and whether the removal is permanent, for a catheter change, or an unplanned catheter change (resulting from unforeseen problems encountered during usage). It is also very necessary to take into account the site of insertion of the catheter (whether urethral or suprapubic) before removal.

Although catheter removal is a simple and uncomplicated procedure, there are some recognized and documented competencies for the task. These competencies include legislations, policies, standard practices, anatomy and physiology, care of individual, carrying out procedure, equipments required, medication and infection control that relates to catheter care.

During removal of a Foley catheter, it is required that the balloon be deflated by removing the solution present in it with a syringe before the actual catheter is removed.

If you have any difficulty during catheter removal, the following tips might help:

1. A different syringe could be used
2. You could leave the syringe minus the plunger, attached to the inflation valve for around twenty  minutes.
3. The catheter could be milked along its length to unblock any debris or obstructions.
4. To clear a blockage a few ml of sterile water could be inserted.

Note: Never try to burst a catheter balloon by over inflation. It could break into fragments within the bladder.

1. The first thing that a caregiver needs to do is to get the patient’s consent on what they are about to do and make them understand the process. All symptoms including urgency, frequency and/or discomfort, that might be experienced after removal should be detailed.
2. The patient’s record should then be checked to find out how much water was used to inflate the balloon and to find out the scheduled removal date for the planned removals.
3. Next, one needs to accumulate all equipment that is relevant and required for the removal of the catheter. This includes all appropriate syringes (a 10ml syringe for routine catheters is what is normally used), gloves, cleaning solution (usually normal saline will do), a pot for catheter specimen and another syringe if a sample is needed.
4. The area of the body where the procedure is being performed should be screened so as to maintain privacy. Bedding should be protected using a protective covering.
5. The patient needs to lie down in a supine position. This will preserve their dignity.
6. Hands should be washed, gloves should be worn. Following this, a container needs to be placed in between the patient’s legs so as to receive the used catheter and in case of any urine spillage.
7. Clean the area around the meatus and the catheter with an appropriate solution. This could be a normal saline. Care should be taken to always swab away from the urethral opening.
8. The patient should be asked to relax and to breathe in and out. When the patient exhales the catheter should then be removed gently.

As we all know, one of the biggest risks of catheterization is that it gives rise to Urinary Tract infections. This risk is actually associated with the insertion method used in catheterization, the period that the catheter is in place and the quality and material of the catheter that is used.

What one might not know is that Urinary Tract infections that are related to catheter use are the most common Health Care Associated Infections or HCAIs that occur in hospitals. The percentage is a whopping 40% of all infections.

The problem is that these are not all minor infections. Some of these infections are serious and could lead to significant morbidity and in some cases mortality.

These infections are caused by bacteria. A bacterium which enters the urinary tract comes either from the healthcare workers’ hands when the catheter is inserted or from the patient’s perineal flora. It is however, also possible that a contamination occurs due to reflux of bacteria from a urine drainage bag that is contaminated. Bacteria actually develop into colonies, which then adhere to the catheters surface and to the urine drainage bag. The bad thing is that these bacteria are highly resistant to antibiotics. Due to this it is also possible that encrustation develops in the catheter. This happens if there has been long term catheterization.

There is also new evidence that suggests that using catheters which are impregnated with antiseptic or antimicrobial agents (as compared to standard ones) could possibly prevent or maybe delay the onset of Urinary Tract Infections related to catheter usage.

Urinary Tract Infections (UTIs) that are associated with catheter usage can be caused by various pathogens such as: escherichia coli, Proteus, Enterococcus, Enterobacter, Serratia, Candida, etc.

The thing that most people don’t know is that most of these microorganisms are already a part of a person’s endogenous bowel flora, although they can also be contracted by transmission from other patients or by exposure to contaminated solutions or non-sterile equipment.

Several reports have singled out escherichia coli as the most common uropathogen followed by pseudornonas aeruginosa.

Other facts about UTIs are:

1. Bacteriuria occurance in patients with an indwelling catheter is 24.72% or 7 in 100 person days with catheter.
2. Bacteriuria can be found as early as the second day of catheterization in patients with an indwelling catheter.
3. There is an increased risk of incidence of bacteriuria where there is an open drainage system and prolonged use of indwelling catheterization.
4. Unless there is absolutely no other option, indwelling urethral catheters should be avoided.
5. Once they have completed their life or are no longer needed, catheters should be removed.
6. Catheter insertion should always be done by a professional and strict asepsis needs to observed.
7. One should always have a closed-catheter drainage system implanted. if a break is found in the system, replace the whole system do not try to mend and use it.
8. The catheter system should be inspected frequently so as to maintain a free downhill flow of urine. This inspection also needs to check if there is any other kind of obstruction present.

It is very common nowadays for people to be diagnosed with bladder issues. These problems are being diagnosed in men, women and children. This is where Intermittent Self Catheterization or ISC comes in. it helps one to lead a normal life.

Bladder problems are better explained by your doctor but we can tell you what Intermittent Self Catheterization or ISC is.

Intermittent self catheterization is the process where a catheter tube is temporarily inserted into the bladder so as to remove urine from it. The catheter is inserted through the urethra and the bladder is emptied at regular intervals.

It is not that difficult, in fact its actually fairly simple to do, after a little practice. It only takes a few minutes too. A patient can be taught by a specialist nurse to self-catheterize easily and also how often to do it. The specialist can also help them make the choice of which type of catheter suits their needs.

The main advantage of Intermittent Self Catheterization is convenience. Intermittent Self Catheterization allows one to manage their bladder at times and places that suit them.

Intermittent Self Catheterization is very efficient in emptying the bladder and prevents small residues of urine from remaining in the bladder.

There are several different types of catheters that can be used for Intermittent Self Catheterization. Although they all perform the same function, but one can have their own preference.

You have the following options:

• A plain nelaton catheter that is lubricated with a water soluble gel – It has a 5 day reuse limit
• A Hydrophilic catheter has a special coating which is activated after it is immersed in water for 30 seconds – This one can be used only once
• Then you have the Pre-lubricated catheter that comes with a gel coating which is already active – It’s ready for immediate use (These are also for single use only)