a

Foley Catheter

we're going to perform the basic

procedure of how to put in a Foley

catheter to catheterize the urinary

bladder and this is obviously a male

patient will have our kit it's already

opened and ready for action and

initially the first thing one will do is

clean off the area around the meatus for

both male and female so we're not going

to go through that step but this would

be dipped in betadine or chlorhexidine

and clean around the me Aida is cleaning

around the shaft of the penis and can

anything clewd the surrounding perineum

the next thing that you want to do is

test and make sure that your catheters

balloon is working correctly so that's a

Foley catheter and it has two inputs one

input hooked up to a syringe that just

has saline and this saline when you

inject it if you watch the tip of the

Foley will inflate this balloon and

it'll be that balloon that rests inside

the urinary bladder and prohibits the

catheter from coming out so that's

important you don't want to blow this up

when it's inside the urethra that's a

no-no generally you'll put a few cc's in

but you definitely have to test the

balloon and make sure that it's

operational it's always bad form to have

this inside the bladder and then your

balloons not operational and the thing

slides out as soon as you've worked hard

to put it in the other entry into this

Foley catheter is going to be attached

to our Foley catheter bag so after we've

cannulated and secured this in we'll

connect this to the back and then the

urine will go out into the the bag

there's also usually an attachment that

allows you to adhere this to the inner

thigh of the patient and then a little

snap device that allows you to clamp the

tubing on so that there's not extra

tension on the urinary catheter which

can be very uncomfortable for the

patient and also just to make sure it

stays inside the next thing one will do

the kits will come with a small

container and you'll always capture

some of the urine from the container and

that'll be sent off to lab to make sure

there's not a urinary tract infection so

this is here and will be sent at a later

time the next thing is the kids will

come with some type of lubrication some

type of KY gel and you can usually just

put this into the tray somewhere or on

the side normally you would not go

through putting towels around we just

had these and they were convenient the

kits will come with their own little

sterile drape so once you've sterilized

the area with let's say betadine then

you would put the paper toweling around

just to make sure you don't contaminate

things the person putting in the

catheter will have gloved already gowns

are not necessary but gloves are will

start off you'll pick the appropriate

sized catheter and these are measured in

French and you base that based on just

your experience and the size of the

urethral opening obviously if you're

hitting a lot of resistance going down

there Yuri throughout you'll go to a

different French size that's a smaller

in calibre

so once we've lubricated the tip of the

Foley catheter and we use that liberally

we'll take the penis in our non-dominant

hand and pull up on it slightly then

you're going to take the Foley catheter

and try to align the tip of the catheter

with the urethra slowly let that go in

and making sure there's no resistance so

that you don't cause a false passageway

within the urethra so we can advance

that toward the urogenital diaphragm or

the external urethral sphincter and at

about that point you can hit some

resistance right so I'm at the external

urethral sphincter and if the resistance

is significant then we can pull up on

the penis a little bit advance the

catheter

in the elderly male it's often that the

prostate is hypertrophied so there may

be additional resistance sometimes a

guide wires put inside the Foley

catheter to help get around that and if

there's significant resistance than

urology is called and they can come and

do different things to try to

catheterize so I would like to go a

little farther than that I have a fear

that it's probably hanging up on his

prostate on the median lobe and often

you can go all the way up to the hub

that way you know you're inside the

bladder I may be in the bladder now so

by holding the penis you don't want to

let go because then your catheter will

fall out you'll drop the Foley down so

that gravity will let any urine come out

that's within the bladder if you don't

see anything pretty quickly palpate the

pubic bone and then just behind the

pubic bone you can push down on the

urinary bladder and see if that will

result in any fluid you can also apply

some irrigation to the main tubing to

see if anything comes out most cadaver

bladders the urine is gonna be gone

because the external link urethral

sphincter is not functioning so the

urine has already passed out so once

we're here let's assume that we're

inside the bladder we want to take our

saline and make sure as has been

reported before that we're not getting

the lubrication and putting into this so

the Saline will go back into this tubing

we'll remember we've already tested to

see how much fluid so a few cc's here

once we get to that point we can take

off the Saline we'll give it a tug just

to make sure that it's in nicely and

that the little blown up balloon is

holding on and then we can connect to

our Foley catheter this comes with a

small little elbow and this elbow can be

hung on the side of the patients bed

there's a tie so it can be tied and

doesn't fall out of the bed a frequent

thing is it falls in the floor and pulls

out which is painful the next thing you

have to do is

a connect this tubing so that there's no

tension on it because that causes a lot

of pain so often put a little bit of

laxity here tape this to the thigh and

then remember we're also going to take

the main part of the tubing with this

adhesive to the thigh as well so we'll

have some usually a pink tape is used

here and then this adhesive goes on by

itself