How is a catheter used
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
![Procedure - Foley Bladder Catheterization MALE v2019 [ASE]](https://img.youtube.com/vi/iWNYqV2N6tE/mqdefault.jpg)
