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Bard Bardex Lubricath Latex Foley Catheter provides for smoother insertion and enhanced patient comfort through the hydrogel coatings unique ability to absorb fluid, thus creating a hydrophilic cushion between the catheter surface and the urethra. It delivers maximum comfort and patient protection from irritation.
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Urinary catheter insertion trays and kits are essential accessories for successful catheterization. While trays can be purchased individually, convenient catheterization kits include the tray along with necessary products like sanitizing swabs, sterile lubricant, exam gloves, an underpad or protective sheet, collection devices, flushing syringes, and more. Manage catheterization efficiently with catheter insertion trays and kits at the best prices guaranteed. For peace of mind and further savings, set up routine shipping with our convenient Allegro Autoship program.
A catheter insertion tray stores the supplies necessary for successful catheterization in a sterile environment. For added convenience, the supplies are stacked in the order you or your healthcare professional will use them to minimize the possibility of contamination. The tray itself is used during the catheterization process to apply disinfectant to wipes or swabs and lubricate the catheter. Some popular brands are Cure Universal Catheter Insertion Tray and the Bardia Foley Catheterization Tray.
A catheter kit contains the items necessary to sterilize and prepare a patient for safe catheterization and may include a catheter, fenestrated drapes, an underpad, tweezers, a 10 cc syringe, iodine, two powder-free gloves, antiseptic swabs, a graduated collection tray, specimen sample container, inflation water, or lubricant. To help prevent bladder or urinary tract infections, every item inside the kit is sterile. In some instances, the intermittent or Foley catheter and drainage bag may not be included so be sure to check the item description before purchasing. In preparation for the catheterization process, verify the contents of the kit to make sure you have everything you need prior to opening the package and exposing the sterile field.
Since urinary catheterization involves a very sensitive area of the body, the procedure can be uncomfortable. An anesthetic gel is useful in reducing pain in the insertion region. You may experience discomfort while wearing the catheter, but most people become accustomed to it over time. If discomfort persists, you may find relief in added lubrication or another catheter style, tip, or size.
Catheters are available in many sizes and with several tip styles to accommodate anatomical differences. For example, if a patient has urethral irritation, blockage, fissures, or other restrictions, a coude tip catheter may be more comfortable during the insertion process than a straight tip catheter. Depending on the underlying medical condition requiring catheterization, an external or intermittent catheter may be a welcomed alternative to an indwelling catheter.
Catheter insertion kits most often include the catheter; however, not all supplies are included in every kit. Be certain to check the item description to verify the contents before purchasing. Most experienced healthcare professionals also advise checking the package label for included catheterization products before opening it and exposing the sterile field.
After exposing the sterilized environment, the reuse of catheterization supplies increases your risk of a urinary tract infection (UTIs) and other healthcare-associated infections (HAI). In fact, the Center for Disease Control recommends against prolonged use of catheters, and the FDA classifies catheters as single-use medical devices. This health concern is the reason why vendors sell urethral catheter trays in sterile, disposable packages.
Urinary catheterization is a common clinical intervention to ensure adequate urinary drainage when patients cannot void effectively. When a urinary catheter cannot easily be placed, a thorough understanding of anatomic considerations that may impact catheter placement and fundamental working knowledge of various Foley catheterization techniques can aid physicians and other healthcare professionals in successfully enabling urinary bladder decompression. This activity reviews anatomic and clinical considerations when encountering difficult catheterizations and highlights the role of the interprofessional team in evaluating and managing difficult urinary catheterizations to improve the care for men and women undergoing Foley placement.
Objectives:Identify the contraindications to urinary instrumentation in difficult foley catheterization.Describe the equipment, personnel, preparation, and technique regarding difficult foley catheterization.Review the techniques to assess and treat patients who are difficult to catheterize.Summarize interprofessional team strategies for improving care coordination and communication to improve care for difficult foley catheterization and improve outcomes.Access free multiple choice questions on this topic.
The placement of a Foley catheter is a common clinical intervention performed to allow for external urinary drainage. It is estimated that over 100 million urinary catheters are sold globally every year, with about 30 million used just in the United States.[1]
Urinary catheterization may be performed to relieve bladder outlet obstruction, such as benign prostatic hyperplasia, strictures of the bladder neck or urethra, to treat acute urinary retention, or to adequately drain a hypotonic neurogenic bladder. Routine urinary drainage in perioperative periods or intensive care settings allows for improved bladder drainage, urine chemistry evaluations, and fluid monitoring. Urinary catheterization may be performed to obtain an uncontaminated specimen for culture, irrigate clots or blood from the bladder, instill therapeutic agents intravesically, and evaluate the bladder fluoroscopically or during urodynamic studies.
While most patients tolerate urinary catheterization with minimal discomfort or complications, some patients will endure difficult, painful, or traumatic insertions. Such discomfort is often unnecessary, and multiple attempts at catheter insertion risk significant injury to the urethra, prostate, or bladder. Improper and sub-optimal techniques for addressing difficult urinary catheterizations can lead to bladder distension, reflux, patient discomfort, detrusor damage, unnecessary therapeutic delays, serious urological complications, avoidable urinary infections, permanent scarring, and prolonged hospital stays.[2]
Both normal and abnormal anatomic variations can contribute to failed attempts at urinary catheterization. A patient's urologic history will identify prior surgical or radiological interventions that may impact anatomic relationships important to urinary catheterization. Prior instrumentation, trauma, and sexually transmitted infections can also lead to anatomic changes that could pose a challenge for Foley placement.
A difficult catheterization can be anticipated and properly addressed with a better understanding of patient-reported symptoms, a detailed genitourinary review of systems, obtaining a good urological history, and a thorough physical examination. A risk prediction model to estimate the likelihood of difficult Foley urethral catheterization that will likely require extensive urologic instrumentation has been developed, although it lacks validation.[3] It is also unclear how useful it would be in actual clinical practice.[3]
Education on available techniques, tools, and instruments to assist in performing urinary catheterization can improve successful Foley placements even in difficult patients, minimize preventable urethral trauma, reduce the rate of catheter-related urinary tract infections (CAUTIs), and avoid unnecessary urological consultations. This review article aims to educate and empower readers on the anatomical and physiological basis for difficult urethral catheterizations and outline a practical, reasonable approach to Foley placement when difficulty is anticipated, or several attempts have already been unsuccessful.[2]
A thorough understanding of normal and abnormal anatomic conditions in both males and females can improve urinary catheterization success. The male and female urethra consists of four layers. From the inside out, they are:[2]
Urethral and vaginal tissue will increase blood flow and tissue elasticity when stimulated by estrogen.[5] Decreased circulating estrogen at menopause can thin out vaginal and urethral tissue, leading to atrophic vaginitis. Thinned vaginal tissue may be tender or inflamed, leading to discomfort in exposing the urethra for catheterization. Similarly, atrophic vaginitis may result in the urethral meatus retracting inwards to an anterior position, which is difficult to visualize and intubate with a standard, non-curved catheter from a standard supine frog-legged position.[2]
In women, obesity presents an additional challenge to directly visualizing the urethra for catheterization. To ensure adequate exposure of the urethral meatus in obese women, additional support to retract the abdominal pannus and additional lighting may be necessary.
Prolapse of the pelvic organs or urethra can create difficulty during urinary catheterization procedures. Pelvic organ prolapse, more common in multiparous white and Hispanic women over 50, occurs when the fascial and muscular attachments to the bladder, urethra, rectum, vaginal vault, or uterus become grossly and microscopically weakened by trauma to the neuromuscular structures, hormonal changes, obesity, smoking, connective tissue disorders, and other undetermined environmental and genetic factors. The prolapse of any of these organs can obscure the view of the urethra meatus, compress the urethra leading to retention, and can change the location and look of the expected anatomy. 59ce067264