Urinary Catheterization
Specific considerations
Pediatric catheterization:
- Size- 5, 6,
8, 10Fr. or smaller depending on the size of the urethra and age of child.
- Rarely are
catheters left indwelling, typically they are intermittent and are used to
obtain sterile urine sample to rule-out infection.
- In children
<2years of age, a 5Fr. feeding tube can be used if a small diameter catheter
is not available.
- Using feeding tubes can cause urethral trauma
- A second pair of hands for assistance
is recommended for very young children.
- 16Fr. or
18Fr. catheter is typically used for most men, as they are more rigid and often
easier to insert past the prostate.
- In males it
is helpful to use a Urojet (syringe with lidocaine jelly) to minimize the
discomfort with the catheterizations.
- Males who
present with gross hematuria require 3-way Foley catheters with the largest
diameter that can be safely inserted. (22Fr., 24Fr.,)
- Catheters
should be attached to the inner upper thigh with a CathSecure. This will
minimize discomfort and prevent the catheter from being pulled on/out.
- When the
foreskin is retracted for the purpose of catheterization remember to return it
back to its original place.
- If
resistance is met while inserting the catheter, due care is used not to damage
the enlarged prostate. Never inflate the balloon until urine has been
visualized and is draining.
- 12fr., 14Fr.or 16Fr. catheter is typically used.
- Positioning is important to properly visualize the urethra in
females.
- If you are unable to visualize the urethra, raise pelvis with a
pillow. blanket or inverted bedpan.
- If you insert catheter into the vagina leave it in place as a
landmark and start again with another sterile catheter.
- Never inflated the balloon until you see urine.
- If patient
presents with gross hematuria a larger 3-way catheter needs to inserted.