Catheterisation

MRCS Part B OSCE Revision

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Catheterisation

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Equipment
  • Gloves
  • Tray
  • Catheter Pack
  • Catheter Bag
  • Male/Female Catheter
  • Saline
  • Instillagel
Alt image
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Introduction
  • Wash your hands
  • Introduce yourself
  • Check the patient's identity
  • Explain the procedure to the patient and obtain their consent.

Preparation
  • Prepare Your equipment as above on A portable trolley
  • Open the catheter pack, correctly sized catheter, installagel and sterile gloves
  • Expose the patient
  • Wash your hands and put on two pairs of sterile gloves.
  • Ask your assistant to open the water and fill your syringe for the catheter balloon.
  • Ask your assistant to pour some saline into one of the trays in your pack.
  • Prepare and position the sterile paper drape over the penis (you may want to position a kidney dish below to prevent any leakage onto the bed/patient)

The Procedure
  • Grasp the penis with a swab held in your non-dominant hand.
  • Clean the penis with single sweeps of the saline-soaked gauze, moving away from the meatus towards the perineum. Repeat 2-3 times.
  • Holding the penis upright, gently insert the nozzle of the Instillagel syringe into the meatus and squeeze the contents of the syringe into the penis. Warn the patient that it may sting and feel very cold.
  • Remove your outer glove.
  • Remove the catheter tip from it's bag, ensuring that the rest of the catheter remains within the bag to maximise sterility.
  • Insert it gently into the meatus with the penis geld upright at 90o and feed it steadily inwards (if it gets stuck, you can try to pull the penis downwards gently, which straightens the urethra).
  • Pllace a kidney dish under the free drainage end of the catheter if you have not already done so.
  • Holding the penis and catheter securely in one hand inflate the balloon with the sterile water.
  • Once filled, pull back on the catheter gently to check that the balloon is inflated and the catheter is secure.
  • Attach the catheter to the collection bag

Close
  • Ensure that the foreskin (if present) is pulled down over the glans to reduce risk of paraphimosis.
  • Remove your drapes and all other equipment from the bed.
  • Thank the patient, and ensure that they are comfortable and re-dressed.
  • Document the procedure in the notes
  • Wash hands

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