Page 68 - PJ MED OPS Handbook 8th Ed

Urethral Catheterization (Foley)

Indications:
Inability to void due to spinal cord damage; rupture of bladder; distal urinary tract obstruction;
burns of genitalia
1. Depressed sensorium
2. Need to precisely monitor urine output: shock, multisystem trauma, burn patients, crush syn-
drome/extrication, rhabdomyolysis, etc.

WARNING Catheterization is contraindicated in urethral transection, scrotal hematoma, pelvic
fracture, high-riding or free-floating prostate.

Equipment:
1. Sterile gloves
2. 4 × 4 gauze
3. betadine solution
4. 1-inch surgical tape
5. Water-soluble lubricating jelly
6. 10cc syringe
7. Sterile fluid source
8. Foley catheter with collection bag for urine

Procedure:

NOTE: Use sterile technique throughout the procedure.

Male Catheterization:
1. Check patency of catheter balloon.
2. Drape between patient’s penis and scrotum (Can use glove wrapper as drape).
3. Grasp penis with 4 × 4 gauze and retract foreskin. Clean head of penis from meatus outward with
betadine. Repeat for total of 3 times.
4. Holding penis at 60° angle, slowly insert the catheter until resistance is felt. Apply gentle but firm
pressure pushing catheter through the bladder sphincter muscle. (Do not force catheter. It may
be necessary to wait until sphincter relaxes). Have container ready to collect urine.
5. After there is a urine return, insert catheter to its full length and inflate balloon with 5–10mL
of sterile fluid (do not use air). Gently pull the catheter out until slight resistance is felt. Secure
catheter to right leg with tape.

CAUTION: Don’t inflate balloon until urine has started to flow through the catheter.

Do not give antibiotics prophylactically. Only give antibiotics if the patient develops a fever or other
signs of infection.

66 n Pararescue Medical Operations Handbook / 8th Edition