6 Steps To Change A Suprapubic Catheter

Suprapubic catheterization is a process wherein a catheter is inserted by way of the decrease stomach into the bladder. This kind of catheter is usually used for long-term drainage of urine, and it may be modified on an outpatient foundation. Altering a suprapubic catheter is a comparatively easy process, however you will need to observe the directions of your healthcare supplier rigorously to keep away from any problems.

Earlier than you start, collect the next provides: a brand new suprapubic catheter, sterile gloves, a sterile drape, a syringe stuffed with sterile water, and a pair of scissors. Additionally, you will want a clear towel or blanket to position below your buttocks. After getting gathered your provides, wash your fingers completely with cleaning soap and water and placed on the sterile gloves.

Subsequent, place your self on the mattress or desk together with your buttocks hanging off the sting. Drape the sterile drape over your decrease stomach and safe it with tape. Gently clear the world across the suprapubic catheter with cleaning soap and water, after which rinse it with sterile water. Use the syringe to inject sterile water into the balloon of the suprapubic catheter. It will assist to maintain the catheter in place.

Supplies Required for Suprapubic Catheterization

1. Catheterization Tray

The catheterization tray is a very powerful merchandise you will want for suprapubic catheterization. It incorporates all the crucial instruments and provides to carry out the process, together with:

Scalpel
Hemostat
Forceps
Scissors
Needle driver
Suture
Catheter
Drainage bag

The catheterization tray is often sterile and comes with all the gadgets you want. Nonetheless, you will need to examine the tray earlier than utilizing it to guarantee that all the gadgets are current and in good situation.

1.1 Scalpel

The scalpel is used to make an incision within the pores and skin above the pubic bone. The scalpel ought to be sharp and sterile.

1.2 Hemostat

The hemostat is used to clamp the blood vessels which are reduce through the incision. The hemostat ought to be sturdy and sharp.

1.3 Forceps

The forceps are used to carry the catheter in place whereas it’s being inserted. The forceps ought to be blunt and sterile.

1.4 Scissors

The scissors are used to chop the suture that’s used to safe the catheter. The scissors ought to be sharp and sterile.

1.5 Needle Driver

The needle driver is used to insert the suture into the pores and skin. The needle driver ought to be sharp and sterile.

1.6 Suture

The suture is used to safe the catheter in place. The suture ought to be sturdy and absorbable.

1.7 Catheter

The catheter is the tube that’s inserted into the bladder. The catheter ought to be the right dimension and kind for the affected person.

1.8 Drainage Bag

The drainage bag is used to gather the urine that’s drained from the bladder. The drainage bag ought to be sterile and huge sufficient to carry the urine that will likely be produced by the affected person.

Inserting the Guidewire

As soon as the balloon is deflated and the catheter has been withdrawn barely, a guidewire is inserted into the catheter. The guidewire is a skinny, versatile wire that helps to information the brand new catheter into place. To insert the guidewire, observe these steps:

Take away the stylet from the brand new catheter. The stylet is a skinny, inflexible wire that’s used to maintain the catheter straight throughout insertion.
Join the guidewire to the brand new catheter. The guidewire has a small connector on the finish that matches into the brand new catheter.
Advance the guidewire into the catheter. Gently push the guidewire into the catheter till it reaches the tip.
Maintain the guidewire in place. As soon as the guidewire is in place, maintain it regular to forestall it from transferring.
Verify urine circulate. After the Guidewire is in place, choose up the suprapubic catheter bag and open the clamp. Search for urine circulate within the bag. If urine flows, the Guidewire is almost definitely throughout the bladder.
Withdraw the previous catheter. Whereas holding the guidewire in place, gently withdraw the previous catheter.

Materials
Sterile Gloves
Sterile Robe
Suprapubic Catheter Tray
Native Anesthesia
10 cc Syringe
2% Lidocaine
Drainage Bag
Sterile Water

Making a Suprapubic Tract

Making a suprapubic tract includes making a small incision immediately above the pubic bone to entry the bladder. This process is often carried out below native anesthesia.

Supplies wanted:

Native anesthetic
Scalpel
Hemostat
Suprapubic trocar and catheter

Process:

Infiltrate native anesthetic: Infiltrate the pores and skin and subcutaneous tissue with native anesthetic immediately above the pubic bone.
Create a small incision: Utilizing a scalpel, make a small incision immediately above the pubic bone.
Advance hemostat: Advance the hemostat into the bladder by way of the incision.
Insert trocar: Insert the suprapubic trocar over the hemostat and into the bladder.
Take away hemostat: Take away the hemostat, leaving the trocar in place.
Insert suprapubic catheter: Insert the suprapubic catheter over the trocar in order that the tip is positioned throughout the bladder. Safe the catheter utilizing the fixation pins.

Inserting the Catheter

Inserting the suprapubic catheter is a process that’s usually carried out by a healthcare skilled. Listed below are the steps concerned:

1. Collect the mandatory provides.

You will want a suprapubic catheter package, which incorporates the catheter, a trocar, a stylet, and a syringe. Additionally, you will want sterile gloves, antiseptic answer, and a drape.

2. Put together the affected person.

Have the affected person lie down on a mattress or desk in a cushty place. Clear the world across the insertion web site with antiseptic answer and drape it with a sterile drape.

3. Anesthetize the world.

Inject an area anesthetic into the pores and skin and subcutaneous tissue on the insertion web site. It will assist to numb the world and make the insertion extra snug for the affected person.

4. Make a small incision.

Use a scalpel to make a small incision on the insertion web site. The incision ought to be simply massive sufficient to accommodate the trocar.

5. Insert the trocar.

Insert the trocar into the incision and advance it by way of the fascia and into the bladder. The trocar is a pointy, pointed instrument that creates a channel for the catheter to be inserted.

6. Take away the stylet.

As soon as the trocar is in place, take away the stylet from the catheter. The stylet is a skinny, wire-like instrument that helps to maintain the catheter straight throughout insertion.

7. Insert the catheter.

Gently insert the catheter into the trocar and advance it into the bladder. The catheter ought to be inserted till the balloon is inflated contained in the bladder. The balloon helps to maintain the catheter in place.

8. Inflate the balloon.

Use a syringe to inject sterile water into the balloon. The balloon ought to be inflated till it’s agency however not overinflated.

9. Safe the catheter.

As soon as the balloon is inflated, safe the catheter to the affected person’s stomach with tape or a catheter stabilization machine.

10. Costume the wound.

Apply a sterile dressing to the insertion web site. The dressing ought to be modified commonly to maintain the world clear and freed from an infection.

Submit-Insertion Care

After the catheter is inserted, you will need to observe the physician’s directions rigorously. These directions will usually embody:

Holding the Catheter Website Clear

The catheter web site ought to be stored clear and dry to forestall an infection. The physician will usually advocate cleansing the positioning with cleaning soap and water or a sterile saline answer a number of instances a day.

Monitoring the Catheter

The catheter ought to be monitored for any indicators of an infection, akin to redness, swelling, or drainage. If any of those indicators happen, the physician ought to be notified instantly.

Altering the Catheter Bag

The catheter bag ought to be modified each 3 to 7 days, or as directed by the physician. The bag ought to be emptied and rinsed with heat water earlier than being reattached to the catheter.

Irrigating the Catheter

The catheter might have to be irrigated with sterile saline answer each few days to forestall blockages. The physician will present directions on methods to irrigate the catheter.

Catheter Upkeep Schedule
Process	Frequency
Clear the catheter web site	A number of instances a day
Monitor the catheter for indicators of an infection	Day by day
Change the catheter bag	Each 3 to 7 days
Irrigate the catheter	Each few days

Troubleshooting

For those who encounter any points whereas altering a suprapubic catheter, listed below are some widespread troubleshooting suggestions:

If the catheter turns into lodged, don’t pressure it. Gently pull again and check out once more.
If the balloon is tough to inflate, examine the syringe for any leaks. Additionally, make certain the balloon is totally deflated earlier than inflating it.
If the catheter is leaking, examine the balloon for any harm. If the balloon is broken, change the catheter.
For those who can’t move the brand new catheter, chances are you’ll must contact a healthcare skilled for help.
For those who expertise any ache or discomfort through the process, cease and phone a healthcare skilled.

Issues

Whereas altering a suprapubic catheter is a comparatively secure process, there are some potential problems to concentrate on. These embody:

An infection: An infection can happen if the catheter isn’t inserted or cared for correctly.
Bleeding: Bleeding might happen if the catheter is inserted too deeply.
Leakage: Leakage might happen if the balloon isn’t inflated correctly or if the catheter is broken.
Catheter blockage: Catheter blockage might happen if the catheter turns into encrusted with minerals or different materials.
Catheter migration: Catheter migration might happen if the catheter isn’t secured correctly.

Potential Complication	Signs	Administration
An infection	Ache, redness, swelling, or drainage across the catheter web site; fever; chills	Antibiotics; removing of the catheter if crucial
Bleeding	Blood within the urine or across the catheter web site	Removing of the catheter; strain to the bleeding web site
Leakage	Urine leaking across the catheter	Re-inflation of the balloon; substitute of the catheter
Catheter blockage	Problem passing urine; ache or discomfort; leakage	Flushing the catheter with saline; irrigation of the catheter; substitute of the catheter
Catheter migration	Catheter is now not within the right place	Repositioning of the catheter; substitute of the catheter

How To Change A Suprapubic Catheter

A suprapubic catheter is a tube that’s inserted by way of the stomach into the bladder. It’s used to empty urine from the bladder when an individual is unable to urinate on their very own. Suprapubic catheters are usually modified each 4 to six weeks.

Supplies:

New suprapubic catheter
Sterile gloves
Sterile drape
Sterile saline
Syringe
Antiseptic answer
GauzeTape
Process:
1. Wash your fingers completely with cleaning soap and water.
2. Collect your supplies.
3. Placed on sterile gloves.
4. Drape the sterile drape over the world across the suprapubic catheter.
5. Clear the world across the suprapubic catheter with the antiseptic answer.
6. Disconnect the previous suprapubic catheter from the drainage bag.
7. Insert the brand new suprapubic catheter into the bladder.
  - Maintain the brand new suprapubic catheter in your dominant hand.
  - Gently insert the tip of the brand new suprapubic catheter into the stoma.
  - Advance the brand new suprapubic catheter into the bladder till the flange is flush in opposition to the pores and skin.
8. Inflate the balloon on the brand new suprapubic catheter with sterile saline.
9. Join the brand new suprapubic catheter to the drainage bag.
10. Safe the suprapubic catheter to the pores and skin with tape.
11. Take away your gloves and get rid of them correctly.
12. Wash your fingers completely with cleaning soap and water.